A Washington Post article from this morning provides an interesting inside glimpse at the work of doctors, technicians, volunteers, and researchers contributing to the development of malarial vaccinations, especially the RTS,S vaccine, a promising medicine in the battle to eradicate malaria in many tropical areas of the developing world.

The research is part of an ongoing study in its 17th year known as the “Human Challenge Model”, a project that tests medicines and vaccines in volunteers to study and document their effects. 

The study is put on by the Walter Reed Army Institute of Research and aims to show that human volunteers can be intentionally infected with malaria and then properly and successfully treated.  The research is part of a larger international study financed by the Bill and Melinda Gates Foundation being carried out in a number of African countries to test the effects of several different malarial parasites.

The article focuses on local workers and volunteers in the Washington DC metro area and describes the physical toll malaria has on the body when it infects a human. 

Malaria is largely non-existent in the United States but results in about 1 million deaths in sub-Saharan Africa every year; a serious health and economic concern for hundreds of millions of families and workers on that continent.

The Wall Street Journal has reported on an exciting development in the fight against malaria. An international team of scientists have identified a possible new drug for the treatment of malaria.

The new drug was shown to be very efficient when tested on mice.  Novartis is backing the effort.  From the article

“The discovery comes amid two key developments in the fight against the mosquito-borne illness. Several parts of Africa are showing a decline in malaria deaths, thanks to wider use of insecticides and bed nets to ward off mosquitoes that carry the disease, as well as use of artemisinin, a potent drug.

At the same time, there are worrying signs that the malaria parasite in parts of Southeast Asia is becoming resistant to artemisinin, which is the mainstay of combination therapy for as many as 100 million patients world-wide. Resistance has already rendered some older therapies less effective.”

As resistance continues to be a concern, developing new drugs to treat malaria is critical to maintaining our advantage against the parasite.  Hopefully, this new drug will serve as a new tool for victims of malaria.

New findings about mosquitos’ ability to smell and sense human odors may help with the creation of more effective repellents in efforts to reduce malaria.

Previously, it had been thought that chemicals like DEET and other repellents blocked receptors in mosquitos’ intennae limiting their ability to smell.  The new research shows that mosquitos possess the ability to distinguish between certain scents and have aversions to particular smells. 

Scientists at the University of Vanderbilt have identified a new set of olfactory sensors in malarial mosquitos that provide the incects with information about their environment.  According to the findings, mosquitos repond infavorably to particular stimuli the way humans respond infavorably to certain smells, such as rotten food.

The new research could help scientists to develop more effective repellents to ward off malaria bearing mosquitos or even to attract the insects towards traps where they would be held or eliminated.  In the fight to end malaria, new applications of science are key to improving the technology and methods for irradicating the disease.

Text messaging continues to be utilized for public health needs in Africa. 

Across the continent, more than 30 percent of malaria medicines are estimated to be fake, and many look identical to the real thing.

Soon, Africans will be able to text message a code to a project called mPedigree that allows individuals to verify whether or not their drugs are genuine.  The system is free for consumers and is paid for by pharmaceutical companies and governments. 

Health officials say the innovative system could help Africa curb the tide of fake drugs and potentially save hundreds of thousands of lives. Experts think about 700,000 people die from malaria or tuberculosis every year after taking counterfeit drugs, with some containing little more than sawdust, baby powder and water.   In addition, fake medicines speed up drug resistance. If a drug contains some but not enough of the active ingredient, it won’t kill the disease’s virus or bacteria, but gives it a chance to mutate into a deadlier form instead.

A new weapon against mosquitoes may soon be available to assist in the fight against malaria.  The Charlotte Observer reported on the development.

From the article. 

A mosquito usually lives up to two weeks, just enough time for a malaria parasite to mature and infect the insect’s victims. But diatomaceous earth – ground-up fossilized algae that is nontoxic to humans – is an insecticide that can kill mosquitoes in only a few days, said Marian McCord, a textile engineer at N.C. State.

“It’s very hard to keep a mosquito from biting you, and bed nets are just a physical barrier that can tear,” McCord said. “With diatomaceous earth, we can injure a mosquito, shorten its life span and potentially prevent others from becoming infected with malaria.”

As natural bait, the chalky, abrasive diatomaceous earth attracts insects. When a mosquito lands on it, the substance agitates and damages the waxy outer layer of the mosquito’s exoskeleton, making it susceptible to dehydration and disease. The injuries cut the mosquito’s life span to one or two days, eliminating its ability to transmit malaria. The insecticide is also effective against other pests, including bed bugs.

The following blog appeared on Malarianomore.org. 

Imagine if we could predict malaria outbreaks just like we predict the weather. Well, we just might be able to!

The Kenya Medical Research Institute (KEMRI) has developed a model that predicts malaria outbreaks with 86 to 100% accuracy. The model uses weather predictions, information about mosquito reproductive patterns, and geographical data to predict the probability of an outbreak. Over the past nine years, the model has been tested and proven accurate in several countries including Kenya, Uganda and Tanzania.

Dr. Andrew Githeko, the malaria expert in charge of the project, says, “Rainfall and temperatures can be used to explain up to 80% of statistical variation in malaria incidences. This is because the temperature variations are extremely important in breeding of mosquitoes.”

So what does the current malaria forecast look like? According to the technology, an outbreak is unlikely to occur this season because the current temperature in most areas is not high enough for a mass breeding of mosquitoes.  

