Preventive Measures and Treatment of Drug Resistant Malaria

Author(s):  
Dilip Kumar Gupta ◽  
B. K. Razdan ◽  
Meenakshi Bajpai

Malaria is mostly a preventable but devastating parasite disease widely prevalent in underdeveloped countries. Malaria is a vector-borne infectious disease caused by the protozoan Plasmodium parasites. The annual incidence of malaria is about 515 million people and malaria mortality accounts for nearly 3 million people, the majority of whom are young children in sub-Saharan Africa. Malaria is widespread in tropical and subtropical regions, including parts of the Americas, Asia, and Africa. Due to climate change and the gradual warming of the temperate regions the future distribution of the malaria disease might include regions which are today seen as safe. Currently, malaria control requires an integrated approach comprising of mainly prevention, including vector control and the use of effective prophylactic medicines, and treatment of infected patients with antimalarial drugs. The antimalarial chloroquine, which was in the past a mainstay of malaria control, is now ineffective in most malaria areas and resistance to other antimalarial drugs is also increasing rapidly. Artemisinin-based Combination Therapies (ACTs) are now generally considered as the best current treatment for uncomplicated Plasmodium falciparum malaria. Such combination therapies are currently recommend by the World Health Organization because of widespread resistance of the disease to conventional drug therapies, such as chloroquine, sulfadoxine, pyrimethamine and amodiaquine, has increased. ACTs are the most effective drug treatments currently. ACTs produce a very rapid therapeutic response to malaria and should be adopted worldwide

2017 ◽  
Vol 2 ◽  
pp. 57 ◽  
Author(s):  
David Kyalo ◽  
Punam Amratia ◽  
Clara W. Mundia ◽  
Charles M. Mbogo ◽  
Maureen Coetzee ◽  
...  

Background: Understanding the distribution of anopheline vectors of malaria is an important prelude to the design of national malaria control and elimination programmes. A single, geo-coded continental inventory of anophelines using all available published and unpublished data has not been undertaken since the 1960s. Methods: We have searched African, European and World Health Organization archives to identify unpublished reports on anopheline surveys in 48 sub-Saharan Africa countries. This search was supplemented by identification of reports that formed part of post-graduate theses, conference abstracts, regional insecticide resistance databases and more traditional bibliographic searches of peer-reviewed literature. Finally, a check was made against two recent repositories of dominant malaria vector species locations (circa 2,500). Each report was used to extract information on the survey dates, village locations (geo-coded to provide a longitude and latitude), sampling methods, species identification methods and all anopheline species found present during the survey. Survey records were collapsed to a single site over time.    Results: The search strategy took years and resulted in 13,331 unique, geo-coded survey locations of anopheline vector occurrence between 1898 and 2016. A total of 12,204 (92%) sites reported the presence of 10 dominant vector species/sibling species; 4,473 (37%) of these sites were sampled since 2005. 4,442 (33%) sites reported at least one of 13 possible secondary vector species; 1,107 (25%) of these sites were sampled since 2005. Distributions of dominant and secondary vectors conform to previous descriptions of the ecological ranges of these vectors. Conclusion: We have assembled the largest ever geo-coded database of anophelines in Africa, representing a legacy dataset for future updating and identification of knowledge gaps at national levels. The geo-coded database is available on Harvard Dataverse as a reference source for African national malaria control programmes planning their future control and elimination strategies.


2021 ◽  
Vol 9 ◽  
Author(s):  
Adeola Onasanya ◽  
Michel Bengtson ◽  
Oladimeji Oladepo ◽  
Jo Van Engelen ◽  
Jan Carel Diehl

The control and elimination of schistosomiasis have over the last two decades involved several strategies, with the current strategy by the World Health Organization (WHO) focusing mainly on treatment with praziquantel during mass drug administration (MDA). However, the disease context is complex with an interplay of social, economic, political, and cultural factors that may affect achieving the goals of the Neglected Tropical Disease (NTD) 2021-2030 Roadmap. There is a need to revisit the current top-down and reactive approach to schistosomiasis control among sub-Saharan African countries and advocate for a dynamic and diversified approach. This paper highlights the challenges of praziquantel-focused policy for schistosomiasis control and new ways to move from schistosomiasis control to elimination in sub-Saharan Africa. We will also discuss an alternative and diversified approach that consists of a Systems Thinking Framework that embraces intersectoral collaboration fully and includes co-creating locally relevant strategies with affected communities. We propose that achieving the goals for control and elimination of schistosomiasis requires a bottom-up and pro-active approach involving multiple stakeholders. Such a pro-active integrated approach will pave the way for achieving the goals of the NTD 2021-2030 roadmap for schistosomiasis, and ultimately improve the wellbeing of those living in endemic areas.


