Suchergebnisse

In 2016, 91 countries reported a total of 216 million cases of malaria, an increase of 5 million cases over the previous year, and the estimated malaria deaths worldwide were 445,000 like in 2015. This suggests that despite a substantial reduction in the malaria burden observed since 2010, largely attributed to the scale-up of effective control measures (vector control interventions, efficacious antimalarial treatment), the rate of decline of both clinical cases and malaria deaths has stalled since 2014 and in some regions even reversed. Achieving universal access to standard control interventions, such as case management, implementation of vector control methods, seasonal malaria chemoprevention, and intermittent preventive treatment for pregnant women, remains a priority. It is essential to contain emerging drug resistance in malarial parasite and insecticide resistance in mosquito vector species. Additional new interventions to accelerate interruption of transmission are in crucial need for their rapid integration within the standard control activities. These integrated control approaches must be implemented at community level with the active involvement of the local populations to reach high coverage. Finally, political and financial supports should be maintained and even doubled to reach the 2030 targets of the WHO global technical strategy for malaria.

Background: The Australian Government's Pacific Malaria Initiative (PacMI) is supporting the National Malaria Program in both Solomon Islands and Vanuatu, complementing assistance from the Global Fund for AIDS, Tuberculosis and Malaria (GFATM). Two remote island groups - Tafea Province, Vanuatu and Temotu Province, Solomon Islands have been selected by the governments of both countries as possible malaria elimination areas. To provide information on the prevalence and distribution of the disease within these island groups, malariometric surveys were conducted during the wet seasons of 2008. Methods: In Tafea Province, a school-based survey was conducted which included the 2-12 y age group, while in Temotu a village based all-ages survey was conducted. An effort was made to sample villages or schools from a wide an area as possible on all islands. Diagnosis was initially based on Giemsa stained blood slides followed by molecular analysis using polymerase chain reaction (PCR). Results: In Tafea Province, 73% (5238/7150) of children (2-12 y) were surveyed and in Temotu Province, in the all-ages survey, 50.2% (8742/17410) of the provincial population participated in the survey. In both Vanuatu and Solomon Islands malariometric surveys of their southern-most islands in 2008 showed relatively low over-all malaria parasite prevalence (2 to 3%). Other features of malaria in these island groups were low parasitaemia, low gametocyte carriage rates, low spleen rates, low malaria associated morbidity, a high incidence of asymptomatic infections, and a predominance of Plasmodium vivax over Plasmodium falciparum. Conclusion: For various reasons malaria rates are declining in these provinces providing a favourable situation for local malaria elimination. This will be advanced using mass distribution of bed nets and selective indoor residual spraying, the introduction of rapid diagnostic tests and artemisinin combination therapy, and intensive case detection and surveillance. It is as yet uncertain whether malaria parasites can themselves be sustainably eliminated from entire Melanesian islands, where they have previously been endemic. Key issues on the road to malaria elimination will be continued community involvement, improved field diagnostic methods and elimination of residual P. vivax parasites from the liver of asymptomatic persons.

