MALARIA: What's new for 'malaria rdt' in PubMed

:	William Brieger
Date:	Sat, Aug 3, 2013 6:07 pm

round up of recent abstracts on RDTs from pubmed ...

 

   malaria updates at: https://twitter.com/#!/bbbrieger and http://malariamatters.org/ and http://knowledge-gateway.org/malaria

   https://www.coursera.org/course/communitychange; https://www.coursera.org/course/commhealthworkers

PubMed Results

Items 1 - 3 of 3

1.	Malar J. 2013 Jul 22;12:258. doi: 10.1186/1475-2875-12-258. "Even if the test result is negative, they should be able to tell us what is wrong with us": a qualitative study of patient expectations of rapid diagnostic tests for malaria. Ansah EK, Reynolds J, Akanpigbiam S, Whitty CJ, Chandler CI. Dangme West District Health Directorate, Ghana Health Service, PO Box DD1, Dodowa, Ghana. Ansahekdr@yahoo.co.uk. Abstract BACKGROUND: The debate on rapid diagnostic tests (RDTs) for malaria has begun to shift from whether RDTs should be used, to how and under what circumstances their use can be optimized. This has increased the need for a better understanding of the complexities surrounding the role of RDTs in appropriate treatment of fever. Studies have focused on clinician practices, but few have sought to understand patient perspectives, beyond notions of acceptability. METHODS: This qualitative study aimed to explore patient and caregiver perceptions and experiences of RDTs following a trial to assess the introduction of the tests into routine clinical care at four health facilities in one district in Ghana. Six focus group discussions and one in-depth interview were carried out with those who had received an RDT with a negative test result. RESULTS: Patients had high expectations of RDTs. They welcomed the tests as aiding clinical diagnoses and as tools that could communicate their problem better than they could, verbally. However, respondents also believed the tests could identify any cause of illness, beyond malaria. Experiences of patients suggested that RDTs were adopted into an existing system where patients are both physically and intellectually removed from diagnostic processes and where clinicians retain authority that supersedes tests and their results. In this situation, patients did not feel able to articulate a demand for test-driven diagnosis. CONCLUSIONS: Improvements in communication between the health worker and patient, particularly to explain the capabilities of the test and management of RDT negative cases, may both manage patient expectations and promote patient demand for test-driven diagnoses. PMCID: PMC3723648 Free PMC Article
	PMID: 23876112 [PubMed - in process]
	Related citations

2.	Case Rep Med. 2013;2013:465906. doi: 10.1155/2013/465906. Epub 2013 Jun 19. Irregular Migration as a Potential Source of Malaria Reintroduction in Sri Lanka and Use of Malaria Rapid Diagnostic Tests at Point-of-Entry Screening. Wickramage K, Galappaththy GN, Dayarathne D, Peiris SL, Basnayake RN, Mosca D, Jacobs J. Health Unit, International Organization for Migration (IOM), No. 62, Green Path, Ananda Coomaraswamy Road, 3 Colombo, Sri Lanka. Abstract Background. We describe an irregular migrant who returned to Sri Lanka after a failed people smuggling operation from West Africa. Results. On-arrival screening by Anti-Malaria Campaign (AMC) officers using a rapid diagnostic test (RDT) (CareStart Malaria HRP2/PLDH) indicated a negative result. On day 3 after arrival, he presented with fever and chills but was managed as dengue (which is hyperendemic in Sri Lanka). Only on day 7, diagnosis of Plasmodium falciparum malaria was made by microcopy and CareStart RDT. The initially negative RDT was ascribed to a low parasite density. Irregular migration may be an unrecognized source of malaria reintroduction. Despite some limitations in detection, RDTs form an important point-of-entry assessment. As a consequence of this case, the AMC is now focused on repeat testing and close monitoring of all irregular migrants from malaria-endemic zones. Conclusion. The present case study highlights the effective collaboration and coordination between inter-governmental agencies such as IOM and the Ministry of Health towards the goals of malaria elimination in Sri Lanka. PMCID: PMC3703740 Free PMC Article
	PMID: 23861687 [PubMed]
	Related citations

