Health practitioners in the country say that poor sanitation has allowed mosquito populations greater opportunity to breed in stagnant water surrounding local communities.  The problem has become so bad, that chiefs from all parts of Liberia met to discuss the importance of implementing prevention measures.  The meeting, called the Malaria Prevention Advocacy Meeting, was directed by the Chairman of the National Traditional Counsel (NTC), Chief Zanzan Korwah. Chief Korwah said, “We are taking this message to five counties in order for all our people to know how to prevent and protect themselves from this deadly disease.”

In addition to local efforts, the United States Agency for International Development (USAID) donated about 40,000 bed nets to help protect Liberians.  Kaa Williams, who spoke for USAID, said, “Many mosquito nets were distributed throughout the country and are now underneath the beds of those Liberians that benefitted.  Liberia is in a battle in these recent times against traditions that have been proven unrealistic in today’s world, International organizations and some local ones are fighting to bring Liberia out from war to post war back to normalcy. So diseases common to treat and prevent can be no more in Liberian communities; like, diarrhea and the number one killer in the country, malaria.”

Post-conflict countries tend to be more vulnerable to malaria because of poor infrastructure and less coordinated efforts by newly formed governments.  Helping Liberia build its social, political, and economic foundation will indirectly support the reduction in malaria.  However, continued efforts by USAID and other non-governmental agencies must help to directly support vertical malaria efforts in the region.

A new study on malaria in children in Houston, Texas from 1994 to 2007 showed that all patients in the study were either recent immigrants or had traveled outside the United States prior to showing any symptoms.  In total, there were 104 children aged 19 days to 17.4 years who were diagnosed with malaria and had blood smears present with the parasite.  Twenty one children had severe malaria and 83 had uncomplicated malaria.  Forty three children were immigrants and 61 had recently traveled outside the US.  Interestingly, 90% of those who were diagnosed with malaria had traveled to West Africa.  The remaining 10% were split evenly between Asia and Central America.

The study was also able to identify which traits made individuals more likely to have severe malaria vs. uncomplicated malaria:

Vacation-related travel (67% vs. 27%).

Female sex (67% vs. 39%).

Birth in the United States (64% vs. 35%).

Shorter travel duration (median, 23.5 days vs. 35 days).

Shorter duration between return from travel and appearance of symptoms (median, 13 days vs. 25 days).

History of vomiting (81% vs. 57%).

Higher peak parasitemia (median, 11.2% vs. 1.5%).

Hepatomegaly (71% vs. 39%) and heart murmur (67% vs. 42%) accompanying symptoms.

The study concluded with suggestions for ways to prevent imported malaria.  The first was to improve the rates of pre-travel consultations to discuss proper malaria prophylaxis, and make sure that the appropriate prophylaxis was prescribed for the region they were traveling.  The study notes, however, that the “prophylaxis did not play a role in the severity of disease in children with malaria.”  Rather, greater precautions need to be taken by families to help protect children and recognize the dangers that are present, particularly when traveling in West Africa.

The Bill and Melinda Gates Foundation said that a partially effective vaccine to prevent malaria is about three years away from being released. The vaccine called “RTS,S” is in the final stage of human trials which began last summer.  The vaccine contains a weakened strain of the whole Plasmodium parasite, which means the vaccine would be effective against all strains. 

The Gates Foundation has spent billions of dollars on malaria initiatives and is hopeful that a vaccine, new malaria drugs, improved insecticides, and greater distribution of bed nets will help towards eventually eradicating or eliminating the disease.

Despite the gains made in malaria, Gates warned in an open letter yesterday, that budget deficits and money being spent to reduce global warming could negatively impact aid being given to the third world.  He said, “I am concerned that some of this money will come from reducing other categories of foreign aid, especially health.” 

It will be interesting to hear tonight what President Obama will say in his State of the Union Address regarding global health.  The State of the Union will be on the majority of major news stations at 9pm ET and 6pm PT.

Malaria and cholera are serious health problems in the developing world. Malaria is a mosquito-borne illness that kills 1 million people annually.  Although many vaccines are in development, there are currently none on the market.  Cholera is a diarrheal illness that can be fatal if not treated.  Although there is a vaccine for it, it is too expensive to be used on a mass scale in the developing world.

A team of biomedical researchers at the University of Central Florida believe they have found a solution to both problems, and have developed the first inexpensive dual vaccine.  The team was able to genetically engineer tobacco and lettuce plants to create the vaccine.  One the vaccine was created they injected or orally administered the vaccine through freeze-dried plant cells to mice. When the mice were infected with the cholera or malaria parasite, the treated rodents showed no effect.  Those not given the vaccine became ill quickly.  The treated mice were immune for over 300 days, which would be approximately 50 human years!

