Why Earth Day should be Renamed "Malaria Day"

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More trials of Malaria vaccine needed...

More Trials of First Malaria Vaccine Needed
October 23, 2015 — A World Health Organization advisory group recommends continued clinical trials of a promising malaria vaccine to test its efficacy and safety. Separately, the Strategic Advisory Group of Experts on Immunization or SAGE is calling for the replacement of the current oral polio vaccine with another.

More than one million people die of malaria each year; the vast majority are children in Africa. That is why the prospect of a vaccine to end the deadly toll is so exciting. While the first malaria vaccine, known as RTS,S shows promise, the SAGE advisory group says more studies are needed before it can be rolled out for use. The proposed vaccine works against the world's most deadly malaria parasite and the most prevalent in Africa. Four doses are required for a child to be fully protected. The first three doses are given one month apart followed by the fourth dose 18 months later. And that is where the main problem lies.

A child is vaccinated during a Malaria vaccine trial in Bagamoyo, Tanzania​

Chair of SAGE Jon Abramson says the vaccine is about 30 percent effective in children who receive all four doses. But, children who do not receive the fourth dose will lose their protection. “There is no question we need four doses. The real question is how best to get these four doses in at times when we do not normally have a health care interaction with the child. So, that is our main question and is the reason we have asked for… demonstration studies," said Abramson. Abramson says SAGE recommends three to five large demonstration studies to be staged over several years, with about one million children taking part. He says the cost of the vaccine is about five dollars per dose, making it one of the most cost-effective interventions.

He notes the vaccine does not replace proven malaria control measures, saying it complements existing measures, including insecticide treated mosquito nets, diagnostics and treatment. SAGE also has decided to act on polio eradication. Only 38 cases of the crippling disease remain. Currently, oral polio vaccine is the primary tool used to eradicate polio. However, on very rare occasions, the live attenuated vaccine viruses contained in that vaccine have caused cases of paralysis among young children. As a result, SAGE recommends all countries still using the trivalent oral polio vaccine should switch to the safer bivalent oral polio vaccine by May 1, 2016.

More Trials of First Malaria Vaccine Needed

 

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Ivermectin may stop malaria transmission...

Parasitic Illness Drug Could Stop Malaria Transmission
October 28, 2015: Scientists may have hit on a way to prevent the transmission of malaria with a Nobel Prize-winning drug originally developed to treat parasitic illnesses. The drug is called ivermectin, and it's currently being tested in parts of Africa.

Ivermectin has completely revolutionized the treatment of worm diseases like River Blindness and elephantiasis, and could lead to their eradication if it's used effectively. Now, it appears ivermectin may be effective against the spread of malaria. Vector biologist Brian Foy of Colorado State University led a study in Burkina Faso that found a reduction in childhood malaria when the drug was given to adults in the region. “We don’t think this is any sort of magic bullet, but it adds another arsenal to strategies to control both malaria as well as the other neglected tropical diseases, the worms, the parasitic diseases that are in these villages," said Foy.

A young girl with malaria rests in the inpatient ward of the Malualkon Primary Health Care Center in Malualkon, in the South Sudanese state of Northern Bahr el Ghazal.​

The ongoing trial involves giving a single dose of ivermectin once every three weeks to the majority of people in four villages. Small children didn’t receive the drug, but the treatment blocked transmission of malaria in 16 percent of the children, the disease’s main victims. Foy says ivermectin, even at low levels, is toxic to disease carrying mosquitos. The drug's unique action targets the mosquito, not the parasite that causes malaria. For this reason, researchers in the U.S. and Thailand believe ivermectin might help control transmission of a drug-resistant form of malaria in Southeast Asia.

For now, Foy is cautious about claiming that ivermectin holds the key to stopping malaria transmission. He says more studies are needed. “Probably in a much bigger area and probably in different places that have different intensities of malaria transmission, and hopefully really prove that this idea is robust and can be used in many different areas," he said. Since the late 1980s, an estimated one billion doses of ivermectin have been distributed around the world. Foy, who presented his findings at a meeting of the American Society of Tropical Medicine and Hygiene, wraps up the current trial at the end of next month, before moving on to the next phase of testing.

