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WHO Collaborating Centre for International Drug Monitoring

Dr. Mohamed Farah

the Uppsala Monitoring Centre

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WHO Drug Monitoring ProgrammeFounding Members 1968

Australia New ZealandCanada Denmark Germany Ireland Netherlands

United States of AmericaUnited KingdomSweden

WHO Drug MonitoringProgramme

WHO Drug MonitoringProgrammeFounding membersFounding members

1968

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WHO Programme for International Drug Monitoring

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WHO Collaborating Centrethe Uppsala Monitoring Centre

• established as a foundation 1978

• based on agreement Sweden – WHO

• international administrative board

• WHO Headquarters responsible for policy

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Signalling ProcedureWhat should be achieved?

• Signals should not be missed

• Signals should be found early

• ‘False’ signals should be kept to a minimum

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Process for joining WHO Programme

1. Ministry of Health (or equivalent) designates National Centre

Ministry of Health

National Centre

the UMC

WHO-HQGeneva

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52. Ministry of Health sends formal application to WHO-HQ, Geneva

3. National Centre sends sample reports to the UMC

4. UMC notifies WHO-HQ that reports are compatible

5. WHO-HQ advises Ministry of Health of admittance to the Programme

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Official member

Morocco (1992)

South Africa (1992)

Tunisia (1993)

Zimbabwe (1998)

Ghana (2001)

Nigeria (2004)

Mozambique (2005)

Associate member

Botswana

Democratic Republic of Congo

EritreaEthiopia

Madagascar

Sierra leone

Uganda

Zambia

Algeria

Egypt (2001)

Tanzania (1993)

Africa -WHO

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Nomina si nescis, perit et cognitio rerum. (Carl von Linné, Critica botanica)

If you do not know the names, the knowledge about the things vanishes as well.

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Isibhaha

Syn: Warburgia breyeri Pott.; Warburgia ugandensis Sprague; Chibaca salutaris Bertl. f.

Uses: Expectorant, Chest infections, Sinusitis, Malaria, Venereal diseases, Stomach ulcers, Toothache and Dermatological disorders

Chemistry

warburganal muzigadial polygodial mukaadial

Warburgia salutaris (Bertol. f.) Chiov.

Common names: Pepper bark tree, Pepperbasboom (Afr.), Shibaha (Tsonga), Amazwecehlabayo (Zulu), Isibaha (Z, V), Manaka (Venda), Sebaha (Sotho)

Muthiga (Kikuyu), Sogdom (Amharic), Msokonoi (Swahili)

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Artemisia annua L. leaf

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Artemisia annuua L.The plant can grown in many places but it may notcontain artemisinin. For example: Visitors of the ancientpalaces in the forbidden city in beijing can find niceartemisia annua plants pushing left and right as weeds,but these plants do not contain artemisinin

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Artemisia annua L.

but a clone from China could contain up to 1.1 % artemisinin

The average artemisinin concentration in plants of European origin range from 0.03 to 0.22 % (dry leaves weight basis) artemisinin,

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Artemisia annua L.

1,8-Cineole: leaf pesticide, insectifuge, herbicideAlpha-Pinene: leaf herbicide, insecticide, pesticide, insectifuge, insectiphile

Artemisic-acid: plant: pesticideArtemisinin: flower leaf antimalarial, pesticide, schizonticide, herbicideBeta-Pinene: plant: herbicide, insectifuge, pesticideBeta-Sitosterol: plant: pesticide, antifeedantBorneol: plant: herbicide, insectifuge, pesticide, insect-repellentCamphene: plant: insectifuge, pesticideCamphor: leaf antifeedant herbicide, insect-repellent, insectifuge, pesticideCaryophyllene-oxide: plant: antifeedant, insecticide, pesticideCuminaldehyde: leaf: larvicide, pesticideDelta-Cadinene: plant: pesticideDeoxyartemisinin: plant: pesticideMenthol: plant: pesticide, termiticideOcimene: plant: insecticideP-Cymene: plant: herbicide, insectifuge, pesticideScopoletin: plant: herbicide, pesticideTerpinen-4-ol: plant: herbicide, insectifuge, pesticide

