eradicating malaria Archives

August 5, 2011December 22, 2012

Text Messages Advance Malaria Care

Text messages could be a cost effective way of improving care for African children with malaria, according to researchers.

A six month study involving 119 health workers in Kenya, published by The Lancet, showed texts increased the number following government guidelines.

Half of children received the correct treatment at the end of the study, more than double the starting figure.

Researchers said there was “huge potential” to improve care.

There has been concern that government guidelines on malaria treatments are not always followed in the field.

Guidelines include the correct prescription of anti-malaria drugs – artemether-lumefantrine (AL) – and advice to parents.

Health workers in the study were sent text messages twice a day, five days a week, for six months.

An example of the sort of sent was: “advise mother to finish all AL doses over three days even if the child feels better after two doses”.

Improvement

At the beginning of the study, 20.5% of children were correctly managed, this increased to 49.6% after the six month study.

Continue reading the main story

“Start Quote

We need to explore ways of scaling up such intervention to all health workers in the country”

End Quote Dr Willis Akhwale Ministry of Public Health and Sanitation

The effect appeared to persist after the texts stopped. Six months after the trial ended, 51.4% of children were receiving the correct treatment.

Professor Bob Snow, who headed the research group, said: “The role of the mobile phone in improving health providers’ performance, health service management and patient adherence to new medicines across much of Africa has a huge potential.”

The cost of the texts was estimated at £1.59 for the whole six months for each worker.

However, the authors acknowledge that “we do not fully understand why the intervention was successful”.

They suspect it may act as a reminder or reinforce the importance of the messages in the texts.

Dr Willis Akhwale, from the Kenyan Ministry of Public Health and Sanitation, said: “We need to explore ways of scaling up such intervention to all health workers in the country.”

Bruno Moonen and Justin Cohen, from the Clinton Health Access Initiative in Nairobi, said: “A combination of interventions will most likely be needed to improve adherence to national guidelines.”

The study provides “strong evidence that text message reminders can be an effective, low-cost component of such a package”.

April 10, 2011April 10, 2011

Students Aim to Combat Malaria With Smartphone Software

By Barbara Liston (Reuters)

A team of graduate students has created a new smartphone application they say will allow healthcare workers in remote locations to diagnose malaria cases on the spot.

But first, the students hope their application wins this weekend’s Imagine Cup 2011 national finals in Seattle.

The 9th-annual Imagine Cup, sponsored by Microsoft, asks student entrants to “imagine a world where technology helps solve the toughest problems.”

Tristan Gibeau, 25, a graduate computer engineering student at the University of Central Florida in Orlando, said his team’s application fits the bill.

“It’s going to make a difference in trying to contain the outbreak of malaria,” said Gibeau, the project’s software designer.

“In the big picture, it’ll hopefully help in the fight against most diseases out there and make everybody’s life a little easier.”

His team’s prototype is a Windows 7-equipped Samsung Focus smart phone modified with a microscopic camera lens.

Gibeau said the software application can take a picture of a blood sample, process the data to detect malaria parasites, quantify how much malaria is in the sample and point the parasites out to the phone user.

“It actually draws a red box around the clusters of malaria, and it actually notifies you how many it found,” Gibeau said.

Although microscopic lenses are already available for smart phones, Gibeau said the software takes the concept’s usefulness to another level.

It would enable a doctor or nurse working, for example, in an African village lacking Internet access to make a diagnosis without having to upload data for processing elsewhere.

However, once the data stored in the phone is uploaded, it can be used to spot disease trends, Gibeau said.

He said he is working on smart phone applications to detect sickle cell and other diseases and also plans to make the software easily adaptable to lab-based microscopes.

The smart phone application was the idea of team member Wilson To, a 25-year-old graduate student in comparative pathology at the University of California at Davis.

It builds upon a mobile microscope concept that To and a different team created to win last year’s Imagine Cup national finals.

Gibeau said the team is working toward patenting and marketing the new application.

“From different conversations we’ve had with investors, we feel that this definitely is a money-maker,” he said.

