MALARIA IS BEATABLE!

Malaria's Victims are babies like this one. We must say no to malaria now.Also, malaria is disease of poverty. It immobolizes an entire family.

MALARIA IS BEATABLE! Together we can make malaria history like polio. Just do your part.

PRESIDENT BUSH IN AFRICA

Fighting Malaria

Malaria Information Sheet
pdf - 350 KB

List of all Malaria Global Fund funded programs

Partners Projects:

WHO's Global Malaria Program
Roll Back Malaria Partnership

Malaria Links

This page has been updated to report results from Global Fund-supported programs. The statistics shown here are the aggregated results from individual programs supported by the Global Fund in 140 countries.
104 million bed nets were distributed to protect families from transmission
108 million malaria drug treatments were delivered
The Global Malaria Epidemic
Malaria, one of the world's most common and serious tropical diseases, is a protozoal infection transmitted from human to human by mosquitoes.

Each year, malaria causes nearly one million deaths, mostly among children under 5 years of age, and an additional 189 to 327 million clinical cases, the majority of which occur in the world's poorest countries.

Almost half the world’s population, that is 3.3 billion people, is at risk for malaria, and the proportion increases yearly due to deteriorating health systems, growing drug and insecticide resistance, climate change, and war.

High-risk groups include children, pregnant women, travelers, refugees, displaced persons, and laborers entering endemic areas.

Impact Within and Outside the African Region
Malaria is prevalent in 109 countries, 45 of which are within the WHO African Region. In 2006, 86 percent of malaria cases occurred in the African Region, with a high concentration (80 percent) in 13 countries. Among the cases that occurred outside the African Region, 80 percent were in India, Sudan, Myanmar, Bangladesh, Indonesia, Papua New Guinea and Pakistan.

Ninety percent of malaria deaths occur in Africa. Each day approximately 2,200 Africans die from malaria, 85 percent are children under 5 years of age.

Social, Economic, and Development Impact
Malaria increases poverty by significantly reducing productivity and social stability.

Rural and poor populations carry the overwhelming burden of malaria because access to effective treatment is extremely limited. In rural areas, the infection rates are highest during the rainy season - a time of intense agricultural activity. Research indicates that families affected by malaria clear 60 percent less crops than other families.

Malaria has been estimated to cost Africa more than US$ 12 billion every year in lost GDP, even though it could be controlled for a fraction of that sum.

Prevention and Care
The combination of tools to prevent and treat malaria includes long-lasting insecticidal nets and artemisinin-based combination therapy (ACT), supported by indoor residual spraying of insecticide and intermittent preventive treatment in pregnancy. In 2005, the World Health Assembly set targets of more than 80 percent coverage of these key interventions by 2010.

Recent studies in four African countries showed that high coverage of both prevention and treatment interventions can decrease malaria mortality in children up to 50%, and greatly reduce the overall burden of malaria in both adults and children.

Unfortunately, in most African countries, coverage of these interventions is far below the 80 percent target. Surveys in 18 African countries found that 34 percent of households owned an insecticide-treated net; 23 percent of children and 27 percent of pregnant women slept under an insecticide-treated net; 38 percent of children with fever were treated with antimalarial drugs, but only 3 percent with ACT; and 18 percent of women used intermittent preventive treatment in pregnancy. Only five African countries reported coverage of indoor residual spraying sufficient to protect at least 70 percent of people at risk of malaria.

In regions other than Africa, intervention coverage is difficult to measure because household surveys are uncommon, preventive methods usually target high-risk populations of unknown size, and National Malaria Control Programmes do not report on diagnosis and treatment in the private sector.

The 2001 report of the WHO Commission on Macroeconomics and Health estimated that up to US$2 billion are needed each year to achieve the goal of halving the burden of malaria by 2010. While contributions from the international community and countries themselves are steadily increasing, much work and investment is still needed, especially in Africa, to protect the millions at risk.