3.	Malar J. 2013 Jul 12;12:240. doi: 10.1186/1475-2875-12-240. Community case management in malaria: review and perspectives after four years of operational experience in Saraya district, south-east Senegal. Ndiaye Y, Ndiaye JL, Cisse B, Blanas D, Bassene J, Manga IA, Ndiath M, Faye SL, Bocoum M, Ndiaye M, Thior PM , Sene D, Milligan P, Gaye O, Schellenberg D. Ministry of Health and Social Action, Dakar, Senegal. youlebou@gmail.com. Abstract BACKGROUND: Despite recent advances in malaria diagnosis and treatment, many isolated communities in rural settings continue to lack access to these life-saving tools. Community-case management of malaria (CCMm), consisting of lay health workers (LHWs) using malaria rapid diagnostic tests (RDTs) and artemisinin-based combination therapy (ACT) in their villages, can address this disparity. METHODS: This study examined routine reporting data from a CCMm programme between 2008 and 2011 in Saraya, a rural district in Senegal, and assessed its impact on timely access to rapid diagnostic tests and ACT. RESULTS: There was a seven-fold increase in the number of LHWs providing care and in the number of patients seen. LHW engagement in the CCM programme varied seasonally, 24,3% of all patients prescribed an ACT had a negative RDT or were never administered an RDT, and less than half of patients with absolute indications for referral (severe symptoms, age under two months and pregnancy) were referred. There were few stock-outs. DISCUSSION: This CCMm programme successfully increased the number of patients with access to RDT and ACT, but further investigation is required to identify the cause for over-prescription, and low rates of referrals for patients with absolute indications. In contrast, previous widespread stock-outs in Saraya's CCMm programme have now been resolved. CONCLUSION: This study demonstrates the potential for CCMm programmes to substantially increase access to life-saving malarial diagnostics and treatment, but also highlights important challenges in ensuring quality. PMCID: PMC3716525 Free PMC Article
	PMID: 23849053 [PubMed - in process]
	Related citations

MALNUTRITION: Swaziland: The cost of hunger

Photo: Guy Oliver/IRIN

Malnutrition a major crisis

MBABANE, 1 August 2013 (IRIN) - Swaziland’s reliance on international donors has averted famine but masked the reality of chronic food shortages and widespread malnutrition and stunting, according to a new study released by the government and the World Food Programme (WFP). 

The Cost of Hunger in Africa (COHA) survey, part of the African Union Commission initiative to enable African nations to quantify the human and economic costs of malnutrition within their borders, found that malnutrition follows most Swazis throughout their life. 

The COHA study was undertaken by Swaziland’s National Children’s Coordinating Unit in conjunction with the Ministry of Economic Planning and Development, which sought data on the true cost of hunger on the Swaziland economy. The ministries of agriculture, education and finance partnered with WFP to coordinate the first survey of its kind in the country. 

“Swaziland is among the first four countries to complete the Cost of Hunger process. Others include Egypt, Ethiopia and Uganda. Eight more have just begun. The Swazi government has been fully supportive of the initiative and a key participant,” Julia Cocchia, a consultant with WFP Swaziland, told IRIN. 

Children first to suffer 

WFP noted that the high cost of hunger is undermining the impoverished country’s economy and is tied to social and individual regression. ““A large proportion of costs related to undernutrition are met by the families themselves as often these children are not provided with proper health care” the report concluded. 

The most dangerous time for a Swazi is after birth through a child’s first five years; malnutrition is responsible for 8 percent of child mortalities. Due to Swaziland’s patchy health system, one-third of ill children do not receive medical care, the survey found, while 69 percent of cases of child undernutrition are not treated. 

“You can spot the children who have not eaten,” said Thandi Simelane, a fifth-grade teacher in Manzini. “Their eyes droop. They cannot concentrate. They haven’t any energy. Often they have flus because their bodies haven’t the nourishment to fight off viruses. They don’t keep up with their studies. The parents don’t have money to pay school fees just as they don’t have money for food, and we lose these children. It is not that they drop out of school because they cannot study, but it is part of the overall poverty of the family. 

“There are some neighbourhood care points where they children can get a meal, but these are mostly pre-school children. There are no government-supported food feeding schemes in Swaziland. What food there is comes from fees paid by parents and donors,” said Simelane. 

Life does not improve for the malnourished as they grow older. The effects of undernutrition, the report notes, “exacerbate the problems in social integration and increase or intensify poverty. A vicious cycle is perpetuated as vulnerability to malnutrition grows.” 

Forty percent of adult Swazis are stunted, largely due to malnutrition at an early age, with effects that are likely follow them throughout life. 

