Showing items related by title, author, creator and subject.

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  The Effect of Drug Pressure and Transmission Setting on Sulfadoxine-Pyrimethamine Resistant Plasmodium falciparum Haplotype Prevalence and Selective Sweep Characteristics, in Malawi

  Artimovich, Elena M.; Takala-Harrison, Shannon (2014)

  Background: The continued expansion of resistance to anti-malarial chemotherapies is a threat to public health, and to malaria control and elimination. The reexpansion of drug sensitive parasites after the removal of drug pressure has renewed interest in epidemiological factors affecting resistance haplotype dynamics, in the hopes that previously abandoned drugs might once again find clinical utility. Objectives: Estimate the effect of changes in drug pressure and different malaria transmission settings on sulfadoxine-pyrimethamine (SP)-resistant haplotype prevalence and characteristics of selective sweeps. Methods: DNA was extracted from dried blood spots representing malaria infections from three time periods (high-SP use 1999-2001, transition-period 2007-2008, low-SP use 2012) of drug pressure in Malawi and three transmission settings (urban-low, rural-moderate, rural-high). Pyrosequencing and microsatellite genotyping were performed on all samples to determine haplotype prevalence and sweep characteristics. Changes in haplotype prevalence were assessed via Chi-squared tests and changes in sweep characteristics via permutation. Results: We observed the persistence of the DHFR 51I/59R/108N and DHPS 437G/540E haplotypes, five years after reduction in SP pressure as well as an increase in the prevalence of DHPS 437G/540E/581G haplotype. Selective sweeps indicated little to no fitness cost to the DHFR 51I/59R/108N and DHPS 437G/540E haplotypes in the absence of strong SP pressure. A decline in polyclonal infections was found across the three time periods. No significant difference in haplotype prevalence was found between transmission settings. Sweep characteristics could suggest divergent evolutionary history in the rural-moderate transmission setting. Conclusions: There is little to no fitness cost of SP-resistance in the absence of strong SP pressure in these three transmission settings within Malawi. The reexpansion of SP sensitive parasites in the region is not expected under current epidemiological conditions. Reduction in the amount of malaria in the region could further reduce the likelihood of reexpansion through the elimination of rare haplotypes due to genetic drift.
• A study of family life education experiences among Chewa grandmothers, mothers, and daughters in Malawi

  Banda, Eta Elizabeth; Ruth, M. Virginia; Kreider, Mildred Sherk, 1936- (1991)

  A significant problem in adolescent health care in Malawi is a lack of information about family life education. The purpose of this descriptive and correlational study was to describe family life education experiences of Chewa grandmothers, mothers and daughters as a means of identifying the nature of the organization and type of educational programme/learning experiences that traditionally have been offered for developmental task readiness for adult life. The subjects for preliminary interviews were limited to three sets of grandmothers, mothers and daughters, i.e. nine participants. This data was used to develop the tool utilized for data collection in the study. The sample size for this study was 300. Data analysis was carried out using descriptive statistics, chi-square, analysis of variance and content analysis. Family life education organization was primarily perceived to be either the responsibility of the family or a shared responsibility between the family, village and other social organizations. Family life education was mainly informally conducted within the family, although multiple resources were utilized for teaching. Music in combination with verbal communication played an important role in instruction and reading was observed to be almost absent as a method of teaching across all generations. Although mostly of the teaching was done didactically there was some practical experience in the sex education component where a female adolescent was given a male partner to learn and this male was called a 'fisi'. Significant differences were found in virtually all organizational variables, by generation and area of residence. Ten categories of family life education learning experiences were identified and tested for differences on the basis of generation and area of residence. The results revealed statistically significant intergenerational as well as geographic differences in learning experiences in sex education, menstruation and sanitary towel care, anatomy and physiology of the female reproductive system, socialization into adulthood, relationships with parents, elders, peers of the same and opposite sex, and disabled persons, traditional practices, psychological and spiritual issues. In addition analysis of variance to examine differences in traditional values between grandmothers, mothers and daughters revealed a statistically significant main effect for generation on traditional family values. (Abstract shortened with permission of author.)
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  UM School of Medicine Receives $2 Million Grant for HIV Research in Malawi

  2017-08-02