Cabo Verde hasn't had a case of malaria in three years. It once had the deadly disease on all ten of its islands.We live in a time when there is a lot of tough news related to our struggle against poverty and poverty-enhanced disease. By some estimates, nearly 7 million people have died from COVID-19, and the virus's economic costs have been catastrophic for families, communities, and countries the world over.However, there is renewed hope for progress in tackling one of the world's greatest killers: malaria. Caused by more than 100 types of parasites, malaria enters the body through the bite of the female Anopheles mosquito and contaminates the bloodstream. While the US successfully eliminated the disease as a public health threat in 1951, half the world remains at risk of infection according to Malaria No More, a global organization that mobilizes political commitments and funding for malaria eradication.This January, Cabo Verde joined the ranks of 43 nations and one territory certified as malaria-free by the World Health Organization (WHO)—a remarkable achievement highlighted by Secretary of State Antony Blinken during his recent trip to the country's capital of Praia. Cabo Verde's malaria-free status is especially important in a country where tourism accounts for nearly a quarter of its GDP. Thanks to the US President's Malaria Initiative, the Global Fund to Fight AIDS, Tuberculosis, and Malaria, and dedicated health leadership in participating countries over the last two decades, the world has made substantial progress in reducing the disease's spread and associated deaths. However, the COVID-19 pandemic saw momentum against the disease reduced (and in some places even reversed) for a variety of reasons. Cabo Verde's success story serves as a reminder of what can be achieved if global health leaders refocus their efforts on eradicating malaria once again. Taking on the malaria scourge requires a multi-pronged approach: carefully investigating, diagnosing, and counting malaria cases; providing ill individuals with free, effective, and early treatment; and preventing new cases by administering medicines, controlling mosquito breeding areas, and providing insecticide-treated mosquito nets. To be sure, Cabo Verde's path to eliminating malaria had its difficult moments. In 2017, the country reported 184 cases, marking its worst outbreak in more than 20 years. But Cabo Verde made the right investments. When it achieved independence less than 50 years ago, it had only 13 doctors. Today, 80% of its citizens live within 30 minutes of a healthcare facility.So why is any of this newsworthy and important? Despite great strides, malaria continues to claim approximately 600,000 lives each year—and 95% of these deaths occur in Africa. The 2023 World malaria report found that just four countries make up nearly half of the world's malaria cases: Nigeria, the Democratic Republic of the Congo, Uganda, and Mozambique. And even more tragically, the WHO reports that 80% of malaria deaths in the region are children under the age of five. Even for those who survive their bout with the disease, malaria has severe long-term costs and consequences. Sick children are unable to attend school and fall behind on their lessons. In fact, malaria keeps kids out of school more than any other disease. Sick adults are unable to work, straining family incomes and limiting national economic growth. While Malaria No More estimates that $12 billion is lost as a direct result of malaria infections, the true cost of lost growth potential is immeasurable. Measures to prevent malaria's spread have saved many millions of lives, and new vaccine developments offer renewed hope for a malaria-free future. Cameroon is currently rolling out the world's first malaria vaccine—RTS,S, or Mosquirix—following successful trials in Ghana, Kenya, and Malawi. As of November 2023, more than 2 million children had received a vaccination, leading to a 13% decrease in early childhood deaths across the three countries. Another 17 nations are waiting in the wings for their own vaccine rollout. And a second vaccine to help keep up with demand, R21/Matrix-M, is undergoing clinical trials.Cabo Verde may soon have company with its malaria-free status. Sao Tome and Principe, as well as the Comoros, reported no malaria deaths for the first time in 2022. Botswana, Eritrea, and Eswatini have each reported less than 10 malaria deaths. And while it is difficult to know the true impact of malaria treatments and preventative measures, the WHO calculates that 2.1 billion cases of malaria were averted globally between 2000 to 2022. It's true that Cabo Verde is a small archipelago—and São Tomé and Principe, along with the Comoros, are also small nations. Their makeup and geography offer advantages in taking on diseases like malaria. Importantly, they also offer proof of concept. They show that with focus, leadership, tools, and discipline, we can defeat diseases that have stolen lives as far back as we can measure—and they offer hope.This blog was researched and drafted with the assistance of Katherine Schauer.