Economic toll 
The levels of illness and physical impairment caused by stunting represent a major crisis for the small country of about one million people. The 37 million working hours lost due to malnutrition-related mortalities in 2009 (the period analysed by the survey) cost the country US$40 million, or 1.4 percent of its GDP. In addition, about $92 million was lost in 2009 as a result of child undernutrition, equivalent to 3.1 percent of GDP. 

Economic Planning Minister Prince Hlangusempi Dlamini, whose ministry was a principal partner in the survey, noted of the survey data: “The saddest thing is that this cycle [of malnutrition] is not limited to the life cycle of each individual, but affect that person’s children, who will pass it on to yet another generation.” 

The report noted, “In Swaziland, the results of the study strongly suggest that to achieve sustainable human and economic growth, special attention must be given to addressing nutrition in the early stages of an individual’s life.” 

Recommendations put forward by the report call for massive spending on nutritional interventions, but do not acknowledge Swaziland’s inability to finance such interventions without a significant reordering of public spending and international donor help. 

jh/kn/rz 

IPS August 1 2013

2013/8/1	Click here for the online version of this IPS newsletter
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Read more IPS reporting on Poverty & MDGs here.

POVERTY: Study links hygiene and height

Photo: Nancy Palus/IRIN

Have you had your soap and clean water today?

BANGKOK, 1 August 2013 (IRIN) - Soap and clean water for effective handwashing can help boost a young child’s growth, according to the first large-scale scientific review to link hygiene to height - one measure of child nutrition.

While medical studies have amply proven how improved hygiene can reduce outbreaks of diarrhoea - a leading killer among children under the age of five - they have not systematically measured the impact of water, sanitation and hygiene interventions on a child’s height. 

The latest study showed a “small but improved” average growth of half a centimetre among children who received clean water and soap for handwashing as opposed to those who did not. Researchers found clean water and soap reduced stunting by up to 15 percent. 

There is growing scientific evidence that repeated bouts of diarrhoea reduce a gut’s ability to absorb life-enhancing nutrients that allow children to develop mentally and physically. 

“WASH [water, sanitation and hygiene] squarely fits under the heading of an underlying cause of malnutrition,” one of the study’s lead authors, Alan Dangour, a public health nutritionist from the London School of Hygiene & Tropical Medicine, told IRIN. 

Researchers identified 14 studies conducted in low and middle-income countries that provided data on the impact of WASH programming on the physical growth of nearly 9,500 children. Included were five studies with control groups of children who did not receive clean water and soap, but who were similar in most other ways to the ones who did. 

“This is a scientifically robust study design that largely removes the problems faced by observational studies,” added Dangour. 

Chronic malnutrition, as evidenced by stunting (when a child is too short for his or her age group), is a leading cause of preventable mental disability and contributor to three million deaths annually of children who have yet to reach age five (45 percent of all deaths in that age group). 

“Until now, we have not had a demonstration of the direct nutrition impact of WASH interventions on nutrition,” said Francesco Branca, the director of nutrition for health and development at the World Health Organization, who was not involved in the study. “This review shows that a multi-pronged approach [to solving undernutrition] is the way to go.” 

Researchers noted available studies on which they base their most recent findings were short-term (with none lasting more than one year), and some had data shortcomings. 

While Dangour admitted that “we need much more robust evidence to definitely state that WASH is a `cure for stunting’,” the findings are, nevertheless, important, he concluded. 

pt/cb

MALARIA: mapping resistance

	William Brieger
Date:	Sat, Jul 27, 2013 8:33 am

In Africa using the Internet to map malaria drug resistance for a more effective kill

According to UNICEF, “Malaria kills a child somewhere in the world every minute”.   It is one of the greatest causes of infant mortality, competing with HIV, Tuberculosis and wars.  A new internet-based initiative, the IR Mapper is the latest effort at gathering data on resistance to malaria drugs, especially of insecticides.

The World Health Organization gives a 2010 estimate of 219 million cases of malaria of which 660,000 deaths occurred especially among African children.  Things are however improving and although we may not achieve the 2015 UN estimate for total eradication, there is reason to hope thanks especially to the effort of many in the international community.  This has resulted in a reduction of death from malaria by 25% worldwide and 33% in the African region.