Parasitic Illness Drug Could Stop Malaria Transmission

 

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Europe malaria-free...

WHO: European Region World’s First Malaria-Free
April 20, 2016 : From 1995 to 2015, number of so-called indigenous or locally transmitted malaria cases in region dropped from 90,712 to zero

In 2015, for the first time, all the countries in the European region reported no original cases of malaria, the World Health Organization (WHO) said in its annual report released Wednesday ahead of World Malaria Day 2016 on April 25. From 1995 to 2015, the number of so-called indigenous or locally transmitted malaria cases dropped from 90,712 to zero in Europe, the Caucasus and Central Asia, which constitute the WHO’s European region.

In 2015, there were an estimated 438,000 malaria deaths worldwide, according to the WHO, most of them in the African Region (90 percent), followed by the South-East Asia Region (7 percent) and the Eastern Mediterranean Region (2 percent).

An Anopheles stephensi mosquito obtains a blood meal from a human host through its pointed proboscis​

Case importation risk

The WHO recognizes however, that the European region remains prone of a reappearance of the disease due to importation of cases from areas of the world where malaria is endemic. Dr. Zsuzsanna Jakab, WHO Regional Director for Europe, said that “until malaria is eradicated globally, people travelling to and from malaria-endemic countries can import the disease to Europe, and we have to keep up the good work to prevent its reintroduction".

Maintaining zero cases in the European Region will require sustained political commitment, resources and constant vigilance, the WHO said. The region was last declared malaria free in 1975.

WHO: European Region World’s First Malaria-Free

 

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Malaria drug 'should stop for troops'...

Lariam should be drug of last resort for troops, MPs say
Tue, 24 May 2016 | Anti-malarial drug Lariam, which can cause severe side-effects, should be the "drug of last resort" for UK troops, MPs on the defence committee say.

The drug has been prescribed to at least 17,000 service personnel at least once between April 2007 and March 2015. The MPs criticised the MoD over the way it issued the controversial drug, which can cause severe side-effects, including depression and anxiety. The MoD said the "vast majority of deployed personnel already receive alternatives to Lariam". Lariam - the brand name for mefloquine - is prescribed to civilians as well as troops.

British soldiers in Helmand, Afghanistan​

While it is not the main anti-malarial drug used by the armed forces, critics argue its side-effects can be more detrimental to those serving in challenging and dangerous countries. Malaria is a mosquito-borne infectious disease which causes fever, headaches, vomiting and diarrhoea and can be fatal. In 2015, it killed about 438,000 people and there were 214m cases of the disease, mostly in sub-Saharan Africa, according to World Health Organization estimates.

'Mass deployment'

After a six-month inquiry, the defence select committee found the potential side-effects were clearly highlighted by manufacturers Roche, but there was "strong anecdotal evidence" that the stringent conditions laid down for prescription were often disregarded. Committee chairman Dr Julian Lewis said: "It seems quite clear that not only is the MoD unable to follow the manufacturer's guidelines for prescribing the drug in all instances, but a number of troops discard their Lariam rather than risk its potentially dangerous side-effects. "It is our firm conclusion that there is neither the need, nor any justification for continuing to issue this medication to service personnel unless they can be individually assessed, in accordance with the manufacturers' requirements. "And most of the time that is simply impossible, when a sudden, mass deployment of hundreds of troops is necessary."

'Mad Monday'

The drug's use had had " absolutely devastating psychological effects" in a small minority of cases," he told the BBC's Today Programme, and: "In a larger minority of cases there are disturbed nights, damaged sleep, psychological ideas that are unsettling and dangerous." "In reality the whole experience has been deeply unpleasant. So much so that phrases like 'mad Monday' or 'crazy Tuesday' are used amongst the armed forces when this stuff has been doled out in the past." The inquiry came after BBC Radio 4's Today programme revealed that a senior military medic had called on ministers to prescribe an alternative drug until it was clear that Lariam was safe.

'I kept thinking about hanging myself'

 

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Strong Progress in Fighting Malaria, but still Big Funding Gaps...