Cabo Verde hasn't had a case of malaria in three years. It once had the deadly disease on all ten of its islands.We live in a time when there is a lot of tough news related to our struggle against poverty and poverty-enhanced disease. By some estimates, nearly 7 million people have died from COVID-19, and the virus's economic costs have been catastrophic for families, communities, and countries the world over.However, there is renewed hope for progress in tackling one of the world's greatest killers: malaria. Caused by more than 100 types of parasites, malaria enters the body through the bite of the female Anopheles mosquito and contaminates the bloodstream. While the US successfully eliminated the disease as a public health threat in 1951, half the world remains at risk of infection according to Malaria No More, a global organization that mobilizes political commitments and funding for malaria eradication.This January, Cabo Verde joined the ranks of 43 nations and one territory certified as malaria-free by the World Health Organization (WHO)—a remarkable achievement highlighted by Secretary of State Antony Blinken during his recent trip to the country's capital of Praia. Cabo Verde's malaria-free status is especially important in a country where tourism accounts for nearly a quarter of its GDP. Thanks to the US President's Malaria Initiative, the Global Fund to Fight AIDS, Tuberculosis, and Malaria, and dedicated health leadership in participating countries over the last two decades, the world has made substantial progress in reducing the disease's spread and associated deaths. However, the COVID-19 pandemic saw momentum against the disease reduced (and in some places even reversed) for a variety of reasons. Cabo Verde's success story serves as a reminder of what can be achieved if global health leaders refocus their efforts on eradicating malaria once again. Taking on the malaria scourge requires a multi-pronged approach: carefully investigating, diagnosing, and counting malaria cases; providing ill individuals with free, effective, and early treatment; and preventing new cases by administering medicines, controlling mosquito breeding areas, and providing insecticide-treated mosquito nets. To be sure, Cabo Verde's path to eliminating malaria had its difficult moments. In 2017, the country reported 184 cases, marking its worst outbreak in more than 20 years. But Cabo Verde made the right investments. When it achieved independence less than 50 years ago, it had only 13 doctors. Today, 80% of its citizens live within 30 minutes of a healthcare facility.So why is any of this newsworthy and important? Despite great strides, malaria continues to claim approximately 600,000 lives each year—and 95% of these deaths occur in Africa. The 2023 World malaria report found that just four countries make up nearly half of the world's malaria cases: Nigeria, the Democratic Republic of the Congo, Uganda, and Mozambique. And even more tragically, the WHO reports that 80% of malaria deaths in the region are children under the age of five. Even for those who survive their bout with the disease, malaria has severe long-term costs and consequences. Sick children are unable to attend school and fall behind on their lessons. In fact, malaria keeps kids out of school more than any other disease. Sick adults are unable to work, straining family incomes and limiting national economic growth. While Malaria No More estimates that $12 billion is lost as a direct result of malaria infections, the true cost of lost growth potential is immeasurable. Measures to prevent malaria's spread have saved many millions of lives, and new vaccine developments offer renewed hope for a malaria-free future. Cameroon is currently rolling out the world's first malaria vaccine—RTS,S, or Mosquirix—following successful trials in Ghana, Kenya, and Malawi. As of November 2023, more than 2 million children had received a vaccination, leading to a 13% decrease in early childhood deaths across the three countries. Another 17 nations are waiting in the wings for their own vaccine rollout. And a second vaccine to help keep up with demand, R21/Matrix-M, is undergoing clinical trials.Cabo Verde may soon have company with its malaria-free status. Sao Tome and Principe, as well as the Comoros, reported no malaria deaths for the first time in 2022. Botswana, Eritrea, and Eswatini have each reported less than 10 malaria deaths. And while it is difficult to know the true impact of malaria treatments and preventative measures, the WHO calculates that 2.1 billion cases of malaria were averted globally between 2000 to 2022. It's true that Cabo Verde is a small archipelago—and São Tomé and Principe, along with the Comoros, are also small nations. Their makeup and geography offer advantages in taking on diseases like malaria. Importantly, they also offer proof of concept. They show that with focus, leadership, tools, and discipline, we can defeat diseases that have stolen lives as far back as we can measure—and they offer hope.This blog was researched and drafted with the assistance of Katherine Schauer.

The role of malaria in Pacific prehistory has been the subject of considerable study and supposition. In this manuscript, I attempt to clarify the research and reasoning that has led me to suggest that the Austronesian‐speaking peoples had a selective advantage in malarious environments. In particular, I hope to dispel any notion that that advantage was due to resistance to malaria and to re‐affirm my actual assertion that the genetic basis for the Austronesian advantage was resistance to developing the hyperimmune disease, hyperreactive malarious splenomegaly. I believe that an appreciation of this distinction will ultimately prove to be essential to understanding the role of malaria in facilitating the spread of the Austronesians—in the form of people, languages, and/or genes—throughout the Pacific. [Pacific prehistory, malaria, natural selection, Austronesians, immunoglobulins]

Malaria draws global attention in a cyclic manner, with interest and associated financing waxing and waning according to political and humanitarian concerns. Currently we are on an upswing, which should be carefully developed. Malaria parasites have been eliminated from Europe and North America through the use of residual insecticides and manipulation of environmental and ecological characteristics; however, in many tropical and some temperate areas the incidence of disease is increasing dramatically. Much of this increase results from a breakdown of effective control methods developed and implemented in the 1960s, but it has also occurred because of a lack of trained scientists and control specialists who live and work in the areas of endemic infection. Add to this the widespread resistance to the most effective antimalarial drug, chloroquine, developing resistance to other first-line drugs such as sulfadoxine-pyrimethamine, and resistance of certain vector species of mosquito to some of the previously effective insecticides and we have a crisis situation. Vaccine research has proceeded for over 30 years, but as yet there is no effective product, although research continues in many promising areas. A global strategy for malaria control has been accepted, but there are critics who suggest that the single strategy cannot confront the wide range of conditions in which malaria exists and that reliance on chemotherapy without proper control of drug usage and diagnosis will select for drug resistant parasites, thus exacerbating the problem. An integrated approach to control using vector control strategies based on the biology of the mosquito, the epidemiology of the parasite, and human behavior patterns is needed to prevent continued upsurge in malaria in the endemic areas.