Although there have been no clinical trials yet, the UCF researchers believe that if the vaccine is successful, the cost of producing mass quantities would be “pennies on the dollar.”  Distributing the vaccine would also “be easy because it could be made into a simple pill, like a vitamin, which many people routinely take now. There is no need for expensive purification, cold storage, transportation or sterile delivery via injections.”

Should this vaccine work, malaria rates will plummet.  Unlike other vaccines, this one is likely to be purchased in the developing world because of reduced costs, easy storage, and minimal training for health professionals. Clinical trials should begin right away!

It is predicted that in 2010 Tanzania will become one of the “first African countries to achieve universal access to mosquito nets and affordable treatment for all of its citizens” against malaria.  Tanzania recently came public with a new anti-malaria campaign called “Malaria Haikubaliki.”  The program is unique because it recruits advocates from all sectors of society including business, sport, entertainment and religion.  The program is strongly supported by Tanzania’s President, President Jakaya Kikwete, who also happens to be the director of the African Leaders Malaria Alliance (ALMA).  ALMA is a unifying agency meant to bring African leaders together to raise global awareness and support for the fight against malaria. 

Malaria Haikubaliki is directed by the Tanzanian Ministry of Health and Social Welfare.  They are planning to host a concert called Zinduka! (“Wake Up!”) on February 13 in conjunction with Tanzanian musicians, international partners, senior government officials and the business sector.  The concert will be available on TV and radio all across Tanzania.  The new campaign has also inspired 18 popular musicians to collaborate on a song about malaria—the largest compilation yet in Tanzanian history.

The purpose of this new campaign is to help Africans take a new perspective on the fight against malaria.  Many in the continent have come to “think that malaria is inevitable,” but the President believes it is not a disease Africans must be forced to live with.  He hopes to eliminate malaria deaths by the end of 2010 by encouraging bed net usage, better care for pregnant women, and rapid treatment of malaria. 

Malaria No More’s Mark Green and Peter Chernin were at the opening event.  Here is what they had to say:

 former American ambassador to Tanzania, Mark Green noted: “Malaria is a terrible disease that causes widespread suffering and even death. But it is also preventable and treatable and the government of Tanzania has emerged as a true leader in Africa’s fight against the disease”.
However, the government cannot do this alone. Every Tanzanian must join in the country’s fight to end malaria deaths. Only by working together will Tanzania be able to rid its homes, communities and country of malaria”.
The former American envoy said he was so inspired by Tanzania’s commitment to ending malaria deaths that he chose to devote himself to  fight the disease after leaving the US embassy last year.
“I moved to Washington DC to lead the Malaria Policy Center, which encourages governments around the world to support malaria control programmes in Africa,” stated Green.
On his part, Malaria No More’s Peter Chernin said malaria’s most frequent victims are those ‘without a voice’ including young children in remote villages.
He remarked: “Tanzania is ready to give those children a voice by bringing together some of the most influential figures in Tanzanian society. Every person can use his or her voice to help tell Tanzania’s success story against malaria. Entertainers can engage their audiences; corporations can leverage their best practices to support the effort; and faith leaders can involve their congregations in refusing to accept a single malaria death”.

Tanzania is on the right path, and sets a global example of what success can look like.

Although most deaths from malaria are in young children from the malaria strain called Plasmodium falciparum, pregnant women are still extremely vulnerable to malaria from both P. falciparum and Plasmodium vivax, the more common malaria strain.  In Africa both strains cause 200,000 deaths in babies during pregnancy and about 10,000 deaths in pregnant women. 

In a new study, researched estimated that 125 million pregnancies are at risk from complications due to malaria across the globe. They came to this conclusion by looking at various health and population statistics.  Unlike previous studies, researched attempted to estimate the number of pregnancies that were vulnerable to each type of malaria strain.  They concluded that in 2007, there were a total of 54.7 million pregnancies in regions with consistent P. falciparum transmission, and another 70.5 million pregnancies in regions with either low malaria transmission or sole transmission of P. vivax.

Causecast, an organization that helps raise awareness about issues across the globe, posted ten facts about malaria:

1. Malaria is a contagious disease caused by a parasite and is spread through contact with infected mosquitoes. If malaria goes untreated, it is often fatal.

2. More than 40 percent of the world’s population is at risk for malaria every year.

3. Between 300-500 million cases are clinically diagnosed in 109 countries each year, leading to as many as three million deaths.

4. Approximately 90 percent of all malaria cases are diagnosed in Africa. On average, an African child will suffer between one to five bouts with malaria every year.

5. Every 30 seconds, someone dies in Africa of complications associated with malaria. Twenty percent of all childhood deaths in Africa are caused by malaria. Globally, malaria is responsible for 85 percent of deaths in children under the age of five.