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April 7, 2011

Genetically Modified Fungus Could Fight Malaria

Britain Mutant Malaria Fungus — Bacteria use for producing anti-body against malaria are seen through a microscope at Westminster University in London, Tuesday, March 15, 2011. In a cramped London laboratory filled with test tubes, bacteria and mosquitoes, scientists are trying to engineer a new weapon in the battle against malaria: a mutant fungus. For years, Angray Kang at Westminster University and colleagues have been testing whether they could genetically tweak a fungus to kill the malaria parasite carried by mosquitoes.

NPR

In a cramped London laboratory filled with test tubes, bacteria and mosquitoes, scientists are trying to engineer a new weapon in the battle against malaria: a mutant fungus.

For years, Angray Kang at Westminster University and colleagues have been testing whether they could genetically tweak a fungus to kill the malaria parasite carried by mosquitoes.

Now they’ve found that in lab experiments, mosquitoes exposed to the fungus show a sharp drop in levels of the parasite. If it works that way in the wild, that should make it harder for the disease to infect people.

Kang said the mutant fungus could be sprayed onto walls and bednets like insecticides and could be made for a comparable cost.

He said the same process of genetic modification could also be used to target other insect-spread diseases like dengue and West Nile virus. The research was done together with scientists at the Johns Hopkins School of Public Health and was funded by the U.S. National Institutes of Health. Early results were published recently in the journal Science.

“This is very exciting research,” said Andrew Read, director of the Center for Infectious Disease Dynamics at Pennsylvania State University. He has worked on similar projects but was not involved with the fungus research. “It tells us that if you can’t find something in nature to do what you want, you can just make it.”

Read said using the souped-up fungus might be less environmentally invasive than other genetic approaches. Some critics have warned that competing biological approaches, like scientists creating mutant mosquitoes, could wreak havoc to ecosystems if billions of the insects are released into the wild.

With the fungus, “you just spray it on the wall and it does its job,” Read said. “You don’t have to worry about generation after generation of the stuff.”

He also said the fungus technology could be a new way of dealing with insecticide-resistant mosquitoes, an increasing problem that has meant the return of effective but controversial sprays like DDT. “With the (mutant) fungi, you wouldn’t have chemical residues hanging around,” he said. “It would just be a fungus very similar to what is already found in nature.”

In laboratory tests, Kang and colleagues found mosquitoes exposed to the mutated fungus had malaria parasite levels about 85 percent lower than normal. When they added a scorpion toxin to the mix, levels dropped by 97 percent. No tests have shown whether using the fungus would curb human malaria cases, but experts think fewer malaria parasites should translate into fewer cases.

“If the strategy works and there are fewer parasites, this could change how malaria is spread and reduce transmission to humans,” said George Christophides, an infection expert at Imperial College London who was not associated with the research.

Kang’s experiment involved inserting a human antibody against malaria into a fungus commonly found in soil and plants worldwide. Spores made by the fungus burrow into the mosquito, invading its circulatory system. When the malaria-causing parasite multiplies inside the insect, the antibody keeps the parasites from reaching the mosquito’s salivary glands. That theoretically stops the disease’s spread.

“The mosquito can be infected by malaria, but it can’t pass it onto humans,” Kang said. The mutated fungus then eats away at the mosquito from the inside, killing the insect after a couple of weeks. That’s long enough for the mosquito to reproduce, which should lessen its incentive to evolve resistance to it.

The same fungus — minus the genetic modifications — is already produced in industrial quantities to squash locust outbreaks in Australia. The fungus is naturally lethal to locusts, so no genetic modification is needed.

If Kang and colleagues can get enough funding, they hope to test the mutant fungus in malaria-endemic countries like Burkina Faso, Kenya or Tanzania.

Other experts doubted whether the laboratory experiment could be replicated in the wild. “It’s a neat scientific idea, but there are questions about (the mutated fungus’s) stability and formulation,” said Janet Hemingway, director of the Liverpool School of Tropical Medicine. She said the mutant fungus would have to survive being shipped to Africa and then be viable for another three to six months in stifling heat once it’s sprayed onto walls or bednets.

