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World Health Organization (WHO) and Medical Workers Mark Progress in Southeast Asia Malaria Fight, close monitoring on India and Africa

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A Cambodian woman hangs her mosquito net in the temporary dwelling in the fields that she and her husband are clearing to farm. , VOA
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ASIA, April 23, 2017: Concerted campaigns in the Greater Mekong Subregion [GMS] to radically reduce the impact of malaria has lifted hopes a vital target to eradicate malaria from the region may be within reach.

Deyer Gobinath, a malaria technical officer with the World Health Organization (WHO) in Thailand, said the outlook is positive for eliminating severe forms of malaria across the region within the next decade.

The goal is for most of the GMS countries by 2025 to try and eliminate falciparium malaria – the most severe form of malaria – the falciparium malariia – and then by 2030 basically all forms or all species of malaria,” Gobinath said.

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In 2015, WHO leaders said there were 14 million malaria cases across Southeast Asia, resulting in 26,000 deaths. Globally, in the same year, the WHO reported 438,000 lives lost, mostly in Africa and warned that 3.2 billion people – almost half the world’s population – face health risks from the disease.

Mortality rates decline; challenges remain

The campaigns in Southeast Asia cover Myanmar, Laos, Thailand, Cambodia and Vietnam, all reporting consistent declines in mortality rates, by as much as 49 percent since 2000.

Populations most vulnerable to the mosquito-borne disease are largely in remote border regions, isolated from infrastructure and immediate medical support.

ASIA, April 24, 2017: The key areas of concern lie in regions between Thailand and Myanmar – also known as Burma – and in Cambodia among others.

But Saw Nay Htoo, director of the Burma Medical Association, said collaboration between medics and local communities has had a positive impact in reducing malaria’s impact.

“In the ground level we set up the malaria [clinic] post which we have at least one malaria health worker, according to the population they have, to detect malaria,” he said. “And if there is malaria positive then the patient is given the malaria medicine. So we have been doing this for three years. It seems our program is going very well – there are less malaria cases in the border areas.”

Combination of drugs

The fight against malaria is largely based on a combination of drugs known as Artemisinin-based Combination Therapy, or ACT, as the main line of drug treatment.

The World Health Organization’s Gobinath said Thailand’s medical infrastructure and funding support have all contributed to lowering the numbers of malaria cases.

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“For malaria in Thailand here’s been quite a remarkable decrease – a steady decrease, decline in the number of confirmed cases of malaria. In the past 10 years or so something like 30,000 cases in 2012; to 2015 it was 19,000 to 20,000 cases. So it’s been a gradual but persistent decline of confirmed malaria cases,” he told VOA.

But he said for progress to be sustained it will require continued “political will and commitment.”

WHO officials said attention needs to focus on migrant worker populations moving across the region’s borders. Thai health authorities have taken steps to enable medical access to migrant populations at risk of malaria, largely in remote border areas.

The battle far from over

But challenges remain, said Maria Dorina Bustos, a WHO technical officer with responsibilities for monitoring drug resistant strains of malaria across 18 countries in the Asia Pacific.

Dorina Bustos said the region with drug resistant forms of malaria is spreading. “The Thai-Cambodia or the Thai-Myanmar border, you need to think about the Thai-Laos border because the Southern Laos drug resistance is also about evident – is documented, it is also there. And what is actually more alarming is happening in the Cambodia side,” she told VOA.

She said drug resistance becomes evident in the delay in clearance of the parasite from the patient. Dorina Bustos says the use of fake drugs and self-treatment also opens the way to drug resistance.

“What we are seeing in the last five years is that it is really emerging in the most parts of the region – initially just in the Western border of Cambodia and now it has also spread to the east and almost the whole country,” Dorina Bustos said.

She said there is a need for close monitoring of major population centers – especially in India and Africa – to ensure successful treatment and avoiding issues of the use of fake medicines.

A positive note has been ongoing investment and research in new drugs, including commitments by major pharmaceutical industries.

