Category Archives: Malaria/ Tuberculosis

Photo of the Week: Frontline Health Workers Count #Zambia

Frontline Health Workers

I walked quickly beside Dismus Mwalukwanda on a sandy path bordered by overgrown shrubbery leading through the bush to rural homes outside of Lusaka, Zambia’s capital. Mwalukwanda, 43, is a frontline health worker for the Njovo Village and took me to visit a family whose young children he has treated often for malaria. Mwalukwand is in charge of helping families in his area make steps toward malaria prevention like ensuring the use of bed nets and he also tests and treats patients who come down with malaria. During the rainy season Mwalukwanda, who is married and has eight children, can see 25 homes a day. Read more.

Researcher Advocates New Way to Develop Malaria Vaccine

Currently there is no effective vaccine to protect against malaria even though the disease kills 600,000 people annually and 3.4 billion people worldwide are at risk of contracting the debilitating and potentially fatal disease. 90 percent of all malaria deaths occur in sub-Saharan Africa according to the World Health Organization.

The Malaria Vaccine Technology Roadmap set a strategic goal in 2006 to develop and license a vaccine by 2025, more than ten years away. While there has been some successful headway into this effort, all researchers and pharmaceutical companies that work in this field admit that a malaria vaccine is years, probably decades away.

Every year seemingly, researchers report a breakthrough in developing a malaria vaccine. Substantial chatter was made in 2013 among global health experts and the national news that the first vaccine that protected 100% of its test field against the mosquito-bourne disease was discovered. The researchers did, however, use a weakened form of malaria that was radiated and then frozen. While substantial progress was made, it is without doubt that a vaccine is light years away in research and pharmaceutical estimations.

An Australian researcher from the University of Adelaid, Associate Professor Milton McAllister, argued in his latest paper that harnessing the knowledge from animal-based protozoal vaccines will create notable progress in the development of a human malaria vaccine.

“There is one vaccine in development for malaria – but that requires three inoculations and only about half the people vaccinated are protected, and that protection only lasts for about six months”, said McAllister. “Vaccines for similar diseases in cattle and sheep, on the other hand, require only one inoculation and provide solid immunity that endures for more than a year and often covers the life of the animal.”

Cambridge University recently chose Professor McAllister’s research as their “paper of the week”.

“For human malaria, great emphasis has been placed on creating new types of futuristic vaccines using small pieces of DNA and protein from the disease-causing parasite,” says Associate Professor McAllister. “There is a great desire to make malaria vaccines very safe – as they should be – but that approach has just not been effective.”

It may be a stretch to use veterinary science to create a human malaria vaccine, but thinking outside of the box may eventually prove useful. Only time will tell.

Read Professor McAllister’s research at Successful vaccines for naturally occurring protozoaldiseases of animals should guide human vaccine research: A review of protozoal vaccines and their design.

UN Photo/Catianne Tijerina

President’s Malaria Initiative Releases New Report

For those of you who love global health data, the President’s Malaria Initiative (PMI) launched its latest report, the Eighth Annual Report to Congress, last week. Drawing on cumulative country data gathered over the course of fiscal year 2013 as well as over the last eight years when PMI launched we learn pertinent milestones that have been achieved to scale malaria control efforts such as:

  • More than 21 million people were protected as a result of PMI-supported indoor residual spraying in FY 2013.
  • More than 123 million insecticide-treated mosquito nets have been procured and more than 81 million distributed since PMI began.
    Mother picking up an insecticide treated bed net
  • More than 237 million life-saving antimalarial treatments have been procured and more than 185 million distributed since PMI began.
  • More than 114 million rapid diagnostic tests have been procured and more than 67 million distributed since PMI began.
    Rapid diagnostic test - Macha Malaria Hopsital, Macha, Zambia
  • More than 29 million intermittent preventive treatments for pregnant women have been procured and more than 17 million distributed since PMI began.
  • More than 61,000 health workers were trained on case management in FY 2013

Dismus - Frontline Health Worker

These targeted malaria control efforts are helping to keep more children and pregnant women alive when they contract malaria as the infectious disease is wholly preventable and treatable, even for those who have weak immune systems. In fact, malaria deaths dropped 25% between 2000 – 2012.

