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In Ghana, wide-spread resistance to chloroquine has necessitated the drug's replacement as the first-line treatment for malaria, both to increase the likelihood of cure and to reduce transmission. To see if β-artemether could be a suitable alternative to chloroquine, 223 adults (aged ≥ 15 years) with uncomplicated, Plasmodium falciparum malaria were each given a total dose of 480 mg β-artemether over 4 or 5 days. The patients were randomly allocated to receive an initial, loading dose of 80 or 160 mg, and were checked on days 1, 2, 3, 4 (or 5), 7 and 14, for fever clearance and any adverse events. Blood samples collected on days 0, 4 (or 5), 7 and 14 were smeared so that levels of parasitaemia could be evaluated. Haemoglobin concentrations on days 0 and 14 were also determined. In terms of the clinical cure 'rates' estimated in the intention-to-treat analysis (92.5% v. 97.4%) and the evaluability analysis (98.9% v. 100%), and of the frequency of parasitological cure by day 14 (97.0% v. 96.5%), the patients given an initial dose of 80 mg were similar to those given 160 mg as the loading dose. The regimen with the 160-mg loading dose appears as safe and as effective as the regimen with an initial dose of 80 mg. Since the regimen with the higher loading dose is shorter and involves fewer treatments than the other regimen, it would probably be associated with better compliance. [ABSTRACT FROM AUTHOR]

The biological control of the snail hosts of the trematodes that cause human schistosomiasis appears to be a promising method for achieving sustainable reductions in the transmission of the parasites. The possibility of using the Ghanaian strain of an ampullariid snail, Lanistes varicus, for the biological control of the main snail host of Schistosoma mansoni , Biomphalaria pfeifferi, has now been investigated in laboratory-based experiments. Adult and 2-week-old L. varicus were found to feed voraciously on the egg masses and juveniles of B. pfeifferi (from the Tono irrigation canals in northern Ghana). When single L. varicus were exposed to 20–200 egg masses, they consumed all of the masses over 24 h (if adult) or about 50% of them over 4 days (if 2-week-old juveniles). The effect of the secretions of the ampullariid on the reproduction, growth and mortality of B. pfeifferi was also investigated, by maintaining the two snail species in the same aquarium but separated by nylon netting. The presence of L. varicus in the same aquarium reduced the number of egg masses produced by each B. pfeifferi, although, curiously, the presence of a single L. varicus in the aquarium appeared to have more of an impact, on the egg-mass deposition by 20 B. pfeifferi, than the presence of five or more of the ampullariids. It appears that, under laboratory conditions at least, the Ghanaian stain of L. varicus has the potential to limit populations of B. pfeifferi. [ABSTRACT FROM AUTHOR]