{"id":{"repo_id":"utswmed","oai_identifier":"oai:utswmed-ir.tdl.org:2152.5/10632"},"canonical_url":"https://search.dev.ndltd.org/etd/utswmed/oai:utswmed-ir.tdl.org:2152.5/10632","repository":{"repo_id":"utswmed","name":"University of Texas Southwestern Medical Center","base_url":"https://utswmed-ir.tdl.org/server/oai/request"},"display":{"title":"[Part One] Efficacy and Safety of Artemether-lumefantrine to Treat Uncomplicated Plasmodium falciparum After a Decade of Its Use as First-Line Antimalarial Treatment in Namibia; [Part Two] Characterization of Oral Cavity Lesions Within Betel Nut Users in Remote Pacific Islands","abstract":"The general metadata -- e.g., title, author, abstract, subject headings, etc. -- is publicly available, but access to the submitted files is restricted to UT Southwestern campus access and/or authorized UT Southwestern users.","abstract_html":"The general metadata -- e.g., title, author, abstract, subject headings, etc. -- is publicly available, but access to the submitted files is restricted to UT Southwestern campus access and/or authorized UT Southwestern users.","abstract_has_math":false,"creators":["Patel, Hiren Anil"],"institution":null,"degree_name":null,"degree_level":null,"degree_discipline":null,"degree_department":null,"school":null,"contributors":["Chang, Mary","Gebreyohanns, Mehari","Jones, Erica"],"advisors":[],"committee_chairs":[],"committee_members":[],"year":2025,"date_issued":"2025-06-03T19:58:40Z","date_published":"2025-06-03T19:58:40Z","updated_at":"2026-07-24T05:52:17Z","subjects":["Substance-Related Disorders","Pacific Islands","Antimalarials","Artemether, Lumefantrine Drug Combination","Malaria, Falciparum","Plasmodium falciparum","Namibia","Areca","Mouth Neoplasms","Oral Health","Precancerous Conditions"],"languages":["en"],"rights":[],"rights_urls":[],"identifier_entries":[{"key":"dc:identifier","label":"Identifier","values":["1522122309"],"render_values":[{"text":"1522122309","href":null,"code":true}]}]},"links":{"outbound_url":"https://hdl.handle.net/2152.5/10632","outbound_label":"Handle","outbound_source":"dc:identifier"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor","label":"Contributor","values":["Chang, Mary","Gebreyohanns, Mehari","Jones, Erica"]},{"key":"dc:creator","label":"Author","values":["Patel, Hiren Anil"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date","label":"Dc Date","values":["2025-06-03T19:58:40Z","2023-05","May 2023"]},{"key":"dc:type","label":"Dc Type","values":["Thesis","text"]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["Substance-Related Disorders","Pacific Islands","Antimalarials","Artemether, Lumefantrine Drug Combination","Malaria, Falciparum","Plasmodium falciparum","Namibia","Areca","Mouth Neoplasms","Oral Health","Precancerous Conditions"]}]},{"id":"language_rights","label":"Language and Rights","entries":[{"key":"dc:language","label":"Dc Language","values":["en"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier","label":"Identifier","values":["https://hdl.handle.net/2152.5/10632","1522122309"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description","label":"Description","values":["The general metadata -- e.g., title, author, abstract, subject headings, etc. -- is publicly available, but access to the submitted files is restricted to UT Southwestern campus access and/or authorized UT Southwestern users.","This thesis includes 2 separate documents: [Part One] Efficacy and safety of artemether-lumefantrine to treat uncomplicated Plasmodium falciparum after a decade of its use as first-line antimalarial treatment in Namibia and [Part Two] Characterization of oral cavity lesions within betel nut users in remote Pacific Islands.","Pages 1-30 are misnumbered as pages 2-31.","[Efficacy and Safety of Artemether-lumefantrine to Treat Uncomplicated Plasmodium falciparum After a Decade of its Use As First-Tine Antimalarial Treatment In Namibia] BACKGROUND: Artemether-lumefantrine (AL) has been the first-line treatment against uncomplicated Plasmodium falciparum malaria in Namibia since 2005. The World Health Organization regularly monitors and recommends antimalarial drugs in order to contain the rapid spread of the disease and for the early detection of drug resistant strains of the parasite. AIM: The objective of this study is to assess the efficacy of AL in a low-transmission setting in Namibia. METHODS: The study is conducted in the Zambezi region of Namibia and is a secondary analysis of a prior longitudinal cohort study. Symptomatic patients reporting to health facilities that were tested positive on the rapid diagnostic test were included in the study. A total of 44 patients were observed and given a 3-day course of AL and single low dose of primaquine as recommended by the WHO. RESULTS: At Day 7, 100% of the patients had successfully cleared the infection. 95% of the participants had an adequate clinical and parasitological response with 2 patients presenting febrile at a follow-up visit classifying them as having late clinical failure. CONCLUSION: Overall there were no apparent signs of drug resistance and AL was shown to be safe as a first-line antimalarial drug choice in a low-transmission setting for the treatment of uncomplicated P. falciparum malaria.","[Characterization of Oral Cavity Lesions Within Betel Nut Users in Remote Pacific Islands] BACKGROUND: Betel nut is a commonly chewed substance by the residents of Saipan and many other islands in the Western Pacific Ocean. 