One group that campaigns against genetically modified organisms warned the mutant fungus could skew behaviors of other wildlife.

“The release of any genetically modified organism into the environment runs the risk that it may have wider impacts than just its target,” said Pete Riley, campaign director of GM Freeze, a U.K.-based advocacy group. He said the modified fungus could have unintended consequences which might be impossible to reverse. “Nature has a pretty cunning way of getting around everything we throw at it,” he said.

Kang acknowledged that simply having a new mutant fungus would not stop malaria. “We still need better drugs and other interventions,” he said. “But malaria kills about a million people every year so we have to try whatever may work.”

February 10, 2011January 3, 2013

Malaria: What is it and Why I Believe Our Generation Can Defeat it

By Kwabena Amponsah-Manager

What is Malaria?

Malaria is a tropical disease that is caused by the bite from the female Anopheles mosquito. The parasite is known as Plasmodium. Globally about 22 countries are plagued by malaria, most of them in the tropical regions and a few sub-tropical countries.

Symptoms of Malaria:

The symptoms of malaria include fever, anemia, chills, lost of appetite, general body weakness, nausea, convulsions and headache. The most characteristic symptom of malaria is the cycle of sudden chills followed by fever and sweating.

Occurrence:

There are more than 400 million cases of malaria annually. If not treated, the infection can be fatal, especially in infants, pregnant mothers and seniors. Malaria kills between one and three million people, the majority of whom are young children in sub-Saharan Africa, where 90% of malaria-related deaths occur.

The most serious form of the disease is caused by Plasmodium falciparum which is one of several species of the parasite that cause the disease. A milder form of the disease results from the species Plasmodium vivax, Plasmodium ovale and Plasmodium malariae.

Prevention and Treatment of Malaria:

The most effective means of preventing the disease is to prevent the bite from the mosquito. Insecticide treated mosquito nets and insect repellents are first line preventive measures. Mass preventive measures such as spraying insecticides inside houses and draining standing water where mosquitoes lay their eggs are also employed by governments and institutions.

Currently there is no effective vaccine against malaria though a few are in development (GSK is a leader in this aspect). A variety of antimalarial medications are available. In the last 5 years, treatment of P. falciparum infections in endemic countries has been altered by the use of combinations of drugs containing an artemisinin derivative. Severe malaria is treated with intravenous or intramuscular quinine or, increasingly, the artemisinin derivative artesunate. Several drugs are also available to prevent malaria in travelers to malaria-endemic countries (prophylaxis). An example of prophylactic malaria drug is Malarone. Chloroquine used to be most commonly prescribed medicine against malaria but the parasite developed resistance to the drug. It is still being used to treat and prevent malaria though not as effective as it used to be. In places where drug resistance parasites have not yet been confirmed, such as Central America and parts of the Middle East, Chloroquine is still the drug of choice prevent and treat P. falciparum and P. vivax infections.

For reasons not fully understood, a number of diseases appear to provide some resistance to malaria. Notable ones include sickle cell disease, thalassaemias, glucose-6-phosphate dehydrogenase, Duffy antigens. Some people have red blood cells that lack proteins called Duffy antigens on their surface. Duffy antigens act as receptors for Plasmodium vivax merozoites, so people without Duffy antigens are resistant to infection from this parasite. Again, individuals who live in malaria-endemic regions acquire immunity to malaria through natural exposure to malaria parasites. In fact, naturally acquired immunity to falciparum malaria protects millions of people routinely exposed to Plasmodium falciparum infection from the disease.

Even though malaria has not received the global attention required for a killer of such profile, wealthy foundations, some private companies, and smart governments across the world are beginning to wake and make malaria a priority. However, there are still skeptics who doubt humans’ ability to eradicate malaria. Early November of 2010 a series of papers published in a respected scientific journal, the Lancet cast a gloomy cloud over any hope of dealing with malaria, at least in our lifetime. The papers concluded by urging governments, donor agencies and foundations to focus more on minimizing the prevalence of malaria and not on eradicating the killer.