“World Malaria Report 2008,” World Health Organization, Geneva, September 2008

“Impact of long-lasting insecticidal-treated nets (LLINs) and artemisinin-based combination therapies (ACTs) measured using surveillance data, in four African countries,” World Health Organization, Geneva, January 2008

“Roll Back Malaria information sheet: Malaria in Africa", World Health Organization, Geneva, 2003

"Malaria Fact Sheet," World Health Organization, Geneva October 1998

http://www.who.int/malaria/

Malaria in Africa

Malaria is an infection caused by a parasite and carried from person to person by mosquitoes. If bitten, anyone can become infected. Patients with malaria typically are very sick with high fevers, shaking chills, and flu-like illness—headache, muscle aches, fatigue.

Symptoms may appear within 24 hours but can take as long as 14 days to manifest after the infectious mosquito bite. If drugs are not available for treatment or the parasites are resistant to them, the infection can progress rapidly to become life-threatening. Malaria can kill by infecting and destroying red blood cells (anemia) and by clogging the capillaries that carry blood to the brain (cerebral malaria) or other vital organs.

Though malaria is preventable and treatable, the World Health Organization estimates that each year 300–500 million new cases occur and more than 1 million people die. Not only does malaria result in lost life and lost productivity due to illness and premature death, but it also hampers children's schooling and social development through both absenteeism and permanent neurological damage associated with severe cases.

Malaria thrives in certain global zones because of geography, poverty and existing infected mosquito populations. Infection is a constant hazard for almost half the world's population and is a constant challenge and resource drain for more than 100 governments.


Mosquito bed net installed in a hut in the village of Kiyi, Kuje, near Abuja, Nigeria

© WHO/Pierre Virot
Treatable, Yet Deadly

This preventable, treatable disease remains one of the most severe public health problems worldwide. It is a leading cause of death in many developing countries. Most of the victims are young African children. Across the continent, an African child dies every 30 seconds of malaria.

Currently, there is no vaccine, but treatment is available. Also, prevention methods are well understood and relatively inexpensive. Mosquito-killing sprays and bed nets protect people from the tiny bite that means infection, and often death. The challenge remains to spread knowledge and resources across borders to those in need.

And those borders are widening. Malaria causes a negative cycle: Impoverished people without access to prevention methods and health systems are infected at the highest rates. Then, the disease slows development by overwhelming households and existing infrastructure. The weight of malaria on fragile governments and social services reduces the economic growth of countries. The result is even more poverty, increasing the number of people who are vulnerable to malaria.

This cycle can be disrupted.


Small child in advanced stage of malaria at Garki General Hospital in Abuja, Nigeria

© WHO/Pierre Virot
International Action

Clear targets and strategies unite the international community in the eradication of malaria. The Millennium Development Goals outline what needs to be done, while the Roll Back Malaria initiative lays out a plan. The World Health Organization (WHO), United Nations (UN) and World Bank are working alongside thousands of partners to control malaria on a large scale.

At the World Bank, the counterattack on malaria in Africa includes a multi-country prevention and treatment Booster Program. The effort, as of July 2006, includes a commitment of US $167 million to eight countries with US $240 million more planned in six additional nations. This year, the program already invests three times more than last year.

About 240 million people, including 42 million children under the age of 5, and nearly 10 million pregnant women are in areas covered by Booster Program projects in Sub-Saharan Africa.

The global response to malaria is growing outside the World Bank, too.

New large-scale non-governmental organizations, like the Bill and Melinda Gates Foundation, are active in the fight. The World Bank is a partner with the Gates Foundation and other groups in anti-malaria programs. Private businesses play an essential role as well. More local insecticide, bed net and medicine manufacturers need to open up and compete to create lower prices for prevention and treatment in Africa.

To wipe out the devastating disease, the fight against it is expanding from incremental country-by-country programs to a continent-wide strategy.


What Youthink! Heard From You!

Summer interns at the World Bank shared their thoughts on why it's important to stop malaria and why that's so hard to do.

Read their answers
What Can I Do?

If you live in a country with a high risk of malaria infection, arm yourself with knowledge. Most national health ministries have detailed maps about where danger is greatest and least. Generally, places of special caution are the countryside and wherever there is standing water, from puddles and cisterns to swamplands.

Be aware of malaria regions when you travel. This includes most of the Southern Hemisphere and the entirety of Sub-Saharan Africa. Rural areas are particularly hazardous. Take precautions to protect yourself against infected mosquitoes.

