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The East African : Mar 23rd 2015
The EastAfrican 36 OUTLOOK MARCH 21-27,2015 S CI E N C E Malaria burden stays high in Uganda Ac≥oss sub-Saha≥an Af≥ica, the p≥evalence ≥ate of the disease is dec≥easing, says ≥epo≥t By CHRISTABEL LIGAMI Special Correspondent T he malaria burden continues to be very high in Uganda, despite recent studies showing that prevalence rates are decreasing across many parts of sub-Saharan Africa, a new study notes. The findings of the study, pub- lished in the American Journal of Tropical Medicine & Hygiene, highlight the need for more aggressive methods of controlling the disease in high transmission areas of subSaharan Africa. While access to the most current malaria medications has increased dramatically in Uganda, the use of other recommended interventions is less widespread, according to the authors of the study. For example, the study shows that only up to 36 per cent of households have at least one long lasting insecticide-treated bednet, while only 6-7 per cent reported receiving indoor residual spraying with insecticides between 2006 and 2011. To prevent the further burden of the disease, the scientists say that there is a need to scale up campaigns to distribute insecticidetreated bednets and spray homes with insecticides, while considering new interventions such as using malaria drugs. “The use of both longlasting in- secticide treated nets and artemisinin-based combination therapies may be sufficient for minimising the severity of disease, improving child health and reducing childhood mortality at the level of an individual,” says the report. The report, however, suggests that in areas with high transmission intensity, reducing morbidity will require enhanced communitywide coverage of these interventions, and consideration of addi- WHO FACTS According to the World Health Organisation Malaria Report 2014, about 20,000 deaths due to malaria were reported in East Africa in 2013. Kenya, Uganda and Tanzania were ranked among the countries in sub-Saharan Africa, accounting for 90 per cent of the estimated number of P. falciparum — a malaria-causing parasite — infections. Since 2000, global investments in many types of malaria control are estimated to have resulted in a 47 per cent drop in the disease’s global mortality rate, and a 58 per cent decrease in the mortality rate among African children. “Current efforts at controlling malaria may not be as effective as previously believed.” Grant Dorsey, co-author of malaria study tional interventions. These include expanding indoor residual spraying (IRS), larval source management (which involves both the modification of water habitats and the direct application of larvicides to control mosquito production) and other novel vector control strategies, che- A mother and child sleep under a mosquito net. Picture: File moprevention (the use of chemical agents, drugs or food supplements to prevent disease) at the individual and/or community level, mass drug administration, and/or an effective vaccine. “Our findings suggest that cur- rent efforts at controlling malaria may not be as effective as previously believed in high-transmission areas, where the disease is the biggest threat,” said Grant Dorsey, a co-author of the study, and professor of infectious diseases at the University of California, San Francisco in the US. The study was conducted by sci- entists from Makerere University in Uganda, the University of California, San Francisco, Durham University in the UK, the University of Oxford and the London School of Hygiene and Tropical Medicine. It gathered surveillance data over 24 months — from August 2011 to September 2013. Initially, 755 children aged be- tween six months and 10 years with differing malaria characteristics were enrolled from 300 houses, randomly selected from three areas of Uganda. Episodes of malaria per person per year rose from an average of 0.97 to 1.93 in the moderate-transmission in one area, and from an average of 2.33 to 3.30 in a hightransmission rural area near the southeastern border with Kenya. The families were provided with bednets and had access to 24-hour medical care free of charge at a designated study clinic for episodes of fever. The children were also routinely tested for malaria every three months, irrespective of whether they had symptoms. Mosquito specimens were also collected monthly from light traps strategically placed in each house to estimate the percentages of mosquitoes in the study areas that were carriers of malaria. Healthcare workers provided over 2,500 treatments for malaria over the course of the study. “Children in our study experi- enced a significantly high rate of infection, and that rate increased in the two rural areas,” said Prof Dorsey. “Based on prior data, our higher transmission sites are