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It kills hundreds of thousands a year and infects many millions more across the globe, but no place bears the brunt of malaria like Africa. According to the World Health Organization (WHO), 90 percent of 2015's malaria cases occurred in Africa, as did 92 percent of malaria deaths. It is here that WHO has chosen to pilot the world's first malaria vaccine next year, with Ghana, Kenya and Malawi to be the first recipients.
But climate change may be putting an end to that safeguard. A new study led by a researcher at the University of Maine found that since 1981, the elevation needed to protect people from malaria has risen by 100 meters. For the first time, people living in Ethiopia’s highlands could be vulnerable to the disease. “What’s happening is the conditions, at least in terms of temperature, that are suitable for malaria are slowly creeping up at higher elevations,” said Bradfield Lyon at Maine's Climate Change Institute and School of Earth and Climate Sciences. “The same thing would be true in other highland locations throughout the tropics.” "It's sort of eroding this natural buffer," he said.
The two most common types of parasites that cause malaria in the region require consistent temperatures above 18 degrees Celsius and 15 degrees Celsius respectively. Lyon’s study found that temperatures in the Horn of Africa are rising by an average of 0.2 degrees Celsius per decade due to climate change. He said this may not sound like a major change, but that over the course of the years studied (1981 to 2014), more than 6 million people who once lived areas protected from malaria may have lost that protection. Ethiopia’s capital Addis Ababa, at 2,300 meters above sea level, still sits well above the threshold for malaria. Lyon said the communities potentially at risk are at elevations between 1,200 and 1,700 meters.
Two children stricken down with malaria rest at the local hospital in the small village of Walikale, Congo.
Still, he emphasized that this is simply a meteorological study. He has not seen evidence that people in the described areas actually contracted malaria. But the research is pointing out that it is possible. “It does not mean that these people, therefore, are going to get malaria. It just says that it is slowly enhancing the risk if we leave all other factors alone,” Lyon said. “I mean the hope is through interventions and so forth that we can, in fact, eradicate malaria in this and other regions of the tropics.”
In 2015, about 212 million people worldwide fell ill with malaria and about 429,000 died, according to the World Health Organization. About nine-tenths of the cases and deaths occurred in sub-Saharan Africa. Worldwide, about 214 million people fall ill with malaria each year and 438,000 people die as a result, according to the Centers for Disease Control and Prevention. The most vulnerable are children living in sub-Saharan Africa.
Climate Change Could Bring Malaria Risk to Ethiopia's Highlands
That's where Nicholas Akhonya comes in. With the aid of a simple medical kit and his mobile phone, Akhonya, a trained community health volunteer, is able to diagnose villagers with malaria in their own homes, offer treatment, and refer acute cases and pregnant women to health facilities for specialized care. Malaria cases are on the increase in Kenya, and experts attribute the upsurge to changes in the climate. According to Dr. James Emisiko, coordinator for the Division of Vector Borne and Neglected Tropical Diseases in Kakamega County, mosquitoes breed particularly well in stagnant water in warm temperatures. The females feed on human blood in order to produce eggs, and if a mosquito carrying the malaria-causing plasmodium parasite bites a person, it is likely to infect them.
Miriam Opechi, a community health volunteer in Emusala village, in Western Kenya's Kakamega County, carries out a malaria test on a resident sick with a fever
Kenya's recent drought — the harshest in East Africa since 2011— followed by sporadic rainfall in the middle of this year has created a perfect breeding environment for mosquitoes, Emisiko told Thomson Reuters Foundation. The result is an upsurge of malaria cases, especially in the Western Kenya region and around Lake Victoria. "The only way to control deaths from this life-threatening disease is to ensure that all fever cases are tested wherever the patients are, malaria-positive cases [are] treated and all complicated cases referred to nearby health centers," the doctor said.[ He said that parents in rural areas often initially give painkillers to children with fever. When families finally seek proper medical attention, it is often too late for those who have malaria to respond to simple anti-malarial drugs, and they require expensive hospitalization instead.