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Artemisia annua L., flower, leaf

ARTEMISININ

Antitumor

Antiviral Calcium-Antagonist

Cytotoxic

Herbicide

Immunomodulator

Neurotoxic

Pesticide

Plasmodicide

Schizonticide

Teratogenic

Antimalarial

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Artemisia annua L. leaf

Dihydroartemisinin

Arteether Artesunate Artemether

Artemisinin 青蒿素

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Artemisinin Synthesis

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butsynthetic compound is unlikely to be economicallycompetitive with the naturally produced compound

Artemisinin can be synthesized,

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Case report

WHO Record number:Country: GhanaType of report: Spontaneous report/HospitalAge: 54 Years Sex: FemaleAdverse Reaction(s): Face oedema; Oedema periorbitalOutcome: Not recovered Suspected Drug: ArtesunateDrug administration data: 200 Milligram Oral TotalIndication: MALARIAConcomitant Drug(s): Nifedipine 20 Milligram Oral per DayRechallenge action: RechallengeRechallenge outcome: Reaction recurred

Nifedipine: 17 Face oedema 29 Oedema periorbital

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ArtemetherTotal number of reports 44

Agitation 6 Headache 9 Paroniria

Anorexia Hypoplasia cerebellar Stomatitis

Ataxia cerebellar Fra Insomnia Sweating increased 2

Confusion Jaundice Urine abnormal 2

Confusion Fra Nausea 2 Vision abnorma

Dizziness 9 Neurosis Vomiting 2

Eye malformation Zaf

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Artesunate Reports 22260

Anxiety 8 Alopecia 8 Agitation 341 Face oedema, Gha Abdominal pain 11

Ataxia 2 Cheilitis 29 Anorexia 513 Fever tha,Vnm Allergic reaction Zaf

Delirium Coughing 2 Asthenia Gha Gingival bleeding 2 Dizziness Gha, 1439 Th

Dyspnoea Nausea 990 Bullous eruption Hallucination 20 Hypoaesthesia Tza

0anaemia Epistaxis 3 Confusion 195 Hyperventilation Oedema periorbital Gha

Insomnia 6 Flatulence Depression 53 Hypotension Gha Paranoid reaction 6

Naevus Haematuria Diarrhoea 207 Palpitation 241 Paroniria 52, Gha 1

Rash 2 Jaundice 61 Headache 1161 Spasm generalized Rash maculo-papular 6

Pallor 85 Melaena Stomatitis 40 Urine abnormal 2 Rash erythematous 24

Purpura Pharyngitis vomiting 720 Urticaria 3, 1 Vnm Sweating increased

Pruritus 47 Tachycardia Anaemiah aemolytic 2 Thrombocytopenia 2

Tinnitus 3 Vision abnormal 168

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Artemisinin and derivativesThere is a fear that improper use of artemisinin and its

derivatives will spur the malaria parasite to evolve to

resist treatment with the compounds, something that has

happened to all previous malaria therapies

Spread of chloroquine

resistance of Plasmodium falciparum

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Natural Mosquito Repellents

*It is ten times more effective than DEET at repelling mosquitoes

Agastache cana (Hook.) Woot. & Standl.

Azadirachta indica Juss f.

Cymbopogon nardus (L.) Rendle

Melissa officinalis L.

Nepeta cataria L.*

Pelargonium citrosum Vanleenii

Pelargonium graveolens L'Her. ex Ait.

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Mosquito’s natural enemy

Mosquitofish

Bat 600/h

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If you think you're too small tobe effective, you have never been in

bed with a mosquito!

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Thank you for your attention!

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Is it acceptable that an African child dies of malaria every 30 seconds when safe and effective treatment is available.

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”Pull out, Bettyl Pull out...You’ve hit on artery”

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Mystic Herbal balm ?

Mystic Herbal balm ?

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