Background Malaria is an important cause of illness and death across endemic regions. Considerable success against malaria has been achieved within the past decade mainly through long-lasting insecticide-treated nets (LLINs). However, elimination of the disease is proving difficult as current control methods do not protect against mosquitoes biting outdoors and when people are active. Repellents may provide a personal protection solution during these times. Objectives To assess the impact of topical repellents, insecticide-treated clothing, and spatial repellents on malaria transmission. Search methods We searched the following databases up to 26 June 2017: the Cochrane Infectious Diseases Group Specialized Register; the Central Register of Controlled Trials (CENTRAL), published in the Cochrane Library; MEDLINE; Embase; US AFPMB; CAB Abstracts; and LILACS. We also searched trial registration platforms and conference proceedings; and contacted organizations and companies for ongoing and unpublished trials. Selection criteria We included randomized controlled trials (RCTs) and cluster-randomized controlled trials of topical repellents proven to repel mosquitoes; permethrin-treated clothing; and spatial repellents such as mosquito coils. We included trials that investigated the use of repellents with or without LLINs, referred to as insecticide-treated nets. Data collection and analysis Two review authors independently reviewed trials for inclusion, extracted the data, and assessed the risk of bias. A third review author resolved any discrepancies. We analysed data by conducting meta-analysis and stratified by whether the trials had included LLINs. We combined results from cRCTs with individually RCTs by adjusting for clustering and presented results using forest plots. We used GRADE to assess the certainty of the evidence. Main results Eight cRCTs and two RCTs met the inclusion criteria. Six trials investigated topical repellents, two trials investigated insecticide-treated clothing, and two trials investigated spatial repellents. Topical repellents Six RCTS, five of them cluster-randomized, investigated topical repellents involving residents of malaria-endemic regions. Four trials used topical repellents in combination with nets, but two trials undertaken in displaced populations used topical repellents alone. It is unclear if topical repellents can prevent clinical malaria (RR 0.65, 95% CI 0.4 to 1.07, very low certainty evidence) or malaria infection (RR 0.84, 95% CI 0.64 to 1.12, low-certainty evidence) caused by P. falciparum. It is also unclear if there is any protection against clinical cases of P. vivax (RR 1.32, 95% CI 0.99 to 1.76, low-certainty evidence) or incidence of infections (RR 1.07, 95% CI 0.80 to 1.41, low-certainty evidence). Subgroup analysis of trials including insecticide-treated nets did not show a protective effect of topical repellents against malaria. Only two studies did not include insecticide-treated nets, and they measured different outcomes; one reported a protective effect against clinical cases of P. falciparum (RR 0.40, 95% CI 0.23 to 0.71); but the other study measured no protective effect against malaria infection incidence caused by either P. falciparum or P. vivax. Insecticide-treated clothing Insecticide-treated clothing were investigated in trials conducted in refugee camps in Pakistan and amongst military based in the Colombian Amazon. Neither study provided participants with insecticide-treated nets. In the absence of nets, treated clothing may reduce the incidence of clinical malaria caused by P. falciparum by approximately 50% (RR 0.49, 95% CI 0.29 to 0.83, low-certainty evidence) and P. vivax (RR 0.64, 95% CI 0.40 to 1.01, low-certainty evidence). Spatial repellents Two cluster-randomized RCTs investigated mosquito coils for malaria prevention. We do not know the effect of spatial repellents on malaria prevention (RR 0.24, 95% CI 0.03 to 1.72, very low certainty evidence). There was large heterogeneity between studies and one study had high risk of bias. Authors' conclusions There is insufficient evidence to conclude topical or spatial repellents can prevent malaria. There is a need for better designed trials to generate higher certainty of evidence before well-informed recommendations can be made. Adherence to daily compliance remains a major limitation. Insecticide-treated clothing may reduce risk of malaria infection in the absence of insecticide-treated nets; further studies on insecticide-treated clothing in the general population should be done to broaden the applicability of the results.

A survey of 411 household heads was undertaken in Gokwe district, Zimbabwe, to assess villagers' knowledge, practices and perceptions about malaria and their implications for malaria control. Our results show that although the government has sustained an annual indoor insecticide spraying programme for over four decades, about 50% of respondents did not adequately understand its purpose, with 26% believing that the programme was intended to kill domestic pests, not including mosquitos. During the 1991-92 spraying cycle, 72% of the villagers had their homes sprayed. However, 21% of such villagers refused to have some rooms in their homes sprayed. Householders' understanding of the function of the spraying programme was significantly related to their compliance with it (P < 0.05). A total of 82% of respondents reported not taking any measures to protect themselves from malaria. Taking preventive measures was significantly related to knowledge of the causes of malaria (P < 0.05). The study shows the importance of involving communities in a control programme intended to be to their benefit and of informing them about available options for protection against malaria.