WHO Reports Strong Progress in Fighting Malaria, Warns of Big Funding Gaps
December 12, 2016 — In its latest annual report, the World Health Organization says strong progress has been made in the fight against malaria, particularly in offering effective control programs to children and pregnant women in Africa.

The organization, however, warns funding has plateaued, putting targets for tackling the disease at risk. The WHO’s 2016 report highlights significant achievements in the global fight against malaria. Mortality rates for the annual number of deaths from malaria have been halved in the past 16 years to just over 400,000.

A doctor tests a child for malaria at a hospital in Arusha, Tanzania, May 11, 2016. Children under the age of five account for an estimated 70 percent of all malaria deaths.​

Programs to distribute insecticide-treated mosquito nets are the cornerstone of malaria prevention efforts in Africa, says Dr. Jo Lines of the London School of Hygiene and Tropical Medicine. “The progress is that now 53 percent, just over half that target population and it's a very large target population in some very difficult to reach places. Fifty-three percent of those people now report sleeping under an insecticide-treated net,” said Lines said. “That's fantastic."

Mosquitoes becoming resistant

As more insecticide is used to prevent malaria, however, the mosquitoes that transmit the disease are becoming resistant. "Insecticide resistance is spreading very rapidly. Now that we're achieving those high levels of coverage, it's spreading more rapidly than ever and becoming really strong in some places,” said Lines. “So there are places in Africa that now report that their mosquitoes can stand one thousand times the dose of the original population.”

Workers look for holes in mosquito netting at the A to Z Textile Mills factory producing insecticide-treated nets in Arusha, Tanzania.​

Diagnostic testing for malaria has also increased sharply in the last five years allowing for the rapid prescription of life-saving treatment, particularly for children. "What's clear now is that we need to do a much more differentiated set of interventions,” said Lines. “We need to tailor what we do to each place.”

Funding has waned

 

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Dat's why Granny always tellin' Uncle Ferd to plug uppa holes inna walls...

Study: Better Housing a Powerful Tool for Malaria Prevention
February 28, 2017 - Improving housing conditions may provide a boost to malaria prevention at a time when other efforts may be losing steam, according to new research.

As Africa rapidly moves away from traditional mud-and-thatch housing, experts see a chance for architects and urban planners to join the fight against the disease. Bed nets and indoor insecticide spraying have been extremely effective in curtailing malaria. Rates are down by about 40 percent worldwide. But these efforts are not enough. More than 400,000 people died of the disease in 2015, mostly African children, according to the World Health Organization. And mosquitoes are becoming resistant to the insecticides.

A Sudanese woman suffering from malaria sits inside her makeshift house in Golo, Fashoda county in Upper Nile State​

At the same time, researchers are seeing a transition across Africa. Traditional mud-walled, thatch-roofed housing is being replaced by more modern construction, with concrete walls and metal or tile roofs. Housing is also changing as the continent experiences among the world's fastest rates of urbanization. As these transitions take place, "We have an opportunity to tap into the changes that are ongoing in many parts of Africa in order to build healthier housing," says University of Oxford epidemiologist Lucy Tusting, lead author of the new study in the journal PLOS Medicine.

Housing as a public health tool

Most mosquitoes that carry the malaria parasite bite indoors at night. So better-quality housing, with fewer gaps in the walls and ceiling where insects can get in, should help prevent the disease. Using housing as a public health tool against malaria is not a new idea. Screened windows and doors were the very first effective technique used to prevent the disease in the early 20th century. But there hasn't been much research on the subject. Tusting and colleagues looked at health and demographic surveys from 21 countries. They found that children living in modern-construction homes were 9-to-14 percent less likely to have malaria than those living in traditional housing.

That's similar to the level of protection insecticide-treated bed nets provided. Children sleeping under bed nets had 15-to-16 percent lower odds of malaria infection than those who did not. That's not to diminish the importance of bed nets, Tusting says. As Africa's population expands rapidly, she adds, "We can leverage those changes. But to do so, it's important for health specialists to reach beyond the health sector" and work with architects, urban planners and policymakers to build malaria prevention into the habitat of the continent's growing cities.