In this case, we’ll take all the rain checks we can get if it means protecting the millions of people at risk of malaria.

Kai Matuschewski and his research team from the Max Planck Institute for Infection Biology in Berlin may have discovered a ‘needle-free’ malaria vaccine by combining antibiotics with malaria infected mosquitoes. The idea behind their research, which was published in the journal Science Translational Medicine last month, was to “combine a classical prophylaxis aspect -which is antibiotic treatment- (that travelers use to protect themselves against malaria)- together with a natural exposure.”

The scientists infect mice with sporozoites released from the malaria carrying mosquitoes. The sporozoites migrate to the liver where they replicate abundantly and mature to the disease-causing blood stage cells called merozoites. However, in this study, although the merozoites continued to develop in the liver, the antibiotics prevented them from actually entering red blood cells, which disabled the onset of malaria symptoms. “The mosquito is our sort of syringe that delivers the pathogen and we stop the parasite from growing in the liver through antibiotic prophylaxis.”

Not only did the mice not get sick from this treatment, but subsequent trials that eventually did not include the addition of antibiotics revealed that the mice developed long term immunity. The antibiotics used in the study were clindamycin and azithromycin, both generic drugs that are cheap and readily available; good news for poorer countries.

However, Dr. Michael Knappik from the Berlin Center for Tropical and Travel Medicine pointed out the potential risks of using generic antibiotics in the long-term, starting that they can lead to drug-resistance, a significant problem in today’s treatment of malaria. The research team hopes to offset the likelihood of antibiotic resistance by administering the drugs once a year at the beginning of the rainy season.

If successful, the new treatment could dramatically reduce the nearly one million deaths caused from malaria every year. The treatment is not aimed at travelers, because it protects against the disease once it is already contracted, but has positive implications for those living in endemic areas. Rather than attempting to protect against all mosquito bites like malaria prevention methods such as the utilization of bed nets, this treatment uses the infection as part of the solution in combination with antibiotics.

Due to the availability of the generic drugs, Matuschewski and his research team are hopeful that clinical trials can begin in sub-Saharan Africa by the start of next summer. While the findings are promising, scientists are careful to point our that their research constitutes just one component of the many needed to fight the disease and end deaths from malaria.

A new evidence-based mapping study calculates that 2.85 billion people lived at risk of infection of the malaria parasite Plasmodium vivax in 2009, mostly in central and southeast Asia, reported BMJ News.

P vivax is the most widely distributed malaria parasite in the world, and mapping the parasite is critical so that strategies can be put in place to control it. The Malaria Atlas Project conducted the study, a multinational research collaboration that received the majority of its funding from Wellcome Trust. Cutting edge methods were used by the researchers, including “developing global maps of Duffy negativity, which confers partial protection against P vivax. People who are Duffy negative lack an antigen on the surface of red blood cells that codes for a protection receptor for P vivax.”

P vivax potentially represents a greater burden on human health in some areas of the world than P falciparum, which “is undeniably the main killer of the two,” said Dr. Guerra. “Even though more people are exposed to the risk of P vivax infection than P falciparum, most deaths from malaria are reported in Africa,” where people are less vulnerable from becoming infected with P vivax due to high prevalence of Duffy negativity on the continent.

In order to significantly reduce the malaria burden from both parasites it is imperative that a better understanding of the aspects of the mosquito life cycle that directly mediate malaria transmission are investigated.

Mumbai, India has seen a drastic increase in malaria cases this year. 

The BMC blames the heavy rains for the unusual spurt in malaria. “This has been the wettest July in the past eight years. Colaba has already recorded 133% of average rainfall, whereas Santa Cruz has recorded 115%,” said Manisha Mhaiskar, additional municipal commissioner.

In July alone, 12,000 people tested positive from the 1 lakh slides taken in house-to-house surveys. Last year, the positive cases for all July stood at 4,380.

Data with the civic body shows 33% of positive cases were reported from F/South, G/South and L wards, whereas 25% of cases were from E, G/North, K/East and N wards. Civic officials claim that a higher level of vector control activity has started in those areas. BMC officials said this analysis was in sync with last year’s death audit on malaria that also shortlisted these areas as the high-risk ones.

“We carried out the positivity analysis this year to map positivity geographically and into significant groups. Moreover, the death audit of last year and this year’s positivity analysis gave us almost the same results. So we know the highly vulnerable areas and are curbing mosquito breeding in those areas,” said Mhaiskar.

As a result of these increased malaria rates, fast diagnosis has been greatly needed.  The faster results lead to faster treatment and help stem this rising tide of malaria.

Robert Black, Chair of Johns Hopkins Bloomberg School of Public Health’s Department of International Health, and his team of researchers recently determined that pneumonia, diarrhea, and malaria are the top three causes of death of 6 million children around the globe. “We now have the latest country-specific estimates of the major causes of child deaths.”

An expert on child mortality, Black implored the leaders of donor and developing host countries to take action to confront this avoidably high death toll. Take malaria for example, an extremely preventable and treatable disease that is still killing over 800,000 people every year, the majority of whom are children younger than five.

“Achieving the global goal of reducing child mortality by two-thirds is only possible if the high numbers of deaths are addressed by health interventions, including vaccines,” he said at a briefing in Baltimore to evaluate the impact of potential of new vaccines, sponsored by the GAVI Alliance and the Johns Hopkins Bloomberg School of Public Health.