Calling in the Volunteers
To tackle the problem, for the past two years county governments in malaria-prone areas have worked with non-governmental organizations to train community health volunteers to diagnose the disease in patients' homes, using rapid diagnostic kits. The volunteers then treat those who test positive, and refer complicated cases to the nearest health center. "In case of any complication, all I need is to have power on my mobile phone so that I can communicate with medical experts using the toll-free number for further advice," said Akhonya, one of the volunteers. The U.S.-based Centers for Disease Control and Prevention estimate that there are 6.7 million new clinical cases of malaria in Kenya each year and 4,000 deaths, most of them in Western Kenya.
Community health volunteers in Emulsala village, in Western Kenya's Kakamega County, use mobile phones to report serious malaria cases to better equipped clinics and hospitals
According to Moses Makokha, clinical officer in charge of the Bumala-A sub-county health center in Busia County, some malaria cases can be fatal little more than 24 hours after symptoms occur, especially in children below the age of five years and pregnant women. In pregnant women, malaria can lead to miscarriage or other serious complications, Makokha said. "It is always an easy disease to manage - but only if it is identified at the onset of the fever and treated immediately using the correct medication," Makokha said. Kakamega County's government has trained 4,200 community health volunteers to manage simple malaria, working with Community Asset Building and Development (CABDA), a local NGO, and with support from Amref Health Africa, an international Kenyan medical charity headquartered in Nairobi.
The volunteers are supplied with test kits and basic drugs to treat the disease at no cost to patients. Treating malaria at the village level, among other interventions, has helped reduce the prevalence of the disease in Kakamega County from 38 percent in 2013 to 27 percent in 2016, according to County Health Executive Peninah Mukabane. "This is one of the success stories that we are all proud of," Ephy Imbali, CABDA's executive director, told the Thomson Reuters Foundation.
Cash - and Status
Death rates from malaria have dropped by 60 percent since 2000, according to the WHO, but attempts to end one of the world's deadliest diseases — which kills around 430,000 people a year — are under threat as mosquitoes become increasingly resistant to measures such as insecticide-treated bed nets and anti-malarial drugs. BASF's new net is based on chlorfenapyr, which has been used in agriculture and urban pest control for over two decades, but BASF reworked it to make it effective on mosquito nets and meet targets for the public health market.
Two children and their mother rest under a mosquito net in the small village of Walikale, Congo
It said the net will provide protection for at least three years or 20 washes. The new Interceptor G2 insecticide-treated net is expected to be available to health ministries and aid organizations beginning toward the end of this year, BASF said. A WHO spokesman said the Geneva-based organization's interim recommendation meant it still had to evaluate the net's public health impact and it was requesting more data from the chemicals company.
BASF is also waiting for the WHO to evaluate another chlorfenapyr product, an indoor spray for walls and ceilings called Sylando 240SC. "This development breakthrough strengthens my personal belief that we really can be the generation to end malaria for good," said Egon Weinmueller, head of BASF's public health business.
BASF Unveils New Mosquito Net in Battle Against Malaria
In a detailed study analyzing more than half the genes in the genome of Plasmodium, the parasite that causes malaria, researchers found that two-thirds of those genes are essential for survival. This is the largest proportion of essential genes found in any organism studied to date, they said.
This is a colorized electron micrograph of a malaria-causing Plasmodium parasite, right, attaching to and invading a human red blood cell. The inset shows the attachment point at higher magnification.
The scientists discovered that the parasite often disposes of genes that produce proteins that give its presence away to its host's immune system. This allows malaria to swiftly change its appearance to the human immune system and hence build up resistance to a vaccine, posing problems for the development of effective shots. "Our study found that below the surface the parasite is more of a Formula 1 race car than a clunky people carrier: The parasite is fine-tuned and retains the absolute essential genes needed for growth," said Julian Rayner, who co-led this study at Britain's Wellcome Trust Sanger Institute.
Good and bad
He said this discovery, published Thursday in the journal Cell, had both positive and negative implications. "The bad news is it can easily get rid of the genes behind the targets we are trying to design vaccines for, but the flip side is there are many more essential gene targets for new drugs than we previously thought," he said. Malaria kills about half a million people a year, the vast majority of them children and babies in the poorest parts of sub-Saharan Africa. Beyond that, almost half the world's population is at risk of becoming infected with malaria, and more than 200 million people fall sick with it each year, according to World Health Organization figures. Despite decades of scientific endeavor, the genetics of Plasmodium parasites have proved tricky to decipher.