Generally speaking, and not necessarily referring to the Lancet papers, considering mankind’s quest to conquer the universe, occupy Space, and pursue every kind of technology to make life easier and better, it would be intellectuality dishonest and morally criminal for humans to accept the theory that malaria is ineradicable.

A few decades ago, significant portion of North America was plagued with malaria in the same fashion as African countries are going through. In fact, it was not until the late 1890′s that scientists even learnt that the disease is caused by a parasite and that it is a mosquito that transmits the parasite from person to person. The assumption in those days was that malaria was caused by some environmental factors. The word malaria actually comes from the Italian “mala aria”, meaning “bad air” because it was generally believed that malaria was caused by breathing in bad or foul air and vapors emanating from swamps, marshy lands and latrines.

It is important to remember that 70 to 80 years ago, Americans traveling to the Eastern Tennessee Valleys had the same fear they now have when traveling to Togo or Ivory Coast because of malaria. With the creation of the U.S. Tennessee Valley Authority (TVA) in 1933 which established an organized malaria control program, the doubts began to fade. At the time, malaria affected 30 percent of the population in the region where the TVA was incorporated. After implementing aggressive research and control operations, the disease was essentially eradicated in the TVA region by 1947.

The US did not win the battle over malaria overnight. Efforts to control malaria became national focus as far back as the early 20th century during the occupation of American military in Cuba and the construction of the Panama Canal. It is recorded that malaria (and yellow fever) caused significant number of deaths among the workers of the canal. This triggered an aggressive program of malaria control which in 10 years had already made remarkable progress.

Malaria can be defeated, albeit, not overnight. The funding available for anti-malaria campaigns, and research and development is tiny compared to the challenges.

In the long run, I believe that prevention of malaria is the cost-effective route to take rather than treatment of the disease. However, for preventive measures to make the required impact, funding would have to be ramped up.

Current statistics show that in many of the malaria endemic countries, funding is less than US$1 per capita, and in fact it is less than US$0.5 in 16 malaria endemic countries, making up about 710 million people.

Much as I wanted this to be educational rather than political, I cannot help but state that malaria could be eradicated from the earth at negligible percentage of the cost of the Iraq war. It has been estimated by Economist Jeffrey Sachs that malaria can be controlled for US$3 billion in aid per year. (The cost of the Iraq war stands at $774 billion at the time of writing this article)

Our generation must stand trial for genocide for inaction on a problem that kills a child every 30-40 seconds. It is every 30-40 seconds!

Germany Halts Payment to Malaria Fund Over Corruption Concerns

Germany has halted its annual payments of 200 million euros ($274 million) to the Global Fund Against AIDS, TB and Malaria due to concerns over allegations of corruption against the Fund.

Announcing suspension of the funds, German Development Minister Dirk Niebel said on Wednesday: “I take the allegations of corruption and breach of trust carried by media against the Global Fund very seriously, and I expect that the fund will promptly clear them up.”

Stressing that an investigation was urgently required into the allegations, Niebel indicated that he had halted all “further payments to the Fund until it is fully cleared up.”

With its annual contribution of 20 million euros, Germany is the third-largest donor to the U.N.-backed Fund that has an annual budget of more than $20 billion. The Fund is the single largest source for fighting AIDS, Tuberculosis and Malaria across the world.

The latest developments come after an international news agency raised allegations of misappropriation and corruption against the Fund. The news agency alleged in a report that funds might have been misappropriated in several countries where the Global Fund’s controls were poor.

Following the report, the Fund acknowledged that its internal investigations had revealed some minor misappropriation of funds in several cases. But the Fund insists that it has taken strict measures to tackle the problem in all identified cases.

According to the Fund, internal investigations and audits carried out in 33 of the 145 countries where the it has grants have unearthed $34 million in misappropriated or unsubstantiated funds.