Malaria is transmitted mainly through the bite of the Anopheles mosquito.  The twin-mainstays of control of the disease have therefore been the provision of insecticide-treated bed nets, and the provision of affordable medicines.  Just as adults survive malaria through developing immunity however, the parasite develops resistance to both the insecticides and the medicines in use.

The IR Mapper initiative is an interactive online database of data of “insecticide susceptibility and resistance mechanisms” tests.  Users can view data published from 1954 to date, and can also upload their own data comparing this with available information.  Data on the IR Mapper were sourced from scientific articles and other published reports.  Data is available from more than 50 countries, from Afghanistan to India, from Bangladesh to South Africa. It includes data from the Democratic Republic of the Congo and Nigeria, two countries said to account for 40% of the estimated total malaria deaths globally.

IR Mapper was developed by a Kenyan firm; ESRI Eastern Africa using the Microsoft Azure platform, while data collation and proofreading were respectively done by the Switzerland based Vestergaard Fransend and the KEMRI/CDC (a joint project of the Kenyan Medical Research Institute and the US Centre for Disease Control).

- See more at: http://www.mercatornet.com/harambee/view/12521#sthash.NNapcPlT.dpuf

According to UNICEF, “Malaria kills a child somewhere in the world every minute”.   It is one of the greatest causes of infant mortality, competing with HIV, Tuberculosis and wars.  A new internet-based initiative, the IR Mapper is the latest effort at gathering data on resistance to malaria drugs, especially of insecticides.

The World Health Organization gives a 2010 estimate of 219 million cases of malaria of which 660,000 deaths occurred especially among African children.  Things are however improving and although we may not achieve the 2015 UN estimate for total eradication, there is reason to hope thanks especially to the effort of many in the international community.  This has resulted in a reduction of death from malaria by 25% worldwide and 33% in the African region.

Malaria is transmitted mainly through the bite of the Anopheles mosquito.  The twin-mainstays of control of the disease have therefore been the provision of insecticide-treated bed nets, and the provision of affordable medicines.  Just as adults survive malaria through developing immunity however, the parasite develops resistance to both the insecticides and the medicines in use.

The IR Mapper initiative is an interactive online database of data of “insecticide susceptibility and resistance mechanisms” tests.  Users can view data published from 1954 to date, and can also upload their own data comparing this with available information.  Data on the IR Mapper were sourced from scientific articles and other published reports.  Data is available from more than 50 countries, from Afghanistan to India, from Bangladesh to South Africa. It includes data from the Democratic Republic of the Congo and Nigeria, two countries said to account for 40% of the estimated total malaria deaths globally.

IR Mapper was developed by a Kenyan firm; ESRI Eastern Africa using the Microsoft Azure platform, while data collation and proofreading were respectively done by the Switzerland based Vestergaard Fransend and the KEMRI/CDC (a joint project of the Kenyan Medical Research Institute and the US Centre for Disease Control).
- See more at: http://www.mercatornet.com/harambee/view/12521#sthash.NNapcPlT.dpuf

According to UNICEF, “Malaria kills a child somewhere in the world every minute”.   It is one of the greatest causes of infant mortality, competing with HIV, Tuberculosis and wars.  A new internet-based initiative, the IR Mapper is the latest effort at gathering data on resistance to malaria drugs, especially of insecticides.

The World Health Organization gives a 2010 estimate of 219 million cases of malaria of which 660,000 deaths occurred especially among African children.  Things are however improving and although we may not achieve the 2015 UN estimate for total eradication, there is reason to hope thanks especially to the effort of many in the international community.  This has resulted in a reduction of death from malaria by 25% worldwide and 33% in the African region.

Malaria is transmitted mainly through the bite of the Anopheles mosquito.  The twin-mainstays of control of the disease have therefore been the provision of insecticide-treated bed nets, and the provision of affordable medicines.  Just as adults survive malaria through developing immunity however, the parasite develops resistance to both the insecticides and the medicines in use.

The IR Mapper initiative is an interactive online database of data of “insecticide susceptibility and resistance mechanisms” tests.  Users can view data published from 1954 to date, and can also upload their own data comparing this with available information.  Data on the IR Mapper were sourced from scientific articles and other published reports.  Data is available from more than 50 countries, from Afghanistan to India, from Bangladesh to South Africa. It includes data from the Democratic Republic of the Congo and Nigeria, two countries said to account for 40% of the estimated total malaria deaths globally.