“It’s really here in the Mekong where we really have a problem. Cambodia, the borders of Thailand, the borders of Thai/Laos and Cambodia/Vietnam – it’s very specific in the Mekong region,” she said. “For Malaysia, the Philippines, Indonesia, Solomon Islands, Vanuatu and even India, Bangladesh and Nepal the ACT [Artemisinin-based Combination Therapy] is all working perfectly well.” (VOA)

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Brian Gitta: A Malaria Test That Would Not Need Blood Samples

The new malaria test kit works by shining a red beam of light onto a finger

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A health service worker takes a blood sample for a malaria test in Dajabon, Dominican Republic, on the border with Haiti, Oct. 6, 2009. A test that doesn't require a needle or blood has won the Africa Prize for Engineering Innovation
A health service worker takes a blood sample for a malaria test in Dajabon, Dominican Republic, on the border with Haiti, Oct. 6, 2009. A test that doesn't require a needle or blood has won the Africa Prize for Engineering Innovation, VOA

Languishing with fever and frustrated by delays in diagnosing his illness, Brian Gitta came up with a bright idea: a malaria test that would not need blood samples or specialized laboratory technicians.

That inspiration has won the 25-year-old Ugandan computer scientist a prestigious engineering prize for a noninvasive malaria test kit that he hopes will be widely used across Africa.

For developing the reusable test kit known as Matibabu, Gitta this month was awarded the Africa Prize for Engineering Innovation. The award by the Royal Academy of Engineering in Britain comes with $32,940.

Malaria is the biggest killer in Africa, and the sub-Saharan region accounts for about 80 percent of the world’s malaria cases and deaths. Cases rose to 216 million in 2016, up from 211 million cases in 2015, according to the latest World Malaria Report, released late last year. Malaria deaths fell by 1,000, to 445,000.

The mosquito-borne disease is a challenge to prevent, with increasing resistance reported to both drugs and insecticides.

No needles

The new malaria test kit works by shining a red beam of light onto a finger to detect changes in the shape, color and concentration of red blood cells, all of which are affected by malaria. The results are sent within a minute to a computer or mobile phone linked to the device.

A Portugal-based firm has been contracted to produce the components for Matibabu, the Swahili word for “treatment.”

“It’s a perfect example of how engineering can unlock development, in this case by improving health care,” Rebecca Enonchong, Africa Prize for Engineering Innovation judge, said in a statement. “Matibabu is simply a game changer.”

A woman carrying a baby holds a treated mosquito net during a malaria prevention action at Ajah in Eti Osa East district of Lagos, Nigeria, April 21, 2016.
A woman carrying a baby holds a treated mosquito net during a malaria prevention action at Ajah in Eti Osa East district of Lagos, Nigeria, April 21, 2016. VOA

Gitta and five colleagues, all trained in computer science or engineering, developed an affordable, bloodless test that does not need a specialist to operate. The new test will be suitable for use in Africa’s rural areas, where most cases of malaria occur, because it will not depend on sending blood samples to a distant laboratory.

Others are also working to fill the need for quicker, easier malaria tests. There are more than 200 rapid diagnostic test products for malaria on the market, according to the WHO.

80 percent accurate now

The fifth-generation prototype of Matibabu, with an accuracy rate of 80 percent, is still a work in process. Gitta and his group aim to refine the device until it achieves an accuracy rate exceeding 90 percent.

Matibabu has yet to be formally subjected to all the necessary clinical trials under Ugandan safety and ethics regulations.

“It excites me as a clinician,” said Medard Bitekyerezo, a Ugandan physician who chairs the National Drug Authority. “I think the National Drug Authority will approve it.”

The government should invest in the project so that its developers don’t struggle financially, he added. The unit cost of the latest prototype is about $100.

Despite the optimism, Gitta has found a hurdle he didn’t anticipate: Some patients are skeptical of unfamiliar technology.

“The doctors will tell you that some people will not leave the hospital until their children have been pricked, and until they have been given anti-malaria drugs and painkillers, even if the kid is not sick,” he said.

Also read: From Radio Signals A Pill Could Tell About Gut Health And Help Doctors

“We think we are developing for hospitals first, so that people can first get attached to the brand, and gain the trust of patients over time.” (VOA)