43% of Asian Pacific Islander adults in Saipan chew betel nut and 13% of cancer-related mortality in this region is due to oral cavity lesions. AIM: The purpose of this study is to further characterize the types of oral cavity cancers that occur due to chewing betel nut and better understand best methods of treatment and prevention. METHODS: A single-institution retrospective review was undertaken for 81 patients who were treated for primary cancers of the head and neck region at the Commonwealth Healthcare Corporation (CHC) in Saipan, CNMI between 2005 and 2019. Biopsies of the oral cavity lesions were obtained from the patients in Saipan and analyzed for further workup. RESULTS: A majority of head and neck cancer patients had oral cavity cancer (64/81, 79.0%). Preliminary biopsy results show a high incidence of squamous cell carcinoma with squamous hyperplasia. A particularly high incidence of rare verrucous carcinoma was found (8/55, 14.5%). CONCLUSIONS: Patients with the uncommon verrucous carcinoma should be treated differently as surgical outcomes differ in comparison to oral squamous cell carcinoma. Surgical resection in comparison to radiation therapy has been shown to have a good prognosis in patients with oral verrucous carcinoma. Further studies should be conducted to best prevent and treat these oral lesions."]},{"key":"dc:format","label":"Dc Format","values":["application/pdf"]},{"key":"dc:title","label":"Title","values":["[Part One] Efficacy and Safety of Artemether-lumefantrine to Treat Uncomplicated Plasmodium falciparum After a Decade of Its Use as First-Line Antimalarial Treatment in Namibia; [Part Two] Characterization of Oral Cavity Lesions Within Betel Nut Users in Remote Pacific Islands","Characterization of Oral Cavity Lesions Within Betel Nut Users in Remote Pacific Islands"]}]}],"canonical_facts":{"dc:contributor":["Chang, Mary","Gebreyohanns, Mehari","Jones, Erica"],"dc:creator":["Patel, Hiren Anil"],"dc:date":["2025-06-03T19:58:40Z","2023-05","May 2023"],"dc:description":["The general metadata -- e.g., title, author, abstract, subject headings, etc. -- is publicly available, but access to the submitted files is restricted to UT Southwestern campus access and/or authorized UT Southwestern users.","This thesis includes 2 separate documents: [Part One] Efficacy and safety of artemether-lumefantrine to treat uncomplicated Plasmodium falciparum after a decade of its use as first-line antimalarial treatment in Namibia and [Part Two] Characterization of oral cavity lesions within betel nut users in remote Pacific Islands.","Pages 1-30 are misnumbered as pages 2-31.","[Efficacy and Safety of Artemether-lumefantrine to Treat Uncomplicated Plasmodium falciparum After a Decade of its Use As First-Tine Antimalarial Treatment In Namibia] BACKGROUND: Artemether-lumefantrine (AL) has been the first-line treatment against uncomplicated Plasmodium falciparum malaria in Namibia since 2005. The World Health Organization regularly monitors and recommends antimalarial drugs in order to contain the rapid spread of the disease and for the early detection of drug resistant strains of the parasite. AIM: The objective of this study is to assess the efficacy of AL in a low-transmission setting in Namibia. METHODS: The study is conducted in the Zambezi region of Namibia and is a secondary analysis of a prior longitudinal cohort study. Symptomatic patients reporting to health facilities that were tested positive on the rapid diagnostic test were included in the study. A total of 44 patients were observed and given a 3-day course of AL and single low dose of primaquine as recommended by the WHO. RESULTS: At Day 7, 100% of the patients had successfully cleared the infection. 95% of the participants had an adequate clinical and parasitological response with 2 patients presenting febrile at a follow-up visit classifying them as having late clinical failure. CONCLUSION: Overall there were no apparent signs of drug resistance and AL was shown to be safe as a first-line antimalarial drug choice in a low-transmission setting for the treatment of uncomplicated P. falciparum malaria.","[Characterization of Oral Cavity Lesions Within Betel Nut Users in Remote Pacific Islands] BACKGROUND: Betel nut is a commonly chewed substance by the residents of Saipan and many other islands in the Western Pacific Ocean. 43% of Asian Pacific Islander adults in Saipan chew betel nut and 13% of cancer-related mortality in this region is due to oral cavity lesions. AIM: The purpose of this study is to further characterize the types of oral cavity cancers that occur due to chewing betel nut and better understand best methods of treatment and prevention. METHODS: A single-institution retrospective review was undertaken for 81 patients who were treated for primary cancers of the head and neck region at the Commonwealth Healthcare Corporation (CHC) in Saipan, CNMI between 2005 and 2019. Biopsies of the oral cavity lesions were obtained from the patients in Saipan and analyzed for further workup. RESULTS: A majority of head and neck cancer patients had oral cavity cancer (64/81, 79.0%). Preliminary biopsy results show a high incidence of squamous cell carcinoma with squamous hyperplasia. A particularly high incidence of rare verrucous carcinoma was found (8/55, 14.5%). CONCLUSIONS: Patients with the uncommon verrucous carcinoma should be treated differently as surgical outcomes differ in comparison to oral squamous cell carcinoma. Surgical resection in comparison to radiation therapy has been shown to have a good prognosis in patients with oral verrucous carcinoma. Further studies should be conducted to best prevent and treat these oral lesions."],"dc:format":["application/pdf"],"dc:identifier":["https://hdl.handle.net/2152.5/10632","1522122309"],"dc:language":["en"],"dc:subject":["Substance-Related Disorders","Pacific Islands","Antimalarials","Artemether, Lumefantrine Drug Combination","Malaria, Falciparum","Plasmodium falciparum","Namibia","Areca","Mouth Neoplasms","Oral Health","Precancerous Conditions"],"dc:title":["[Part One] Efficacy and Safety of Artemether-lumefantrine to Treat Uncomplicated Plasmodium falciparum After a Decade of Its Use as First-Line Antimalarial Treatment in Namibia; [Part Two] Characterization of Oral Cavity Lesions Within Betel Nut Users in Remote Pacific Islands","Characterization of Oral Cavity Lesions Within Betel Nut Users in Remote Pacific Islands"],"dc:type":["Thesis","text"]},"updated_at":"2026-07-24T05:52:17Z"}