IR Mapper was developed by a Kenyan firm; ESRI Eastern Africa using the Microsoft Azure platform, while data collation and proofreading were respectively done by the Switzerland based Vestergaard Fransend and the KEMRI/CDC (a joint project of the Kenyan Medical Research Institute and the US Centre for Disease Control).

- See more at: http://www.mercatornet.com/harambee/view/12521#sthash.NNapcPlT.dpuf

According to UNICEF, “Malaria kills a child somewhere in the world every minute”.   It is one of the greatest causes of infant mortality, competing with HIV, Tuberculosis and wars.  A new internet-based initiative, the IR Mapper is the latest effort at gathering data on resistance to malaria drugs, especially of insecticides.

The World Health Organization gives a 2010 estimate of 219 million cases of malaria of which 660,000 deaths occurred especially among African children.  Things are however improving and although we may not achieve the 2015 UN estimate for total eradication, there is reason to hope thanks especially to the effort of many in the international community.  This has resulted in a reduction of death from malaria by 25% worldwide and 33% in the African region.

Malaria is transmitted mainly through the bite of the Anopheles mosquito.  The twin-mainstays of control of the disease have therefore been the provision of insecticide-treated bed nets, and the provision of affordable medicines.  Just as adults survive malaria through developing immunity however, the parasite develops resistance to both the insecticides and the medicines in use.

The IR Mapper initiative is an interactive online database of data of “insecticide susceptibility and resistance mechanisms” tests.  Users can view data published from 1954 to date, and can also upload their own data comparing this with available information.  Data on the IR Mapper were sourced from scientific articles and other published reports.  Data is available from more than 50 countries, from Afghanistan to India, from Bangladesh to South Africa. It includes data from the Democratic Republic of the Congo and Nigeria, two countries said to account for 40% of the estimated total malaria deaths globally.

IR Mapper was developed by a Kenyan firm; ESRI Eastern Africa using the Microsoft Azure platform, while data collation and proofreading were respectively done by the Switzerland based Vestergaard Fransend and the KEMRI/CDC (a joint project of the Kenyan Medical Research Institute and the US Centre for Disease Control).

- See more at: http://www.mercatornet.com/harambee/view/12521#sthash.NNapcPlT.dpuf

 

http://www.mercatornet.com/harambee/view/12521

MALARIA: Bats devour mosquitoes, help check malaria

RAMESH KUMAR POUDEL CHITWAN, July 28: To everyone´s surprise, experts say that a bat can swallow over 2,000 mosquitoes in one hour. They say the flying mammal can be a boon for eliminating mosquito-borne diseases like malaria and dengue. As very few people are aware of the benefit from bats, many are given to eating the creature. Moreover, bat meat is a much preferred delicacy among members of the Chepang community. But a recent move by Chepangs in hilly Shaktikhor VDC in Chitwan district indicates that the community is also acknowledging the benefit from bats. For the last one and half years, the Chepangs have been conserving bats instead of eating them. “We realize now that bats are not to be destroyed, but rather preserved. They are good for humans as they protect us from mosquitoes,” said Baburam Chepang, a resident of the VDC. Earlier, bat meat was easily available at almost every lodge or eatry in the hills. But over the years, this item has become rare. “And villagers have also stopped eating bat meat,” informed Baburam. The killing of the flying mammal for food purposes has declined drastically, echoed Govinda Shrestha, chairman of Samphang Community Forest in the VDC. “After it was explained to locals that bats devour insects that destroy crops and even help protect us from mosquitoes, they have been for the preservation of the unique mammal,” said Shrestha. Previously, restuarants in the villages would sell roasted bat for Rs. 40 per piece. The locals became active in bat conservation after a non-government organization launched a public awareness program in the village with the support of the United Nations Development Program. The fruits of the churi plant and its seeds are a major source of income for members of the Chepang community. And these fruits and flowers are much liked by bats. “We encouraged locals to cultivate churi and preserve the flying mammal,” said Keshav Prasad Regmi, director of Yuwa Samaj. Bashu Bidari, a conservationist, informed that the bats available in the hill region of the districts are also known as ´fruit bats´. They live on the churi fruit and flowers. Besides the fruits, the bats also eat small insects and mosquitoes, admitted Bidari. He said various studies have already proved that a bat can consume over 2,000 mosquitoes in an hour.