Study: Better Housing a Powerful Tool for Malaria Prevention

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Common Bacteria Might Help Control Disease-Carrying Insects
February 27, 2017 | WASHINGTON — By using a common bacteria, scientists have figured out a way to potentially sterilize disease-carrying mosquitoes. That could make it possible to control the mosquito that spreads Zika and Dengue.

Wolbachia is a common bacteria that has the ability to infect up to 70 percent of the world's insect species. It has evolved in different ways — some insects even rely on it for their existence, but in others, it plays a parasitic role and can interfere with the viability of eggs.

Two genes may hold the key

Unfortunately, say experts, it doesn't infect many disease-carrying mosquitoes. But researchers may have found a way to use Wolbachia's sterilizing power on mosquitos that carry Dengue, and Zika. "It's kind of been the issue with the Wolbachia field is that all of the insects that are really, really medically relevant don't have their own Wolbachia infection,” said John Bechmann, an entomologist at Yale University in Connecticut. “So that's one reason why this is such an important discovery ... one thing that limited the field is people have always tried to make these fake or non-natural infections that can infect these mosquitoes," said Bechmann. "Now we don't have to do that. We can just put the genes in."

Researchers at Yale and Vanderbilt University in Tennessee have discovered two genes in Wolbachia that might make Aedes aegypti, the mosquito that carries Zika and Dengue, sterile. Experiments so far have been successfully performed in fruit flies, and researchers are optimistic that it will work in mosquitoes.

Two strategies outlined

The scientists reported success in two strategies to stop the spread of Zika and Dengue. One method was to flood the environment with male mosquitos carrying Wolbachia. When infected males and uninfected females mate, Wolbachia kills any eggs the female is carrying. The other approach that worked was introduce male and female mosquitos, both infected with Wolbachia, into a mosquito population.

Over time, the Wolbachia-infected mosquitos replaced the Zika- and Dengue-infected mosquitos by making them sterile. Two companion articles on the Wolbachia gene discovery were published in the journals Nature and Nature Microbiology. Bechmann says controlling these diseases may one day be as simple as breeding Wolbachia-carrying mosquitos in captivity then releasing into the wild.

Funding needed

"The problem has always been figuring out systems that work well in mosquitoes and this is one that's going to be great for that,” said Bechmann, who added that the technology also has the potential to work with Anopheles gambiae, the mosquito that carries malaria. Bechmann and colleagues are in the process of trying to get funding to conduct the research in mosquitoes. Because the mosquitoes are genetically modified, Bechmann says his biggest concern is overcoming regulatory hurdles to permit the release of altered, sterilized mosquitoes.

Common Bacteria Might Help Control Disease-Carrying Insects

 

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Malaria Outbreak in Burundi Reaches Epidemic Proportions...

Burundi Says Malaria Reaches Epidemic Proportions
March 14, 2017 - Health experts say more than 700 people have died of malaria so far this year in Burundi, prompting the government to declare the disease an epidemic.

The determination was based on findings of a survey by Burundian and World Health Organization experts, said Josiane Nijimbere, Burundi’s Minister of Health. She said there have been 1.8 million cases of malaria registered since the beginning of the year — a huge number in a country with a population of less than 11 million.

The minister attributed the increase of malaria partly to climate change. “There is a strong association between malaria and warm temperatures, which have led to significant increase in malaria cases because of the spread of mosquitoes,” Nijimbere told reporters Monday.

A woman sits with her child at a health clinic in Bujumbura, Burundi, Apr. 18, 2006. More than one million people die from malaria every year, almost 90 percent are in Africa.​

According to the World Health Organization, some 8.2 million Burundians — 73 percent of the total population — were affected by malaria in 2016. More than 3,800 died. The health minister said government is dispatching doctors and health care providers to villages to care for patients who cannot afford to go to hospitals. The government says it needs at least $31 million to fight the epidemic.

Aid agencies have warned that Burundi’s ongoing political crisis is hurting the economy and contributing to a humanitarian crisis. The small African country has been in turmoil since President Pierre Nkurunziza ran for a controversial third term in 2015. Some 400,000 Burundians have fled to neighboring countries to escape political violence and reported human rights abuses. A U.N. report last month said the number of people in need of assistance increased from 1.1 million to at least 3 million.

Burundi Says Malaria Reaches Epidemic Proportions