The report provides detailed data per country where PMI works as well as overall data over time for malaria control interventions. Space is dedicated to handling counterfeit and damaged malaria medicines and a thorough explanation of partnerships is given with examples of those that are particularly effective.

At 50 pages of malaria data, this report is an effective resource for data gathering when you might be in need of quality numbers on malaria control throughout sub-Saharan Africa.

Photos: Jennifer James

Malaria No More Launches #MalariaSucks Campaign

As you might know last Friday marked World Malaria Day, a day to encourage the global health community, the private sector, governments, NGOs, and everyday, ordinary people to keep up the fight to help defeat malaria.

Every minute a child dies of malaria somewhere in the world, most of whom live in sub-Saharan Africa. In fact, 90% of children who die from malaria live in Africa and 40% of those live in Nigeria and the Democratic Republic of the Congo, according to WorldMalariaDay.org. There is encouraging news, however. From 2000 – 2012 3.3 million lives were saved due to scaled up malaria control interventions. What many might not understand is that malaria is completely preventable and treatable, a fact that is repeatedly reiterated by the World Health Organization and others. Interventions such a insecticide-treated bed nets, residual indoor spraying, and draining of stagnant water helps to control malaria. One of the reasons many children, especially those under the age of five, die from malaria is because they are not treated in time or remote areas do not have access to rapid diagnostic tests and treatments.

Chongwe District Hospital
A mother and son in Chongwe District Hospital outside of Lusaka, Zambia. He was recovering from a severe bought of malaria. Copyright: Jennifer James

Malaria No More, an international NGO that is determined to end malaria, launched its Malaria Sucks campaign on World Malaria Day that encourages donations, as low as $1, to help save more children from dying from malaria. Malaria Sucks’ icon is an orange lollipop that signifies what children in malaria prone areas miss out on – their childhoods. One donated dollar goes to rapid diagnostic testing and full treatment for one child, so a dollar indeed makes a difference.

Celebrities have taken on the issue like Anthony Bourdain and James Ven Der Beek who tweeted their support of the Malaria Sucks campaign.

“MalariaSUCKS is a fun, tangible way for supporters to connect to an issue that may seem distant from their everyday lives,” said Malaria No More CEO Martin Edlund in a statement. “We’re putting our supporters in the spotlight – asking them to help us create real change through an everyday activity like posting a selfie and spreading a powerful humanitarian message through their social networks. It’s our pink ribbon, only sweeter.”

Global social engagement is key to the success of the campaign and Malaria No More is making it fun. Anyone can join the conversation by donating money to www.MalariaNoMore.org/MalariaSUCKS and by posting to #MalariaSucks.

#MalariaSucks http://malarianomore.org/malariasucks

A photo posted by A. Yancey (@fancyayancey) on

You can also generate a lollipop selfie and share with your friends. Here’s mine.

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Visit www.MalariaNoMore.org/MalariaSUCKS to save a life.

Full disclosure: I traveled to Zambia with Malaria No More in October 2013 to cover the global launch of its Power of One campaign.

New Needle-Free Malaria Test Could Be a Game Changer

One of the most effective advancements in malaria testing has been the rapid diagnostic test. Easy to use and inexpensive it cut the wait time for diagnostics drastically and has made testing and treatment easier for frontline health workers around the world particularly in sub-Saharan Africa where the prevalence of malaria is the highest. In countries like Zambia, for example, malaria treatments are up and the mortality rate for children under the age of five has decreased due in large part to rapid diagnostic tests.

Now a new rapid diagnostic test may potentially be even more effective by not requiring a blood sample, but rather using a laser pulse to detect malaria infection. According to the New York Times the new rapid diagnostic test created by a team of researchers at Rice University led by physicist Dmitri O. Lapotko has the potential to diagnose one person every 20 seconds for a mere 50 cents. As it stands now a rapid diagnostic test can diagnose one person every fifteen minute and costs $1.

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Example of rapid diagnostic test used today.

The potential to save lives from malaria deaths, especially children under the age of five and expectant mothers, could be markedly improved with this new laser malaria diagnostic test. Thus far testing mice produced no false positives. Clinical trials with people begin in two weeks. This new test can become another game changer in the fight to reduce malaria deaths.

