SPECIAL REPORT T H E M E M O R Y B U L L E T I N MEDICATIONS AND THE BRAIN Majid Fotuhi, M.D., M.P.H., Forgetting things is common among people of all ages; however, 75percent of people over age 50 report having problems with memor yin the past year. It turns out that some of these memor y failure prob-lems are directly caused by medication. Many of the patients I see at Jo
Microsoft word - malaria by jacob kjell.docPROJECT REPORT
8TH APRIL 2005
TABLE OF CONTENT: Introduction…………………………………………………………………………… p.1 Method…………………………………………… …………………………………. p.2 Evaluation of sources…………………………………………………………………. p.3 Results………………………………………………………………………………… p.3 List of sources………………………………………………………………………… p.4 Original project plan…………………… ……………………………………………. p.6 Introduction: Ten years ago malaria was the most freighting disease in Sub-Saharan Africa. Today we only hear about aids and HIV, being a major killer, but still malaria kills over a million people per year I the whole of Africa. Thirteen years ago I went to Gambia, I was turning six and celebrated my birthday there. One thing I still remember is those tablets you had to take every day and if you weren’t quick swallowing them they excreted a horrible taste that if to be described, best is described as the bad tablet taste. For every one who knows, this should evoke the bitter taste from ones memory and for those who don’t, there’s no real way to explain it. Anyway, the reason for taking these tablets every day of the trip and also one week before and three after, was to prevent malaria. I knew it came from the mosquito, but of course not much more. I couldn’t really imagine malaria; I didn’t really know what it was. But it was a “threat”, and also the only real one I heard of in the realm of diseases. Maybe it wasn’t that likely that I would hear of diseases such as aids, being only six, but still. Therefore the main killer in Africa has always been malaria for me. So now, today not much is heard about this disease and I have been surprised and puzzled. The great media coverage of Aids/HIV has overshadowed the fact that malaria still is, if not the main killer, one of the biggest in Africa. When I got the opportunity to join the Zambia group and then had to choose a topic, I think this is why I choose to investigate malaria. It was a connection I had with Africa, it was a natural science subject and there was an interest and an urge from my side to find out more and by doing so, letting others find out more. It was basically an opportunity for me to do something, if anything, about the silence around malaria that I found so strange and alarming. We formed a group with me, Tora Olsson and Hannah Lindberg, which became the Malaria Group, meaning a greater potential to investigate several aspects of this subject that seemed and also proved to be huge. We started with getting a basic understanding for the disease and its biological attributes. In out mind was the goal, to be able with a seminar, spread awareness and get people in our surrounding informed. Early on we found out that there was a Malaria Day the 25th of April, which if possible seemed like a terrific time for our presentation. We’ll have the seminar in Kungsholmen Gymnasium for students and teachers, with varying knowledge on the subject and even though being natural science students, we’ll cover both biological and social aspects as it otherwise would be impossible to truly get a picture of malaria’s effect. Another part that will further improve and give weight to our seminar will be our actual trip to Zambia. As we have gathered money for a long time and finally actually got to go there, we did as we had planed, namely to talk with students, teachers, doctors and just people in general about malaria. This gave us an insight into how it is to live with malaria every day and how it is to deal with the consequences of it. This element will give many important reflections and together with some pictures we’ll hopefully be able to convey this to the audience. Method: We first tried to get a basic understanding of the disease, all of us finding facts on the internet through different health and malaria organisations and then sharing it and talking in between us about it. It was still hard though, especially getting a whole picture instead of just numbers flying around. Then we had an interview with Dr. Heddini, which knotted everything together and what we’d read got a bit clearer and easier to grasp. So the interview not only gave us facts we couldn’t find in malaria related homepages, but the personal contact made it easier to understand and interpret text and numbers we had come across. This being a good experience, we were sure to come back, when we had found out and knew more. And a lot more there was to be covered. Malaria started to truly show itself to be a huge topic and there were so many aspects and we wanted to cover as many as possible. That is why we divided the individual work up and focused on separately in the three topics; past, present