Bukit Menoreh is a border area of three regencies and two provinces which have malaria problems. The target to achieve and maintain the predicate as being free or has eliminated malaria was carried out byvarious control methods, either as government programs or community participations. The area itself is a Javanese cultural area in which its values are stronglyheld. This affects existing malaria control efforts. The research was conducted with a qualitative approach, held in three districts in Bukit Menoreh, each with 2 villages. The data was obtained through observations, indepth interview, and focus group discussions (FGD) with 3 groups in each village. The results showed that from the various control efforts carried out there was a culture of 'isin' (shame), 'pekewuh' (feeling of reluctant), and the influence of community leaders, especially in 'gotong royong' or community service activities in environmental cleanliness, health educations, and migration surveillance. The conclusion of this study is that some of these values are supportive, and some are hindering the effort to control malaria. Therefore, a special approach is needed with attention to culture. Intervention to control malaria should pay local wisdom and culture so it can be accepted and implemented. Abstrak Bukit Menoreh adalah daerah perbatasan tiga kabupaten dari dua provinsi yang merupakan daerah dengan masalah malaria. Target mencapai dan mempertahankan predikat bebas atau eliminasi malaria dilakukan dengan berbagai cara pengendalian, baik program dari pemerintah maupun peran serta masyarakat. Wilayah ini merupakan wilayah budaya Jawa yang di dalamnya terdapat nilai-nilai budaya yang masih kuat dipegang. Hal ini berpengaruh terhadap usaha pengendalian malaria yang ada. Penelitian dilakukan dengan pendekatan kualitatif, di tiga kabupaten di Bukit Menoreh masing-masing diambil dua desa. Data diperoleh melalui observasi, wawancara mendalam, dan diskusi kelompok terarah (DKT) terhadap tiga kelompok di tiap desa. Hasil penelitian menunjukkan dari berbagai usaha pengendalian malaria terdapat budaya rasa isin (malu), rasa ewuh (sungkan), dan panut (patuh) terhadap pengaruh tokoh dalam masyarakat terutama dalam kegiatan kerja bakti atau gotong royong kebersihan lingkungan, sosialisasi, dan surveilans migrasi. Penelitian ini menyimpulkan bahwa nilai tersebut ada yang mendukung dan ada yang menghambat usaha pengendalian malaria sehingga diperlukan pendekatan khusus dengan memperhatikan budaya. Kebijakan pengendalian malaria sebaiknya memperhatikan budaya lokal sehingga bisa menggunakan budaya lokal dan bisa diterima dan diterapkan.

Background: In 2005, a nationwide survey estimated that 6.5% of households in Ethiopia owned an insecticide-treated net (ITN), 17% of households had been sprayed with insecticide, and 4% of children under five years of age with a fever were taking an anti-malarial drug. Similar to other sub-Saharan African countries scaling-up malaria interventions, the Government of Ethiopia set an ambitious national goal in 2005 to (i) provide 100% ITN coverage in malarious areas, with a mean of two ITNs per household; (ii) to scale-up indoor residual spraying of households with insecticide (IRS) to cover 30% of households targeted for IRS; and (iii) scale-up the provision of case management with rapid diagnostic tests (RDTs) and artemisinin-based combination therapy (ACT), particularly at the peripheral level. Methods: A nationally representative malaria indicator survey (MIS) was conducted in Ethiopia between September and December 2007 to determine parasite and anaemia prevalence in the population at risk and to assess coverage, use and access to scaled-up malaria prevention and control interventions. The survey used a two-stage random cluster sample of 7,621 households in 319 census enumeration areas. A total of 32,380 people participated in the survey. Data was collected using standardized Roll Back Malaria Monitoring and Evaluation Reference Group MIS household and women's questionnaires, which were adapted to the local context. Results: Data presented is for households in malarious areas, which according to the Ethiopian Federal Ministry of Health are defined as being located <2,000 m altitude. Of 5,083 surveyed households, 3,282 (65.6%) owned at least one ITN. In ITN-owning households, 53.2% of all persons had slept under an ITN the prior night, including 1,564/2,496 (60.1%) children <5 years of age, 1,891/3,009 (60.9%) of women 15 - 49 years of age, and 166/266 (65.7%) of pregnant women. Overall, 906 (20.0%) households reported to have had IRS in the past 12 months. Of 747 children with reported fever in the two ...