likely to be representative of most of Uganda and perhaps of most other rural areas in sub-Saharan Africa as well. Af≥ican bush plant could aid ≥enal cance≥ t≥eatment AN AFRICAN bush plant could hold the key to killing renal (kidney) cancer cells, according to researchers from the School of Medicine at the University of Leeds in the UK. Phyllanthus engleri, also known as spurred phyllanthus, is found only in Tanzania, Zambia, Malawi, Zimbabwe and Mozambique. Previous studies have shown that the plant contains the chemical englerin A, which kills renal cancer cells — but they have not shown why. A 2008 study by Ratnayake et al published in the journal Organic Letters, was the first to discover that englerin A selectively killed renal cancer cells. The scientists discovered that very small amounts of englerin A activate the protein, TRPC4, and its close relative TRPC5. This triggers changes in the cancer cell that kill it. “This discovery is exciting because it means we could develop new cancer drugs targeting these particular proteins,” said David Beech, a professor at the School of Medicine at the University of Leeds, and the lead researcher. “Englerin A is particularly interesting because it is selective — it only kills renal cancer cells and a few other types of cancer cells. Other cell types are resistant to it, so we think englerin A has a great deal of potential.” More than 10,000 new cases of renal cancer are diagnosed each year, and half of them survive at least 10 years beyond diagnosis. The research showed that the protein acti- vated by englerin A forms channels that open to allow tiny electrically-charged atoms known as ions to enter cells and trigger changes. This import of ions was studied at a molecular level. “Renal cancer is a devastating disease crying out for novel and innovative therapeutic approaches. The discovery of how englerin A works and its protein target gives hope that new opportunities for treating this cancer can be found,” said Herbert Waldmann, co-author of the study, and director at the Max Planck Institute in the US. Ion channels have hardly been explored in renal cancer and the enigmatic TRPC proteins have not been considered in drug discovery for its treatment at all. The study has been published in the chem- istry journal Angewandte Chemie, and was conducted in cell lines developed from cancer patients. The research team will now work with the Dortmund, Germany-based Lead Discovery Centre, which offers professional support in drug development, on the next stage of the project. - By Christabel Ligami BRIEFS SA doctors successfully conduct penis transplant South African doctors announced that they have performed the world’s first successful penis transplant, three months after the ground breaking operation. The 21-year-old patient had his penis amputated three years ago after a botched circumcision at a traditional initiation ceremony. In a nine-hour operation at the Tygerberg Hospital in Cape Town, he received his new penis from a deceased donor. In 2006, a Chinese man had a penis transplant but his doctors removed the organ after two weeks due to “a severe psychological problem of the recipient and his wife.” Banana research project to begin trials in June A five-year project that aims to improve banana farming in Tanzania and Uganda is set to begin trials in June. The project, which received $13.8 million from the Bill and Melinda Gates Foundation in October last year, aims to develop high-yielding, disease-resistant banana hybrids for smallholder farmers in the two countries, where the crop is a staple. The project will be implemented by the International Institute of Tropical Agriculture alongside five doctoral and eight masters students. Ebola-hit countries face risk of measles outbreak Ebola-hit countries in West Africa are vulnerable to a measles outbreak that could infect hundreds of thousands of people, US researchers warn. Their study in the journal Science suggests that there could be even more deaths from other diseases because of the devastating impact of Ebola on the countries’ vaccination programmes. The scientists estimated that 20,000 more people were becoming susceptible to measles every month. The body of a person who died from Ebola is taken for burial in Monrovia. Pic: File Proposed: How to make ‘good’ weight loss drugs Two promising approaches to finding effective weight loss drugs have been presented at the annual meeting of the Endocrine Society in San Diego in the US. First, a team at Houston Methodist Research Institute used a drug that manipulates the amount of energy burned in the body by mimicking hormones produced by the thyroid. In the second, an early set of human trials on the oxytocin hormone that appeared to help reduce appetite was presented by a team at Harvard Medical School.
Mar 16th 2015
Mar 30th 2015