6. Pregnant women face additional complications associated with malaria, including miscarriage or premature delivery. Malaria can cause low birth weight in babies and contributes to the deaths of approximately 10,000 pregnant women every year.

7. Between March and June of 2000, at the Democratic Republic of Congo’s major hospital in Kinshasa, 84 percent of all blood transfusions were given for anemia associated with malaria infection.

8. Early diagnosis and treatment are essential to controlling the spread and severity of malaria. Treatment and preventions efforts have led to a 33 percent decline in malaria cases in Rwanda and Malawi. Globally, there are eight pharmaceutical drugs known to successfully treat malaria.

9. Malaria is largely preventable and 100 percent treatable. Bed nets, that keep the mosquitoes at bay, can be used to save lives. Bed nets cost an average of $10 per net, but for the billion people around the world who live on less than $1 everyday, purchasing a bed net can be out of reach.

10. The estimated cost of malaria prevention, including the goal of universal protection against malaria, will reach $6.2 billion in 2010 alone.

Malaria is a serious threat to development and health in the developing world. 1 million people die each year from the disease, and over 400 million are infected annually.  To learn what you can do the change the current path of malaria, click here.

Bill Gates has gone on record with encouraging news that he believes a malaria vaccine is as close as three years away.  In a interview with BBC World News, Gates suggested that a breakthrough was coming on a vaccine and soon we will be able to tackle this disease with the ultimate in prevention.

Just like smallpox, Mr Gates believes the disease can be eradicated. As yet, there is no vaccine, but, Mr Gates says, a breakthrough is near.

“We have a vaccine that’s in the last trial phase – called phase three. A partially effective vaccine could even be available within three years, but a [...] fully effective vaccine will take five to 10 years,” he told the BBC World Service’s World Today programme.

Of course a vaccine would be a game changer in the struggle to rid the world of malaria deaths by 2015 and we will be watching with keen interest.

Throughout most of the developing world, drainage systems along the sides of the road are left uncovered—just like on Adeshiyan Street in Ilupeju, Nigeria. Poor drainage systems collect stagnant rainwater, sewage, garbage and other waste causing a strong stench and can be dangerous to ones health. Serious health implications from the water alone are enough to cause concern; however, these open drainage systems also allow for the breeding of mosquitoes near homes to occur more easily.  The more mosquitoes are allowed to breed, the easier it is for people to acquire the malaria parasite.

Joy Chibuzo, a resident on Adeshiyan Street, said she has taken her three-year-old and 11-month-old sons to a hospital at least 10 times in the past six months. She has tried to take control of the swarming mosquitoes by spraying insecticide in her house every day, but the mosquitoes are not letting up.  On top of the increases in malaria, families are being forced to leave their homes because the stagnant water is weakening the surrounding soil, making everything from fences to houses crumble under a weak foundation.

The local government has tried to work with a local contractor to fix the drainage system, but the contractor claims the local government has not paid them, so they abandoned the project.  Local officials claim fixing the drainage system is on-going and that they have met with the construction workers to force them return to work.  As the debate continues whether or not the drainage system will be fixed, “Mrs. Chibuzo, her family, and her neighbors will have to cope with the horrible stench, swarms of mosquitoes and medical bills.”

Sherlock Homes is a famous fictional character who solves mysteries.  He was created by Conan Doyle during the late 19^th century.  Sherlock and Watson have made over 6,000 appearances in different forms of media since 1976, and have traveled all over the world throughout their adventures.  Author Vithal Rajan in his most recent book Holmes of the Raj, brings Holmes and Watson to India to solve more mysteries.  Holmes retains his “tendency to keep Dr. Watson in the dark until the very end, and the good doctor’s gallantry and sense of fairness,” but does so in the Raj era with Indian food, culture, and traditions.

Although most stories are murder mysteries, one story is a medical mystery centered on malaria.  The story involves Holmes and Watson traveling to Hyderabad to meet a man named Nizam.  When they arrive, the youngest son is found to be suffering from malaria.  Dr. Watson is called to find the cure.  He goes on a journey to find the cause of malaria, tracing it back to the anopheles mosquito.  After discovering his findings, he writes it down in his trusty notebook and hands it to “Dr. Ronald Ross, the medical Resident of Bangalore, who would later go on in real life to be recognized for this discovery and receive a Nobel Prize.”

This tale, along with others, is rated highly by Sherlock Holmes’ fans and is a fun way to learn about malaria. It could be a great tool for educating younger students in India about the cause of the disease. This fiction novel shows that educating people about malaria does not always need to include gloom and doom, and that fun and enticing stories can weave in truth about the world today.  There is much to learn about the history of malaria and Dr. Watson is here to help!