Malaria: New Technology and Innovation

“Technology and innovation play a key role in the fight against malaria. Monitoring tools, as well as modeling and mapping malaria data, help us to better understand the disease and to fight”, believes the former president of Tanzania

 “When I was a kid, my brother died of malaria. If he had contracted the disease today, it would probably still be alive. This is the story of millions of Africans. It is something that our children should not live. We have made extraordinary progress, but we cannot stop now. The eradication of malaria in Africa is in sight,” he says. If you are interested in the current research on malaria, you look at this photo gallery.

 

Decline in malaria

Significant progress made over the past fifteen years in the fight against malaria. Since 2000, a 60% reduction in the rate of mortality due to malaria helped save approximately 6.2 million lives. At the same time, the rate of mortality due to malaria fell by 66% on the African continent for all categories of age and 71 percent among children under five years. Through modeling, the World Health Organization pointed out that the United Republic of Tanzania has reduced malaria cases by 50 to 75% between 2000 and 2015. Yes, we are moving a lot.

 

 

The effects of an effective treatment

When I was President of Tanzania, I was told that in a province of the country, 70 percent of children were missing school because of malaria. I sent my Minister of health on the spot to verify this, and I was surprised when he came back to tell me: “Yes, it’s well true. “There is an epidemic of malaria of unimaginable scale.” I then contacted the Ambassador of the United States in Tanzania, the members of the Initiative against malaria of the President and other partners, and together, we sent a team of doctors who have set up a camp in this province to come to the end of the problem. We have used three main types of interventions: combination artemisinin to effectively treat malaria, distribution of ITNs lasting insecticide, and the spraying of insecticide to effect Sticky inside dwellings. The following year, the school had reached 90%.

The importance of concerted action at the scale of the continent

If you effectively treat malaria in a country, but not in the neighboring country, you will be able to control the disease, but parasites will return from the neighboring country. I have discussed this with Ray Chambers, special envoy of the Secretary-General of the United Nations in charge of malaria in New York, and in September 2009 at the General Assembly of the United Nations, eight African heads of State joined me to launch the ALMA. Today, we have 49. ALMA focuses on the elimination of malaria in Africa by 2030. ALMA now meets twice a year at the summits of the African Union and relies on the ALMA score cards to track progress and actions. Whenever the ALMA meets, leaders see scores cards updated for their country. When there is too much red on their scorecard, they realize they still have work to do. This helps them maintain their commitment. This kind of interventions contributed to the acceleration of the remarkable progress that we have seen in the last ten years. With the ALMA, we demonstrate that when we heads of State and Government involved and we guide the process, we get results.

A consensus of African heads of State

When you go into hospitals, plenty of beds are occupied by patients with malaria. African leaders first found the impact on our communities when adults are too sick to go to work and that children who have a fever are unable to go to school. Malaria has a devastating effect on our country. The promise of an Africa without malaria is something that motivates us all.

 

 

Eradicate malaria

Yes, this is the main objective of the ALMA. The World Health Organization recently reported that six African countries (Algeria, Botswana, Cape Verde, Comoros, South Africa, and Swaziland) could eradicate malaria by 2020. The adoption by the African Union of the framework catalytic to eliminate HIV/AIDS, tuberculosis and malaria in Africa by 2030 defines a path towards the elimination of malaria in all countries by 2030. We must continue to do what works and at the same time to support innovative tools and approaches to combat this disease. All this requires, of course, national and international financing. We need a more “national responsibility” and national funding, as well as ongoing support of the international community to achieve our goals.

Role of innovation

Technology and innovation play a key role in the fight against malaria. Monitoring tools, as well as modeling and mapping malaria data, help us to better understand the disease and fight it. Tests for malaria Diagnostics fast help health professionals, especially in rural areas, to perform in a minimum of time to specific diagnoses before administration of the treatment. Research is ongoing regarding other innovations (like a pill dose that could rid a person of all parasites, or even block the transmission of malaria), as well as other interesting innovations to the level of the vector control, which could speed up our progress towards the eradication of this disease.

More necessary finances

When I became President of Tanzania, the overall annual health budget was about $ 250 million. At the time I left office, he had risen to $ 1.1 billion. Cameroon, Chad, Mauritania, South Africa, and other countries have also increased their national funding to combat malaria. And of course, the problem is more complicated for the poorest countries which have very few resources. It is where international aid is essential.