This is partly because they are ancient organisms and about half their genes have no similar genes — homologs — in any other organism, Rayner's team explained, making it difficult for scientists to find clues to their function. Francisco Javier Gamo, a malaria expert at GlaxoSmithKline, a British drugmaker active in this field of research, said the highest achievement for malaria scientists would be to discover genes that are essential across all of the parasite life cycle stages. "If we could target those with drugs, it would leave malaria with nowhere to hide," he said.
Malaria Genome Study Reveals Savvy Parasite
This dangerous form of the malaria parasite cannot be killed with the main anti-malaria drugs. It emerged in Cambodia but has since spread through parts of Thailand, Laos and has arrived in southern Vietnam. The team at the Oxford Tropical Medicine Research Unit in Bangkok said there was a real danger of malaria becoming untreatable. Prof Arjen Dondorp, the head of the unit, told the BBC News website: "We think it is a serious threat. "It is alarming that this strain is spreading so quickly through the whole region and we fear it can spread further [and eventually] jump to Africa."
Failing treatments
In a letter, published in The Lancet Infectious Diseases, the researchers detail the "recent sinister development" that has seen resistance to the drug artemisinin emerge. About 212 million people are infected with malaria each year. It is caused by a parasite that is spread by blood-sucking mosquitoes and is a major killer of children. The first choice treatment for malaria is artemisinin in combination with piperaquine.
Malaria is caused by a parasite spread by blood-sucking mosquitoes
But as artemisinin has become less effective, the parasite has now evolved to resist piperaquine too. There have now been "alarming rates of failure", the letter says. Prof Dondorp said the treatment was failing around a third of the time in Vietnam while in some regions of Cambodia the failure rate was closer to 60%. Resistance to the drugs would be catastrophic in Africa, where 92% of all malaria cases happen.
'Against the clock'
There is a push to eliminate malaria in the Greater Mekong sub-region before it is too late. Prof Dondorp added: "It's a race against the clock - we have to eliminate it before malaria becomes untreatable again and we see a lot of deaths. "If I'm honest, I'm quite worried." Michael Chew, from the Wellcome Trust medical research charity, said: "The spread of this malaria 'superbug' strain, resistant to the most effective drug we have, is alarming and has major implications for public health globally. "Around 700,000 people a year die from drug-resistant infections, including malaria. "If nothing is done, this could increase to millions of people every year by 2050."
Alarm as 'super malaria' spreads
His family announced his death in Heraklion, Crete, on Saturday "after a long illness.'' Born in Crete in 1940, Kafatos was known for his research on malaria and for sequencing the genome of the mosquito that transmits the disease. He was a professor at Harvard University from 1969 to 1994, where he also served as chairman of the Cellular and Developmental Biology Department, and at Imperial College in London since 2005. He had been an adjunct professor at the Harvard School of Public Health since 2007.
Greek scientist Fotis C. Kafatos, then the director-general of the European Molecular Biology Laboratory, addresses a press conference in London
Kafatos was also a part-time professor at the University of Crete in his hometown since 1982. He also was the third director of the European Molecular Biology Laboratory, a life sciences research organization funded by multiple countries, from 1993 to 2005. Kafatos considered the 2007 founding of the European Research Council under the auspices of the European Commission as his crowning achievement. The council funds and promotes projects driven by researchers. He stepped down as president in 2010.
He came to be disillusioned by the heavily bureaucratic rules that, in his mind, hampered research. "We continuously had to spend energy, time and effort on busting bureaucracy roadblocks that kept appearing in our way,'' Kafatos told scientific journal Nature soon after he left the post. But, he added, "We delivered to Europe what we promised.''
Kafatos, Distinguished Greek Biologist, Malaria Researcher, Dies at 77
SHHHHHHHHHH That's what the vaccines are for silly.Africa is so overpopulated and in such misery, that anything lowering their mortality rate isn't doing them any favors in the long run. You just end up with more starvation and misery. Since third-worlders won't control their reproductive systems on their own, they need natural selection to do it for them.