The Fund acknowledged that the amount found to be misappropriated was a large enough figure by itself, but pointed out that it amounted to only 0.3 per cent of the $13 billion the Fund has distributed to countries so far.

by RTT Staff Writer

For comments and feedback: contact editorial@rttnews.com

December 30, 2010January 3, 2013

The fight against HIV/AIDS needs a pragmatic approach (update)

K. Amponsah-Manager

On December 14 2010, the World Health Organization (WHO), the UN agency which over ten years ago started a campaign to cut the number of malaria cases and deaths in half by 2010, reported that Malaria is fast declining in countries where it had been endemic. The report was surprisingly optimistic that we could have a malaria-free world by 2015!

The progress on the malaria front did not come by wishful thinking; it was the result of pragmatic efforts on the part of governments and various organizations. In the past three years alone, 578 million people at risk of malaria have been provided with insecticide-treated mosquito nets. Another 75 million have benefited from indoor residual spraying, the report said.

While such a report gladdens our hearts, it should also remind us of the twin brother HIV/AIDS.

Significant efforts have been expended in combating the spread of HIV with some results to show already. However, it is believed that what has been achieved is minimal compared to what is possible if the energy already spent was used to do the right thing most of the time.

There is the popular notion that HIV is caused by people doing stupid things, and some even think it is a curse for our disobedience of natural laws. Surely, there are some who are living with the virus as a result of doing stupid things, but that is just part of the story. In any case, such perception does nothing to save the millions who continue to contract the virus each year. Some of them are our brothers, sisters, uncles, and our teachers.

Rather than perpetuating the stigma associated with AIDS, I will suggest it is time we spend that energy to discuss how to curtail the rate of spread of the killer and save lives of mothers, fathers, and infants, some of whom have to live with the parasite for no fault of theirs.

There are practical ways that work and those are what we need to focus on. I’ll mention only two here for the sake of space.

Case 1: Sharing needles by drug users: The consequences of the use of illicit drugs on the health of our citizens and the effect it has on our economies and health care system are well known. The practice can therefore never be condoned or encouraged

But the reality is that people will continue to abuse drugs. Several studies have established that the sharing of needles by drug users is a significant avenue for contracting the HIV.

The approach here has to be two fold. The first is a continued education on the consequences of sharing needles which I believe is already well known. The second I think should be an effort on the parts of governments and foundations to consider providing accessible avenues by which the addicts can obtain clean needled when the lust for the substance is uncontrollable. They will continue to use the drugs anyway, but why should we look on while such acts continue to overburden the already stressed health and economic structures and continue to add to the AIDS statistics.

Case 2: Laboratory and epidemiologic studies have shown that even though condoms are not 100% HIV/AIDS-proof, the use of condoms in sexual intercourse reduces the risks of HIV infection significantly. We would wish that people will abstain from sex until they’re in a committed relationship, but the reality is that this approach will not work for all. The truth is that HIV is acquired by having unprotected sex with someone carrying the virus, and not just by having sex.

The massive campaign to encourage the provision and use of mosquito nets is yielding results with the possibility that we could have a world without malaria in less than a decade. It’s time to do same for AIDS.

The campaign to encourage people to stay away from sex until marriage or until they’re in a committed relationship should continue. However, this weapon will work for only a fraction of the population. It is time to be practical and tell people in a plain language that if you cannot abstain, then they should simply cover it.

Even though, it may be appear rather radical, I may suggest that Governments, Non-governmental Organizations (NGOs) and foundations working on HIV/AIDS in Africa should consider making condoms (both male and female condoms) available for free to prostitutes (at least, until a solution is found to the problem of prostitution).

Given the choice, I’ll rather opt to use our scarce national resources to do that which will produce tangible and measurable results.

To the toddler taking care of a sick single HIV/AIDS parent, the issue here is not just statistics, it is life.

Let us learn from the anti-malaria campaign.

(To learn more on Condoms and HIV, click here)

December 19, 2010January 19, 2011

Eradication of malaria is within reach, WHO reports

The World Health Organization, the UN agency which over ten years ago started a campaign to cut the number of malaria cases and deaths in half by 2010, reports that Malaria is fast declining in countries where it had been endemic.

Just five years ago, the anti-malaria campaign was in such poor shape that this news from the UN agency is surprising and gladdens the hearts of both researchers and residents of regions prone to malaria.