Increased International Travel Spurs U.S. Malaria Cases

I travel to many malaria endemic countries and to be completely honest I do not take my malaria medicine as I should. They tend to make me ill, so I just roll the dice and hope for the best. That might not be the smartest thing to do, especially knowing that there has been a marked increase in the number of malaria cases reported in the United States due to increased international travel. In fact, the number of malaria cases in the United States is the highest in forty years.

The CDC says that in 2011 1,925 malaria cases were reported in the United States. That is the highest number since 1971. The number is also 48% higher than 2008. The CDC says that only about half of international travelers routinely take their antimalarials. I am keenly in the other half of those travelers. I do take precautions, however, by using a bed net (even though many I’ve slept under have holes) and I try not to go out at night or I wear long sleeves and pants.

“The CDC provides actual maps and very good recommendations for travelers,” said Kristin Michel, an associate professor of biology at Kansas State University who studies the Anopheles gambiae s.s. mosquitoes, the species most responsible for malaria transmission in Africa. “Anybody who travels outside of the U.S. into potentially endemic area needs to consult the CDC website and/or their physician and ensure that they have the right prophylaxis.”

All it takes is one bite and I could contract malaria. I know. Although malaria cases are decreasing in malaria endemic countries like Zambia and Tanzania where children under the age of five are most vulnerable, the number of Americans who are coming home with malaria, as aforementioned, is increasing. Five people died in the United States from malaria in 2011. Two-thirds of the malaria cases were imported from Africa.

CDC - Malaria Map

“The CDC provides actual maps and very good recommendations for travelers,” said Michel. “Anybody who travels outside of the U.S. into potentially endemic area needs to consult the CDC website and/or their physician and ensure that they have the right prophylaxis.”

[Photos] Inside a Malaria Treatment Center

I have been told enough harrowing personal stories and have read enough reports to understand contracting malaria isn’t a cakewalk. And for children (especially those under the age of five) and expectant mothers malaria can be deadly. Fortunately with rapid diagnosis and malaria treatments children as well as adults can experience speedy recoveries from a disease that is both debilitating and potentially fatal.

While in Zambia last month I visited the Chongwe District Hospital in Lusaka province with Malaria No More to see how robust malaria control efforts funded by the Zambian government, USAID, the Global Fund and other NGOs and private foundations have helped drastically reduced the number of child deaths in the country. Zambia has effectively reduced the number of malaria deaths to 8000 annually through prevention measures including mass distributions of mosquito nets, indoor residual spraying, fogging, and spraying of mosquito-infected areas like bogs and dambos (shallow wetlands). The annual deaths have also been reduced because of the mass test and treatment programs that are being administered by frontline health workers around the country. Unfortunately, the vast majority of these deaths are children under the age of five because their immune systems cannot fight off the disease without the help of a positive diagnosis and follow-up medications.

In Zambia 50% of children are admitted to hospitals due to malaria according to UNICEF. You must also understand that being admitted to a hospital means that frontline health care didn’t work and that hospital care is necessary. In Zambia as well as in most developing countries, most healthcare is done on the local level. Most severe cases are referred to hospitals as was the case of these three children I met in the Chongwe District Hospital located about an hour outside of Lusaka.

While malaria is wholly preventable and treatable some children still struggle getting better when they contract the infectious disease. This little boy was extremely sick, but was steadily getting better. I took his picture as he slept with the permission of his mother who was sitting lovingly at his side.

Chongwe District Hospital Chongwe District Hospital
This little boy played with his mother’s hands and reached to breastfeed as he laid beside her. He had one of the sweetest faces I’ve ever seen and was quickly on the mend from his bout of malaria.
Chongwe District Hospital This little boy, who was snuggled with his mother, was also feeling better than before, but was quite lethargic. There are stages children have to go through to get better. Doctors had a positive prognosis for his eventual improvement. Chongwe District Hospital

By 2015, Zambia has a goal of having 100% of malaria cases are diagnosed and treated with Coartem on the community and health post level. While that goal hasn’t been achieved yet, Zambia with the expertise of Path’s MACEPA program and countrywide campaigns such as Power of One is helping Zambia steadily stand behind its commitment.