Role of the international community

The fight against malaria has benefited from strong leadership and strong global partnerships. The Global Fund to fight AIDS, tuberculosis, and malaria has played an important role in the progress made so far. The Initiative against malaria by the President of the United States, the Department of international development of the United Kingdom, the Bill & Melinda Gates and Foundation Unitaid, which plays a role in the transformation of the market to make it more affordable and more accessible, were support and basic partners in the fight against malaria, with many other donors and partners. We must continue to work to stay the course and to overcome this disease.

Impact on women and girls

In Africa, malaria is one of the leading causes of death among children and pregnant women. Every two minutes a child dies of malaria. Progress against malaria have greatly contributed to reducing the number of child deaths and maternal morbidity on the African continent, but no mother should endure the pain of losing a child because of a mosquito bite. It is possible to prevent and treat malaria. This disease is very serious for families, it prevents the adults from work and children to go to school, and it contributes to the cycle of poverty in our communities. Eliminate malaria is beneficial to us all.

 

 

Malaria in Zambia

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Malaria (malaria)

The risk of malaria is available all year round in areas at risk.
It is recommended to protect against mosquito bites.
It is necessary to take a medication (chemoprophylaxis) before, during and after the trip.

Recommended Vaccination

The following vaccines are recommended for all:
Diphtheria, tetanus, poliomyelitis, measles, hepatitis A
Under special conditions, the following vaccines are recommended: yellow fever, hepatitis B, typhoid fever, rabies, cholera

Notes for vaccination against yellow fever:

Who vaccination recommendation:
-Vaccination generally not recommended: for travel to the western and Northwestern provinces;
-Vaccination not recommended: all other regions;
Very low/theoretical risk
(See also information on vaccination against yellow fever of the Swiss CEMV)

For prescription medications and vaccinations, consult a doctor or vaccination Center. Vaccination against yellow fever can only be carried out by a vaccination Center and some doctors.

Malaria Institute at Macha on Recommended Vaccinations

Systematically:

Vaccinations included in the vaccination schedule to be updated.

Adults

Children and adolescents: in particular, all persons 2 years and older, born since 1980, should have received two doses of the trivalent measles-mumps-rubella vaccine. For children, measles vaccine is recommended from the age of 6 months.

Hepatitis A

Children: From the age of 1 year
According to the terms of the stay:
Yellow fever

Vaccine available only in the international vaccination centres.

Vaccination is generally not recommended for travellers to all Northwestern and Western provinces, except in the case of exposure to mosquito bites.

Vaccination is not recommended for all other areas.

NB: A yellow Fever vaccination certificate is required for travelers over the age of one year from countries where there is a risk of transmission of YF and passengers who have stayed more than 12 hours in transit at an airport in a country where there is a risk of Transmission of yellow fever.

Vaccination regimen: 1 injection to be made at least 10 days before departure.

Children: from the age of 9 months (between 6 and 9 months, only in special circumstances.)

Duration of validity: lifetime.

Indeed, following a decision by the World Health Organization, the obligation of decennial recalls has been abolished. However, according to the opinion of the High Council of Public Health, recalls of yellow fever vaccination remain recommended for:

Children vaccinated before the age of 2: A second dose from the age of 6 years in the event of a new trip to the yellow-endemic zone;
Women who are first-vaccinated during pregnancy, persons living with HIV and those immunocompromised vaccinated under the conditions specified in the HCSP report: A second dose 10 years later;
People whose vaccination against yellow fever is more than 10 years old: A second dose in the event of a reported epidemic in the country visited.

Hepatitis B

For long or repeated stays.

Two injections spaced for one month.

Single reminder 6 months later.

Where immunity is to be rapidly acquired (in the event of imminent departure), an accelerated regimen with three close doses and a fourth dose 1 year later may be used only in adults.
Meningococcal meningitis

In case of prolonged stay in close contact with the local population, or in times of epidemic.
Rage

In case of an extended stay, in an isolated situation.

Children: As soon as they are of walking age.
Typhoid

In case of prolonged stay or in precarious hygiene conditions.

Children: From the age of 2 years
Prevention of malaria

Year-round Transmission throughout the country including Lusaka.
Prevention:

Chemoprophylaxis by Atovaquone/Proguanil or Doxycycline or mefloquine mosquito bites Protection

In the event of a fever occurring during the stay or in the months following the return, a doctor should be consulted as soon as possible.