2020 ◽  
Author(s):  
Stefan David Baral ◽  
Katherine Blair Rucinski ◽  
Jean Olivier Twahirwa Rwema ◽  
Amrita Rao ◽  
Neia Prata Menezes ◽  
...  

BACKGROUND SARS-CoV-2 and influenza are lipid-enveloped viruses with differential morbidity and mortality but shared modes of transmission. OBJECTIVE With a descriptive epidemiological framing, we assessed whether recent historical patterns of regional influenza burden are reflected in the observed heterogeneity in COVID-19 cases across regions of the world. METHODS Weekly surveillance data reported by the World Health Organization from January 2017 to December 2019 for influenza and from January 1, 2020 through October 31, 2020, for COVID-19 were used to assess seasonal and temporal trends for influenza and COVID-19 cases across the seven World Bank regions. RESULTS In regions with more pronounced influenza seasonality, COVID-19 epidemics have largely followed trends similar to those seen for influenza from 2017 to 2019. COVID-19 epidemics in countries across Europe, Central Asia, and North America have been marked by a first peak during the spring, followed by significant reductions in COVID-19 cases in the summer months and a second wave in the fall. In Latin America and the Caribbean, COVID-19 epidemics in several countries peaked in the summer, corresponding to months with the highest influenza activity in the region. Countries from regions with less pronounced influenza activity, including South Asia and sub-Saharan Africa, showed more heterogeneity in COVID-19 epidemics seen to date. However, similarities in COVID-19 and influenza trends were evident within select countries irrespective of region. CONCLUSIONS Ecological consistency in COVID-19 trends seen to date with influenza trends suggests the potential for shared individual, structural, and environmental determinants of transmission. Using a descriptive epidemiological framework to assess shared regional trends for rapidly emerging respiratory pathogens with better studied respiratory infections may provide further insights into the differential impacts of nonpharmacologic interventions and intersections with environmental conditions. Ultimately, forecasting trends and informing interventions for novel respiratory pathogens like COVID-19 should leverage epidemiologic patterns in the relative burden of past respiratory pathogens as prior information.


2021 ◽  
Vol 15 (1) ◽  
pp. 1-11
Author(s):  
Paul Mkandawire ◽  
Joseph Kangmennaang ◽  
Chad Walker ◽  
Roger Antabe ◽  
Kilian Atuoye ◽  
...  

Background/aims With coverage of antenatal care in sub-Saharan Africa approaching a universal level, attention is now turning to maximising the life-saving potential of antenatal care. This study assessed the gestational age at which pregnant mothers make their first antenatal visit in the context of high antenatal coverage in Lesotho. Methods For the purposes of this study, secondary data from the Demographic and Health Survey of 2014 was analysed. These data were collected in 2014, via an interviewer administered questionnaire. Survival analysis was applied to the data, using Stata SE 15 to compute time ratios that estimate time to first antenatal visit in Lesotho. Results Despite near universal coverage, only 24% of mothers start antenatal care before 12 weeks of gestation, as recommended by the World Health Organization. In addition, mothers with unwanted pregnancies are most likely to delay antenatal care until later in gestation, followed by mothers with mistimed pregnancies. Education, but not wealth, correlates with the start of antenatal care. Conclusions Having achieved near universal coverage, emphasising a prompt start and adherence to recommended visits could optimise the life-saving potential of antenatal care in Lesotho.


2019 ◽  
Vol 4 (2) ◽  
pp. 238146831989454
Author(s):  
Joe Brew ◽  
Christophe Sauboin

Background. The World Health Organization is planning a pilot introduction of a new malaria vaccine in three sub-Saharan African countries. To inform considerations about including a new vaccine in the vaccination program of those and other countries, estimates from the scientific literature of the incremental costs of doing so are important. Methods. A systematic review of scientific studies reporting the costs of recent vaccine programs in sub-Saharan countries was performed. The focus was to obtain from each study an estimate of the cost per dose of vaccine administered excluding the acquisition cost of the vaccine and wastage. Studies published between 2000 and 2018 and indexed on PubMed could be included and results were standardized to 2015 US dollars (US$). Results. After successive screening of 2119 titles, and 941 abstracts, 58 studies with 80 data points (combinations of country, vaccine type, and vaccination approach–routine v. campaign) were retained. Most studies used the so-called ingredients approach as costing method combining field data collection with documented unit prices per cost item. The categorization of cost items and the extent of detailed reporting varied widely. Across the studies, the mean and median cost per dose administered was US$1.68 and US$0.88 with an interquartile range of US$0.54 to US$2.31. Routine vaccination was more costly than campaigns, with mean cost per dose of US$1.99 and US$0.88, respectively. Conclusion. Across the studies, there was huge variation in the cost per dose delivered, between and within countries, even in studies using consistent data collection tools and analysis methods, and including many health facilities. For planning purposes, the interquartile range of US$0.54 to US$2.31 may be a sufficiently precise estimate.


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