Can $1 Really Save a Life?

Can $1 really save a life? Global malaria eradication NGO, Malaria No More, says yes.

With Power of One (Po1), Malaria No More’s new, innovative campaign that takes the power of people’s desire to do good coupled with a low price point to online and mobile philanthropy, Malaria No More is on a mission to close the perpetual gaps between malaria testing and treatment in some of the countries where children are hardest hit by malaria.

Malaria is one of the leading causes of child deaths in developing countries. In fact, 330 billion people live in malaria prone areas and 90 percent of all malaria deaths occur in sub-Saharan Africa according to the World Health Organization. A more drastic fact is a child dies every minute from malaria, however these deaths are wholly preventable with early diagnosis and adequate treatment with malaria medicines.

Health Worker - Macha Malaria Institute
A malaria rapid diagnostic test being administered to a volunteer at Macha Malaria Research Institute in Macha, Zambia.

The problem is many children under five who live in remote areas in Africa don’t get diagnosed with malaria and treated quickly enough. Therein lies the big tragedy: a lack of access to malaria testing and medication causes 1400 deaths a day.

Through Power of One, anyone can donate $1 to save the life of a child. $1, according to Malaria No More, will provide testing and medication to a single child through the help of private sector partners such as Novartis and Alere . Malaria No More seeks to reach 3 million children in Zambia, the first country where the Power of One campaign will be rolled out. Zambia has already shown successes in its malaria control efforts through increased rapid diagnostic testing, increased bed net allocations, as well as through mobile rapid reporting systems that allow volunteer frontline health workers to report malaria cases as well as the number of or need for more malaria medical supplies in the most remote areas of the country.

To learn more and donate, visit  www.Po1.org and watch the quick video introduction about how your investment of $1 will save a child’s life.

Sanitation Wisdom from a Zambian Chief #ZambiaHealth

As you may know I am in Zambia with the International Reporting Project as a New Media fellow. Ten of us are here in the country to report on HIV/AIDS, malaria, tuberculosis and other rarely covered stories in the region.

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Yesterday we visited Macha, a small Southern province town 60 miles from the nearest city, Choma. Macha is the home of the Malaria Institute at Macha, an institute that has successfully reduced the number of malaria cases in the area by 90 percent. The vast majority of the residents of Macha are subsistence farmers who live on small homesteads.

In order to achieve such an unprecedented reduction in malaria cases,  the will of the community must first be achieved through the area chief. Chief Macha was the conduit through which much of the malaria success took place.

We were invited to Chief Macha’s palace to speak to him about how he fights HIV/AIDS, but instead he wanted to speak to us about sanitation and health. Now that malaria has been controlled in Macha, Chief Macha has taken up a new cause – village sanitation. In fact, last year Chief Macha was honored as a UNICEF Zambia Supporter for Sanitation.

He spoke to us about his philosophy about ensuring every homestead has its own pit latrine and how he created a 100 percent Open Defecation Free community.

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“You cannot do anything without your health.” – Chief Macha

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“Food and sanitation must be fought the world over. – Chief Macha

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“We should all be sanitation drivers.”  – Chief Macha

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“I have given myself to sanitation.” – Chief Macha

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“Without clean water you have a problem with disease. If you drink dead water you come down with diarrhea.” – Chief Macha

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“If you have the will, things can be done.” – Chief Macha

Photos:  Jennifer James

Reporting from Zambia with the International Reporting Project

As I mentioned a few weeks ago I will be reporting from Zambia as an International Reporting Project Zambia Fellow starting on July 15. I will be in Africa with nine stellar new media journalists. We all have our own beats and will report on different angles about HIV/AIDS, tuberculosis, and malaria. I personally will report on how these infectious diseases acutely affect mothers and children.

You can follow my work on the Gates Foundation blog, Impatient Optimists. You can follow all of our work at the #ZambiaHealth hashtag. You can also follow my personal observations at jjamesonline.com.

Photo:

Children sing at the Fountain of Hope centre in Lusaka, Zambia, during a visit from Secretary-General Ban Ki-moon. The centre helps to rehabilitate thousands of children living on the streets of the Zambian capital.
25 February 2012
Lusaka, Zambia