and future. I took future as it would mean investigating possible remedies for the future, which is what I would want to continue with later in life. Now we could go into our own topic and its own sub-areas, but of course much work was done together as a group and there were always questions and remarks that could be used for one another’s topic. As we hoped from the beginning, it would be beneficial to follow malaria through time, it also was and has helped to give us a good frame of reference. As the topic is broad we’ve also been able to help other groups and get some good information ourselves. Otherwise we’ve also got a lot of information from articles, some books, the interviews with Heddini and Björkman and also from the trip to Zambia and the people there. In my own part, where I’ve investigated the future and its possibilities and been taking it on by starting with current projects and the general situation today. Projects for example where organisations try to find a vaccine or like MIM help local researchers and their work of spreading information, medicine and in this way create a sustainable development they themselves can control. These projects and their results will be the future and depending on their success or failure, the world will look slightly different. There have been many ways to deal with malaria and even more will be used in the future and that is what I will be looking at and will be talking about during the seminar. Also following the disease through time and see what that could give for a prediction for the future, as in how long time it will take for a new more effective medicine to be in the hands of the local population in Africa, if found for example. As for the social side, one might imagine an Africa without malaria in the future or maybe one where no drug is effective because the parasite has become resistant and therefore malaria flourishes. Problems, solutions and possible ways getting there into the obscure future of malaria is what I’ll be researching on. Evaluation of sources: Much of our information came from the internet. This could be a great source of error as there is much on the net that is false, as anyone can put up information there. But I would say that the chances are small, because most of our material we got from GO’s or NGO’s own pages with material checked by them. You can of course never be sure even there, but as we also checked the information with the once we interviewed, Dr. Andreas Heddini and Professor Anders Björkman and also the one we kept contact with through mail, Dr. Chipeta. Except them confirming the information we got, they gave us new and were themselves a great source of information. I would believe them to be a reliable source, if any. We’ve used articles given to us by Mr. Jonsson and as said above, articles on the net too. We only looked in some books, that because the information in them is often old and not up to date. In a field were much happens and even if progress takes time there is so much new after
ten years and that is why an up to date source in certain cases is vital. This is another reason
why we used the net to such a great extent.
One other great source is the trip to Zambia and the people we met and spoke to there. First of
all we spoke to the students of both Monze boarding high school and Hillcrest national
technical high school. Then we talked some with our host families, which basically also
means the teachers. Then we had our most exiting conversation of them all with an Egyptian
doctor in a private clinic. His name was Dr. Shafik and he had worked in Zambia for ten
years, so he had have time to see change in ways of treating malaria. He was working in a
private clinic though, which means that he only treated a certain group of people in society
and this could be something to notice and have in mind. But even so, coming from a different
country he has a greater perspective and he is possibly more objective than if to be a person
born and raised in Zambia.
The original goals have been met and so much more, truly. We’ve found out both biological
and social aspects of malaria, and tons of other facts like what MIM for example does to
prevent more deaths and that Bill Gates gives millions to research of a vaccine. There should
also be an emphasis on we, as this has been a group effort, which has been hard, fun and
rewarding. It was a good choice being a group because the subject was so big, but most of all
just having the experience of working in a group for such a long time as these two years have
been. The trip itself is of course itself a group experience and a good one too, but in most
ways still different and not as one would work in the future.
Our seminar actually is going to be on the malaria day and I have great hopes for it. I am and I
think my group mates also are happy with our work and very satisfied with what we’ve
accomplished. We’ve learnt so much through work, co-operation and the actual trip to
Zambia. It has been an experience for life.
