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We speculate that the significant widespread use of AQ in Kenya as an alternative to S/P prior to the use of ACTs may have resulted in the observed apparent maintenance of CQ resistance due to structural similarities between the two drugs [39], but with the advent and acceptability of ACT use within the Kenyan health care community this drug pressure dissipated in the last 5 years

Inflammation and loss of the intestinal goblet cells were also reported

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Referral to a clinical psychologist, counsellor, or support groups such as those run by Macmillan Cancer Support or Breast Cancer Now can be beneficial

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These are paid services and provide an accessible alternative to NHS testing