Even though experts agree that the campaign will fall short of meeting the goals it set over a decade ago, significant progress has been made over the past few years in distributing the means to prevent and treat malaria and in bringing down death rates in many countries.

As a result, malaria-related deaths have also fallen globally from 985,000 in 2000 to 781,000 in 2009, with most of the deaths registered in children under five. In short, the anti-malaria campaign efforts are saving around 204 000 lives per year right now over the baseline in 2000.

In Uganda, for instance, the report shows that the number of households owning at least one insecticide-treated mosquito net has increased over the last two years from 42 to 47 per cent.

Over the past three to four years, millions of insecticide-treated bed nets have been delivered to sub-Saharan Africa. The number of people whose houses were protected by insecticide spraying jumped to 75 million in 2009, protecting another 10 percent of the population at risk.

The most encouraging news is that experts say that with continued effort, the number of malaria deaths could be halved by the end of 2011 and practically eliminated by 2015.

We posted an article here on November ^7th 2010 with the title ‘Eradicating malaria in Sub-Saharan Africa, Yes We Can’

How ‘prophetic’ we were.

We actually can.

November 30, 2010April 1, 2011

Why African women are saying YES to the female condom

Female condoms campaign

An estimated 22.5 million people are living with HIV in the part of African below the Sahara – around two thirds of the global total. The use of condom during sex is one of several preventive measures against HIV/AIDS. Unfortunately, in most communities, it is difficult to get the men to use the condom.

Some of the excuses men give against the use of condoms are:

it is a sin to use condoms

For these reasons, some anti-HIV campaigns have shifted focus onto the women and educating them to protect themselves if the men will not. The female condom has become and alternative to an increasing number of women which they resort to anytime their partners refuse to use the male condom.

The female condom is a thin, soft loose-fitting polyurethane plastic pouch that is used during intercourse to prevent pregnancy and reduce the risk of sexually transmitted diseases. It has flexible rings at each end. Just before vaginal intercourse, it is inserted deep into the vagina. The ring at the closed end holds the pouch in the vagina. The ring at the open end stays outside the vaginal opening during intercourse. And during anal intercourse, it is inserted into the anus.

If women always use the female condom correctly only 5% of users will report unexpected pregnancy each year. It can even be made more effective if used with a spermicide

Warning: Most spermicides contain nonoxynol-9 which has certain risks. If it is used many times a day, or by people at risk for HIV, it may irritate tissue and increase the risk of HIV and other sexually transmitted infections.

The major limitation of the female condom reported is the coverage of the external genitalia. This coverage had a particularly negative impact on the device’s aesthetics, and noise associated with use.

Again difficulties associated with insertion and removal, discomfort, messiness and inconvenience are easily reported issues.

With estimated 22.5 million people living with HIV in just the part of African below the Sahara, it’s highly welcomed that women are taking charge over their own health even if their male counterparts aren’t on board yet.

We hope our effort here contributes in some way to the campaign. Our hope is a world without HIV and Malaria.

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The penis is directed into the pouch through the ring at the end, which stays outside the vaginal during the intercourse. By covering the inside of the vagina or anus and keeping semen and pre-cum out, female condoms reduce the risk of sexually transmitted infections.

The female condom was first made from polyuthrane. This version is officially called the FC FEMALE CONDOM. A newer version is made of nitrile rubber and called FC2. It is made from natural latex; the same material is used in male condoms.

The newer nitrile condoms are less likely to make potentially distracting crinkling noises. FC1 and FC2 are the only female condoms encouraged by the World Health Organization. They are sold under many brand names, including Reality Femidom, Dominique, Femy, My Femy, Protective and Care.

A target campaign to promote the female condom in some African communities is turning it into a mainstream women accessory; more and more now carries the female condom in their purse.

It is more acceptable to the men as it does not result in a significant decrease in sensation as with the male latex condom. Female condoms do not constrict the penis as do latex condoms. As a result, sensitivity of the male partner may not be substantially reduced.

it decreases pleasure or enjoyment of sex

it ruins the mood

I can’t feel anything when I’m wearing a condom

if a women loves me, then she you should just trust me