 

Health and Safety Zambia

General Tips before you leave

Macha research institute did a research on this topic. However, there may be new instructions due to the emergence of a new problem. Same thing with respect to security. It is important to learn about what is happening in the country before you go to discover it.

-Remember to check that you have purchased insurance that includes health repatriation. If this is not the case, do it! To get informed you can also read the post about Malaria in Zambia.

Health

Vaccinations

-Diphtheria-tetanus-poliomyelitis: update of recommended vaccination.

typhoid fever, viral hepatitis A and B, Rabies: vaccination recommended in some cases (hygiene conditions, length of stay…).

-Measles: The updating of this vaccination may be necessary, especially in children.

-Yellow fever: A vaccination certificate is required for persons arriving from a country or experiencing yellow fever. This vaccination must be done at least six days before the entry into Zambia.

-Bacterial meningitis A + C + Y + W135: recommended vaccination.
Health risks

-Malaria, chikungunya, dengue, yellow fever. Protecting yourself from mosquito bites requires protective measures (sprays, creams, electric diffusers, mosquito nets…). The Palu requires a drug treatment adapted to each individual: Before departure, ask your doctor for advice.

-Traveller’s diarrhea, cholera. Drinking bottled water is one of the essential tips to avoid being reached. Also be sure to cook the food you eat and wash your hands regularly. During the rainy season (November to April), cholera epidemics are frequent, particularly in the mining and Lusaka regions.

-HIV – AIDS: High prevalence rate, estimated at 14.3%.

Security

Areas to avoid, precautions to be taken

-Border areas: armed groups cross the border between Zambia and the Democratic Republic of the Congo. Avoid this area as much as possible. Be very vigilant in the north-west province, bordering on the DRC and Angola: War explosives are not yet eliminated. Do not move out of the main roads and especially not at night.

-Deserted areas between Livingstone and Victoria falls: Tourist attacks have been reported.

-Theft and aggression: one of the main precautions to be taken is to avoid getting around at night. By car, always keep its doors locked and its windows closed. Finally, simple measure of common sense: Do not expose your valuables.

-Tensions during an election period. Avoid rallies.

Once these precautions are taken, do not be alarmed too much. Overall, Zambia remains a calm country.

For more up-to-date information, check out the travel tips from the Department of Foreign Affairs.

Malaria – main facts

Main facts

Malaria is a potentially deadly disease caused by parasitic infections transmitted to humans by infected female mosquito bites.
It is estimated that in 2016, 216 million cases of malaria were in 91 countries, or 5 million more cases than in 2015.
Malaria resulted in 445 000 deaths in 2016, a figure similar to that of 2015 (446 000).
The African region of who supports a disproportionate share of the global burden of malaria. In 2016, 90% of malaria cases and 91% of deaths due to this disease occurred in this region.
In 2016, funding for combating and eliminating malaria was estimated at 2.7 billion (US $) in total. The contributions of the Governments of the endemic countries reached 800 million million (US $), or 31% of the funding.

Malaria is caused by parasites of the genus Plasmodium transmitted to humans by bites of infected female Anopheles mosquitoes, known as “malaria vectors”. There are 5 types of parasite species responsible for malaria in humans, of which 2 – Plasmodium falciparum and P. Vivax are the most dangerous.

Plasmodium falciparum is the most widespread malaria parasite on the African continent. He is responsible for most of the deadly cases in the world.
P. vivax is the predominant parasite outside of Africa.

Symptoms

Malaria is an acute febrile illness. In an unimmunized subject, symptoms usually occur after 10 to 15 days after the infecting mosquito bites. The first symptoms – fever, headache and shivering – can be moderate and difficult to attribute to malaria. If not treated within 24 hours, Plasmodium falciparum malaria can evolve into a severe, often fatal disease.

Severely affected children frequently develop one or more of the following symptoms: severe anemia, respiratory distress following metabolic acidosis or cerebral malaria. In adults, a multi-organic attack is also frequently observed. In endemic areas, people can sometimes be partially immunized, and there may be asymptomatic infections.
Exposed Populations

In 2016, nearly half of the world’s population was exposed to the risk of acquiring malaria. Most cases of malaria and deaths due to this disease occur in sub-Saharan Africa. However, the WHO regions of Southeast Asia, the Americas and Eastern Méditérannnée are also affected. In 2016, 91 countries were confronted with continuous transmission of malaria.