LIST OF SOURCES
Articles from Magazines,
Johnsson, Marguerite ”Malaria: It’s Back” Time International May 31, 1993
Menendez, Clara “Malaria During Pregnancy: A Priority Area of Malaria Research and
Control” Parasitology Today Volume 11- Num. 5 1995
Articles from the Internet
Clarke, Tom “Genes means drugs and vaccines” 03 October 2002
http://www.nature.com/news/2002/021001/pf/021001-5_pf.html Crutcher, James M. & Hoffman, Stephen L. ”Malaria” Medmicro Chapter 83 http://jsbs.utmb.edu/microbook/ch083.htm
Desowitz, Robert S. The Malaria Capers (More Tales of Parasites and People, Research and
Reality). W.W. Norton & Company, New York, 1991
Herwig Jansen, Dr. F., ARTESUNATE and ARTEMETHER – Towards the eradiction of
Malaria?, 2002, Dafra Pharma ltd (Belgium)
Bergmark, Matts, Lust och lidande – Om droger på gott och ont, 1968, Natur och Kultur
Beattie, Pauline and Renshaw, Melanie, Malaria Research Capacity in Africa, 1999, The
Trustee of the Wellcome Trust (London)
African Malaria Network Trust
Bill and Melinda Gates Foundation
Brown University: Public Health Interventions
http://www.brown.edu/Courses/Bio_160/Projects1999/malaria/ph.html Centers for Disease Control and Prevention http://www.cdc.gov/az.do?az=az&id=0900f3ez8000e035#A www.cdc.gov/malaria/history Directory of the African Malaria Vaccine Testing Network www.amvtn.org European Vaccine Initiative www.emvi.org The Global Fund http://www.theglobalfund.org International Federation of Pharmaceutical Manufactures Associations http://www.ifpma.org/Health/malaria/health_coartem_mal.aspx Kimball’s Biology Pages http://users.rcn.com/jkimball.ma.ultranet/BiologyPages/I/Insecticides.html The Lancet www.thelancet.com username: malarzamb password:vivillaka Malaria Foundation International www.malaria.org Malaria Vaccine Initiative Medicines for Malaria Venture http://www.mmv.org Multilateral Initiative on Malaria (MIM) http://www.mim.su.se Roll Back Malaria http://www.rbm.who.int
Swedish Malaria Network
United States National Library of Medicine: Malaria Research Resources
World Health Organization
-Fact sheet: http://www.who.in/inf-fs/en/fact094.html
-Special Program for Training and Research in Tropical Disease: http://www.who/tdr/
-Using DDT for Malaria Prevention: http://cube.ice.net/~malaria/docs/MalariaFamily.html
Anders Björkman- Professor of Infectous Disease at Karolinska Institutet
Andreas Heddini M.D., Ph. D. Secretariat Coordinator Multilateral Initiative on Malaria Dr. Shafik Dr. Shafik Hospital, Livingstone, Zambia firstname.lastname@example.org James Chipeta B.Sc.<HB>,MB ChB,PhD
Senior Registrar/Honorary Lecturer
University Teaching Hospital, Lusaka, Zambia
Aim: Our aim is to find out about treatments against Malaria which can be used in developing
countries and to evaluate these treatments. Malaria kills a huge amount of people in Zambia
every year and it is Africa which suffers the most from the disease (90%). Currently, there is
more emphasis put on the problem of AIDS in Africa and we would like to spread awareness
of the fact that Malaria is one of the worst and most fatal diseases in the world.
General Questions (see individual parts for more):
How does Malaria/its treatments affect the human body from a biological point of view?
Parasite life cycle
Traditional treatments (quinine, artimisinine)
Previous, existing and future treatments (DDT, chloroquine, vaccine?)
Other means of preventing infection?
Roll Back Malaria projects; spreading awareness as well as equipment (nets)
Sustainable insecticide use – DDT used with care?
MIM; supporting local research groups
Social problems; public fright for medicine and financial problems?
(How to raise the money? How to organize the group work?)
Methods (malaria project):
Books and articles from library (Stadsbiblioteket + KI)
Interview with Andreas Heddini and possibly Anders Björkman
Trip to Zambia; interviews with students at Hillcrest and the other school
+ Possibly interview with Dr. Thomas Sukwa in Ndola, Zambia?
Flea markets (Christmas market + indoors market at Skärholmen)
Hopefully Lucia celebrations
Funding (group and individual)
Individual Log Books to be handed in all even weeks.
Have “part of project work” preliminarily finished by Friday the 22nd of October, definitely done before Autumn Holiday (Friday the 29th of October). Including brief answers to our common research questions and first thoughts and comments about the individual questions (see individual plan for further details) The last questions, about the more practical work involving money-raising, will be dealt with in individual log books. No written draft will therefore be presented concerning this. Submit a “First Draft” preliminarily the 3rd of December.
Including more in-depth studies of our individual questions
Hopefully also including the interview with Andreas Heddini, which will definitely be done before the
Interviews with “normal” people about malaria
Talk to nurse in school, perhaps hospital visit?
Possible interview with a Zambian researcher as mentioned above; Dr. Sukwa
We’re taking photos, which we will show during our presentation
Final product will be ready and presented depending on if we get to go to Zambia. If not, then
week 10, otherwise week 11.
General question about Malaria
Interview with Heddini and possibly people from the Zambian trip
Individual Questions (past, present and future of Malaria)
Individual research Questions:
Tora: Why is it so hard to find a cure for Malaria and what remedies have been used in the past? Hannah: What medicines exist today to prevent and cure Malaria and how accessible are they to the people of Zambia? Jacob: What medicines and prevention methods are the most efficient in combating Malaria in Zambia and how should they be developed in the future?
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