Live with awareness. Get active in the global fight again malaria through donating your time (for instance, helping arrange an activity around World Malaria Day which is usually in April every year), or money toward the cause.

Visit the links in the Learn More box on this page for more information.

A Public-Private Partnership Helps to Contain Malaria Outbreaks on Zanzibar

Using a cell phone, a health worker enters data into Zanzibar’s early case detection and reporting system, made possible through a novel public-private partnership. Participating health facilities report the total number of outpatient visits,number of laboratory-confirmed malaria cases, and number of persons tested for malaria that week.
Source: Hafidh Mohammed/RTI
Malaria has declined to such low levels on Zanzibar that early detection and prompt reporting of malaria cases have become critical to prevent outbreaks. Using cell phones, 52 participating health facilities report weekly malaria data via a customized text messaging menu. This innovative approach has been made possible through a public-private partnership between Selcom wireless, (a Tanzanian information technology company), the Zanzibar Malaria Control Program (ZMCP), PMI, and Research Triangle Institute. The malaria data are transmitted to a secure computer server, processed, and then sent to the ZMCP program manager,district medical officers, and other MOH authorities. When the number of weekly laboratory-confirmed malaria cases exceeds the average number of cases from the previous three-month period, representatives from the district health management team and ZMCP visit the health facility within 24 hours. If an outbreak is confirmed, the district surveillance officer will notify the affected community and alert all health facilities in the affected district. Officials will then make house-to-house visits to provide presumptive ACT treatment to all residents with a fever, regardless of whether they have laboratory-confirmed malaria. Officials may also decide to initiate selective IRS to supplement the already high levels of ITN ownership and usage.

Scientists Reveal Malaria Parasites' Tactics For Outwitting Our Immune Systems

Main Category: Immune System / Vaccines
Also Included In: Tropical Diseases
Article Date: 01 Dec 2009 - 6:00 PST

email to a friend printer friendly view / write opinions rate article
Ads by Google
--------------------------------------------------------------------------------
Malaria Information
Find Info on Causes, Symptoms, Treatments & More - Faster w/Bing ™
www.Bing.com
Current Article Ratings:

Patient / Public:

Health Professional:

Article Opinions: 0 posts

Find other articles on: "malaria in africa"
Malaria parasites are able to disguise themselves to avoid the host's immune system, according to research funded by the Wellcome Trust and published recently in the journal Proceedings of the National Academy of Sciences.

Malaria is one of the world's biggest killers, responsible for over a million deaths every year, mainly in children and pregnant women in Africa and South-east Asia. It is caused by the malaria parasite, which is injected into the bloodstream from the salivary glands of infected mosquitoes. There are a number of different species of parasite, but the deadliest is the Plasmodium falciparum parasite, which accounts for 90 per cent of deaths from malaria.

The malaria parasite infects healthy red blood cells, where it reproduces. The P. falciparum parasite generates a family of molecules, known as PfEMP1, that are inserted into the surface of the infected red blood cells. The cells become sticky and adhere to the walls of blood vessels in tissues such as the brain. This prevents the cells being flushed through the spleen, where the parasites would be destroyed by the body's immune system, but also restricts blood supply to vital organs.

Symptoms can differ greatly between young and older children depending on previous exposure to the parasite. In young children, the disease can be extremely serious and potentially fatal if untreated; older children and adults who have grown up in endemic areas are resistant to severe malaria but rarely develop the ability to rid their bodies of the parasite.

Each parasite has 'recipes' for around sixty different types of PfEMP1 molecule written into its genes. However, the exact recipes differ from parasite to parasite, so every new infection may carry a set of molecules that the immune system has not previously encountered. This has meant that in the past, researchers have ruled out the molecules as vaccine candidates. However there appear to be at least two main classes of PfEMP1 types within every parasite, suggesting different broad tactical approaches to infecting the host. The most efficient tactic or combination of tactics to use may depend on the host's immunity.

Now, Dr George Warimwe and colleagues from the Kenya Medical Research Institute (KEMRI)-Wellcome Trust Programme and the Wellcome Trust Sanger Institute, have shown that the parasites adapt their molecules depending on which antibodies it encounters in the host's immune response. They have also found evidence to suggest that there may be a limit to the number of molecular types that are actually associated with severe disease.