Some groups of the population are at a much higher risk than others to get malaria and to be severely affected: infants, children under the age of 5, pregnant women, people with HIV or AIDS, Non-immunized migrants, itinerant populations and travellers. National malaria control programmes should take specific measures to protect these malaria groups, taking into account their situation.
Burden of disease

According to the latest report on World Malaria, published in November 2017, there were 216 million cases of malaria in 2016, compared to 211 million in 2015. The number of deaths due to malaria in 2016 is estimated at 445 000, a figure similar to that of the previous year (446 000).

The WHO region of Africa supports a disproportionate share of the global burden of malaria. In 2016, 90% of malaria cases and 91% of deaths due to this disease occurred in this region. 80% of the burden of malaria-related morbidity weighed over 15 countries – all in sub-Saharan Africa, except India.

In areas where malaria transmission is intense, children under 5 years of age are particularly vulnerable to infection, disease and death; More than two-thirds (70%) of deaths due to malaria occur in this age group.

The number of deaths recorded among children under 5 years of age increased from 440 000 in 2010 to 285 000 in 2016. However, malaria still remains a major factor in mortality among children under the age of five and a child dies every two minutes.

Malaria – transmission

Transmission

In most cases, malaria is transmitted by female Anopheles bites. There are more than 400 different mosquito species of Anopheles mosquitoes, of which about 30 are very important vectors of malaria. All important malaria vector species sting between dusk and dawn. The intensity of the transmission depends on factors related to the parasite, the vector, the human host and the environment.

The Anopheles lay their eggs in the water. These eggs hatch into larvae and then become adult mosquitoes. Female mosquitoes are looking for a blood meal to feed their eggs. Each species has its own preferences; Some for example prefer shallow freshwater such as puddles and the footprints left by Animal hoofs, which are abundant during the rainy season in tropical countries.

Transmission is more intense in places where mosquito species have a relatively long lifespan (allowing the parasite to complete its development cycle within the mosquito) and instead sting human beings rather than animals. The long life span and the strong human preference of African vector species explain that nearly 90% of malaria cases occur in Africa.

The transmission also depends on the climatic conditions that can influence the abundance and survival of mosquitoes, such as the precipitation regime, temperature and humidity. In many places, the transmission is seasonal with a peak during or just after the rainy season.

Epidemics of malaria can occur when climate and other conditions suddenly encourage transmission in areas where populations are little or not immune. They may also occur when low-immunized people move to areas of intense transmission, for example to find work or as refugees.

Human immunity is another important factor, especially in adults in areas of moderate to intense transmission. Immunity develops after years of exposure and, although it never confers total protection, it reduces the risk that malaria infection will cause severe disorders.

This is why most malaria deaths in Africa occur in young children, while in low-transmission areas and where the population is poorly immunized, all age groups are exposed.

Malaria – elimination

Elimination

Disposal is defined as the interruption of local transmission of a well-specified Plasmodium species in a geographical area defined as a result of deliberate efforts. Continual measures are required to avoid the recovery of the transmission. (Certification of the elimination of malaria in one country implies that local transmission has been interrupted for all species of Plasmodium parasita humans).

The eradication of malaria is defined as the permanent reduction to zero of the global incidence of infection caused by human malaria pests as a result of deliberate activities. There is no longer a need for intervention once the eradication has been achieved.

The pace of progress in a particular country depends on the robustness of the national health system, the level of investment in malaria control and a number of other factors, such as biological determinants, the environment and Social, demographic, political and economic realities of the country in question.

In countries with moderate to high malaria transmission, national malaria control programmes are aimed at minimizing the number of cases and deaths due to this disease.

When countries approach elimination, enhanced surveillance systems contribute to the detection, treatment and notification of each infection in the National Malaria Registry. Patients diagnosed with malaria should be treated quickly with effective antimalarial drugs in order to protect their own health, but also to avoid further transmission of the disease in the community.

Countries that have managed for at least 3 consecutive years to zero local malaria cases meet the requirements to ask who to certify the elimination of malaria. In recent years, the Director-General of WHO has certified that 8 countries have eliminated malaria: the United Arab Emirates (2007), Morocco (2010), Turkmenistan (2010), Armenia (2011), Maldives (2015), Sri Lanka (2016) and Kyrgyzstan (2016 ) and Paraguay (2018).

The WHO Framework for Malaria Elimination (2017) provides a comprehensive set of tools and strategies for achieving and maintaining elimination.