"The malaria parasite is very complex, so our immune system mounts many different responses, some more effective than others and many not effective at all," explains Dr Peter Bull from the KEMRI-Wellcome Trust Programme and the University of Oxford, who led the research. "We know that our bodies have great difficulty in completely clearing infections, which begs the question: how does the parasite manage to outwit our immune response? We have shown that, as children begin to develop antibodies to parasites, the malaria parasite changes its tactics to adapt to our defences."

The researchers at the KEMRI-Wellcome Trust Programme studied malaria parasites in blood samples from 217 Kenyan children with malaria. They found that a group of genes coding for a particular class of PfEMP1 molecule called Cys-2 tended to be switched on when the children had a low immunity to the parasite; as immunity develops, the parasite switches on a different set of genes, effectively disguising it so that immune system cannot clear the infection

Dr Warimwe and colleagues also found an independent association between activity in Cys-2 genes and severe malaria in the children, suggesting that specific forms of the molecule may be more likely to trigger specific disease symptoms. This supports a previous study in Mali which suggested that the same class of PfEMP1 molecule was associated with cerebral malaria.

The findings could suggest a new approach to tackling malaria, in terms of both vaccine development and drug interventions, argues Dr Bull.

"If there exists a limited class of severe disease-causing variants that naturally-exposed children learn to recognise readily, this opens up the possibility of designing a vaccine against severe malaria that mimics an adult's immune response, making the infections less dangerous. But this would still be an enormous task.

"Similarly, if we can establish what the particular class of molecules are doing, then we may be able to develop a drug to modify this function and relieve symptoms of severe disease."

Malaria Mistreated in Nearly Two Thirds of Cases in Kenya

Authors and Disclosures

Information from IndustryAssess clinically focused product information on Medscape.
Click Here for Product Infosites – Information from Industry. November 26, 2009 (Washington, DC) — Results from a study conducted in 2 health facilities in Kenya show that the mistreatment of malaria might be as high as 66%. The findings, presented here at the American Society of Tropical Medicine and Hygiene 58th Annual Meeting by Yaw A. Afrane, MB, from the Kenya Medical Research Institute in Kisumu, confirm those from other studies about the mistreatment of malaria in certain regions.

Intensive malaria control programs have been implemented in sub-Saharan Africa; however, the reliability of hospital data on diagnosis and treatment has been questioned.

To determine if or how much misdiagnosis was occurring, Dr. Afrane and colleagues conducted both passive clinic-based and active community-based case surveillance in the communities of Kakamega, Vihega, and Emuhaya. Malaria is endemic in these communities, which are situated in the western highlands of Kenya.

The catchment populations for the passive clinic-based surveillance ranged from 21,000 to 26,085 patients; for the active community-based surveillance, the sampled populations ranged from 1789 to 1954. Mosquitoes, which breed during the wet weather, transmit malaria, so disease prevalence varies by season.

As expected, the active surveillance found a typical peak prevalence of 6% to 7% from May to July, the rainy season, and of 2% to 3% during the nonrainy season. However, when Dr. Afrane put the curve for the passive surveillance pattern against the active one, no seasonality pattern emerged.

"When we saw this discrepancy in the number of cases between one method and another, we wanted to see what was going on," Dr. Afrane said during an interview with Medscape Infectious Diseases. "You wouldn't expect to see a difference with a seasonally occurring disease like malaria." Several factors could explain such a difference, including overtreatment, misdiagnosis, presumptive treatment, and underreporting.

To study this, random blood slides were made from patients referred for malaria testing. Slides were analyzed by Dr. Afrane's research team and by hospital technicians. All readings were done in a masked fashion; readers did not know how the others had interpreted the slides.

Blood slides were obtained from patients who were presumptively treated for malaria because of the symptoms they showed. A questionnaire was designed to collect information from these patients, and clinicians were asked how they made their diagnosis of malaria.

The findings were quite striking, Dr. Afrane said. Among the 2544 outpatients (close to half were children younger than 5 years), 42% were diagnosed with clinical malaria and 85% presented with a fever.

According to Dr. Afrane, clinical malaria is diagnosed by the presence of fever, parasitemia (by microscopy), and other related symptoms, such as vomiting, headache, nausea, and diarrhea. However, microscopy didn't bear these findings out.

Of the 2544 patients, microscopy showed the "true positive" rate to be 35% (n = 914) and the "true negative" rate to be 64% (n = 1630). Among the 914 cases of true positives, the clinic diagnosed 54% as positive. All these subjects received antimalarial treatment.

For the 45.7% diagnosed as negative by the clinic, more than half (57%) received antimalarial treatment. Treatment of the true negatives shed even more light on what was going on, Dr. Afrane explained. Among these 1630 patients, the clinic diagnosed 28% as positive by microscopy. All these patients received antimalarial treatment. Among the nearly 72% that were deemed negative by the clinic, 68% received treatment.

The difficulty lies in the reliability of the microscopy test. "There are several reasons for the unreliability of microscopy," said Meredith McMorrow, MD, MPH, FAAP, from the Centers for Disease Control and Prevention's Malaria Branch in Atlanta, Georgia, and chair of the session. "Limited resources probably play a big role in terms of having good equipment, but high staff turnover and limited opportunities for training may also play a role."

Dr. Afrane agreed that this is a big part of the problem. "Some of the misdiagnosis problems can also come from cases where parasite levels are low, and therefore more difficult to accurately detect," Dr. Afrane told Medscape Infectious Diseases. "So what happens is that clinicians end up not trusting the test and make the decision to treat people based on clinical judgment."

Dr. Afrane and his team also studied data from 784 outpatients who did not receive diagnostic testing at the clinic visit, 37% of whom had a clinical diagnosis of malaria. The reasons for the diagnosis varied; 45% of patients refused testing because of lack of money, fear of having their blood drawn, or believing it wasn't necessary. Physicians did not request laboratory confirmation of malaria in approximately half the cases because they considered it unnecessary.

The Kenyan investigator reported that 63% of patients ended up being overprescribed malaria drugs, mostly artemisinin-combination therapy (ACT). ACT is now considered the best therapy for malaria caused by Plasmodium falciparum.

"There is a very big debate about whether presumptive treatment is or isn't good," said Dr. Afrane. "It's very hard for clinicians to see sick patients and not treat them." This challenge is compounded when a reliable diagnostic test is not available.

However, the misuse of drugs — as demonstrated in this study — always generates concern about the early onset of resistance, Dr. Afrane explained. In addition, the unreliability of hospital-based data makes accurate evaluation of malaria programs difficult.

But there is light on the horizon, he said. Rapid diagnostic tests (RDTs) for malaria detect specific antigens produced by malaria parasites that are present in the blood of infected individuals. Some RDTs also test for the presence of antibodies. "RDTs are being rolled out now for use in settings like this," noted Dr. McMorrow. "There are still some technical challenges, like stability under varying field conditions and educating staff about these new tools, but we think these are very promising in terms of improving diagnostic accuracy."

The study was funding by National Institutes of Health grants. The authors have disclosed no relevant financial relationships.

American Society of Tropical Medicine and Hygiene (ASTMH) 58th Annual Meeting: Abstract 679. Presented November 20, 2009.

[CLOSE WINDOW]
Authors and Disclosures
Journalist
Maria Sgambati, MD
Maria Sgambati, MD is a freelancer for Medscape.

Print This

More on This Topic
eMedicine Clinical Reference
Malaria (Pediatrics: General Medicine)
Malaria (Infectious Diseases)
Malaria (Emergency Medicine)


Medscape Medical News © 2009 Medscape, LLC
Send press releases and comments to news@medscape.net.

Scientists reveal malaria parasites' tactics for outwitting our immune systems

IMAGE: This is an Anopheles gambiae mosquito sucking blood from human skin. This mosquito is the vector for malaria in Africa.


Click here for more information.



Malaria parasites are able to disguise themselves to avoid the host's immune system, according to research funded by the Wellcome Trust and published today in the journal Proceedings of the National Academy of Sciences.

Malaria is one of the world's biggest killers, responsible for over a million deaths every year, mainly in children and pregnant women in Africa and South-east Asia. It is caused by the malaria parasite, which is injected into the bloodstream from the salivary glands of infected mosquitoes. There are a number of different species of parasite, but the deadliest is the Plasmodium falciparum parasite, which accounts for 90 per cent of deaths from malaria.

The malaria parasite infects healthy red blood cells, where it reproduces. The P. falciparum parasite generates a family of molecules, known as PfEMP1, that are inserted into the surface of the infected red blood cells. The cells become sticky and adhere to the walls of blood vessels in tissues such as the brain. This prevents the cells being flushed through the spleen, where the parasites would be destroyed by the body's immune system, but also restricts blood supply to vital organs.

Symptoms can differ greatly between young and older children depending on previous exposure to the parasite. In young children, the disease can be extremely serious and potentially fatal if untreated; older children and adults who have grown up in endemic areas are resistant to severe malaria but rarely develop the ability to rid their bodies of the parasite.

Each parasite has 'recipes' for around sixty different types of PfEMP1 molecule written into its genes. However, the exact recipes differ from parasite to parasite, so every new infection may carry a set of molecules that the immune system has not previously encountered. This has meant that in the past, researchers have ruled out the molecules as vaccine candidates. However there appear to be at least two main classes of PfEMP1 types within every parasite, suggesting different broad tactical approaches to infecting the host. The most efficient tactic or combination of tactics to use may depend on the host's immunity.

Now, Dr George Warimwe and colleagues from the Kenya Medical Research Institute (KEMRI)-Wellcome Trust Programme and the Wellcome Trust Sanger Institute, have shown that the parasites adapt their molecules depending on which antibodies it encounters in the host's immune response. They have also found evidence to suggest that there may be a limit to the number of molecular types that are actually associated with severe disease.

"The malaria parasite is very complex, so our immune system mounts many different responses, some more effective than others and many not effective at all," explains Dr Peter Bull from the KEMRI-Wellcome Trust Programme and the University of Oxford, who led the research. "We know that our bodies have great difficulty in completely clearing infections, which begs the question: how does the parasite manage to outwit our immune response? We have shown that, as children begin to develop antibodies to parasites, the malaria parasite changes its tactics to adapt to our defences."

The researchers at the KEMRI-Wellcome Trust Programme studied malaria parasites in blood samples from 217 Kenyan children with malaria. They found that a group of genes coding for a particular class of PfEMP1 molecule called Cys-2 tended to be switched on when the children had a low immunity to the parasite; as immunity develops, the parasite switches on a different set of genes, effectively disguising it so that immune system cannot clear the infection

Dr Warimwe and colleagues also found an independent association between activity in Cys-2 genes and severe malaria in the children, suggesting that specific forms of the molecule may be more likely to trigger specific disease symptoms. This supports a previous study in Mali which suggested that the same class of PfEMP1 molecule was associated with cerebral malaria.

The findings could suggest a new approach to tackling malaria, in terms of both vaccine development and drug interventions, argues Dr Bull.

"If there exists a limited class of severe disease-causing variants that naturally-exposed children learn to recognise readily, this opens up the possibility of designing a vaccine against severe malaria that mimics an adult's immune response, making the infections less dangerous. But this would still be an enormous task.

"Similarly, if we can establish what the particular class of molecules are doing, then we may be able to develop a drug to modify this function and relieve symptoms of severe disease."


###

FREQUENTLY ASKED QUESTIONS ABOUT MALARIA

http://www.umc.org/site/c.lwL4KnN1LtH/b.5303261/

THIS IS THE VECTOR THAT TRANSPORTS THE KILLER PATHOGEN(PLASMODIUM

Malaria Brings Poverty

Many people ask many funny questions about Africa and the problems and the Afriacans face but one thing people fail to recognize or realise is the fact that Africa is a tough and rough environment. Can you figure out growing out in an environment where you know one time you will fall sick with malaria? However, people go on with their lives as usual.

MALARIA CAN BE BEATEN ONCE AND FOREVER

It only requires people like you accepting to be counted with the history makers people of The United Methodist Church.