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The East African : March 3rd 2014
The EastAfrican 36 OUTLOOK MARCH 1-7,2014 S CI E N C E Anti-malaria interventions paying off The disease bu≥den associated with P. falcipa≥um ≥emains poo≥ly defined By CHRISTABEL LIGAMI Special Correspondent A frica has recorded a substantial reduction in malaria transmis- sion over the past decade, a new analysis by Lancet shows, giving credit to the multibillion dollar interventions by governments and donors. However, 57 per cent of the popu- lation in 2010 continued to live in areas where transmission remains moderate-to-intense, thus global support to sustain and accelerate the reduction of transmission must remain a priority, the Lancet report said. “If investments in malaria are not sustained, hundreds of millions of Africans run the risk of rebound transmission, with catastrophic consequences,” it adds. The analysis, carried out across 49 endemic African countries including all the East African countries, indicates that in most countries there has been a reduction in transmission. These reductions probably contributed to progress towards the disease burden targets in the Global Malaria Action Plan and the Millennium Development Goals. Over a decade ago, the Roll Back Malaria Partnership was launched, followed by unprecedented investment in malaria control. Africa was then grappling with an unprecedented disease epidemic. Increases in overseas develop- ment assistance have led to substantial improvements in the number of vulnerable populations protected 10 YEARS LATER... The Lancet has conducted a temporal and spatial analysis of the largest parasite prevalence data assembly in Africa to define Plasmodium falciparum transmission intensity at the launch of Roll Back Malaria in 2000 and a decade after substantial financing of malaria control. The study, funded by against malaria infection and who have access to drugs that effectively treat the disease. However, for most malaria-en- demic countries in Africa, the disease burden associated with P falciparum, and how this has changed over the decade, remains poorly defined. Attempts to track the changing burden of malaria in Africa have focused on modelled predictions of clinical and fatal outcomes. However, the clinical presentation of P. falciparum shares similar symptoms with competing causes of febrile illness and death, while the presence of infection does not infer disease due to acquired clinical immunity. Conversely, malaria infection may be an underlying risk factor for deaths from other causes. Most importantly, disease and Wellcome Trust, focused on national estimates of change in transmission intensity and populations at risk in Africa during the period 2000—2010 in Africa. It aimed to quantify the effect of the investment in malaria control over the past decade and to forecast future changes in malaria burden. If investments in malaria are not sustained, hundreds of millions of Africans run the risk of rebound transmission, with catastrophic consequences. Pic: File mortality events associated with malaria infection are often treated and occur outside of the formal health sector. They are are thus under the radar of poorly functioning health information and civil registration systems. A less ambiguous and ubiquitous measure of malaria, which has been used for over 100 years in Africa, is whether an individual selected through random community surveys has evidence of infection after a blood sample examination. Recent modelled descriptions of parasite prevalence in Africa predict the contemporary intensity of P falciparum. These predictions, the researchers say, do not provide information on the extent and intensity of transmission before scaled malaria control. Consequently, they cannot be used to examine changing risks, the effect of individual or combined interventions, or the rebound transmission that might be expected if financing for malaria control were to end. FAO ≥ules out human to animal t≥ansmission of bi≥d flu By CHRISTABEL LIGAMI Special Correspondent THERE IS no evidence that human patients infected with influenza A(H7N9), a low pathogenic virus in poultry, can transmit the virus to animals, including birds, the Food and Agriculture Organisation (FAO) has said. This comes after the first case of A (H7N9) outside China. The case was detected in a traveller from an H7N9-affected area of China. The patient, originally from Guangdong Province, where she is thought to have contracted the infection, was visiting Malaysia as a tourist. Guangdong is one of the Chinese provinces most affected by the H7N9 virus in 2014. “This case does not come as a surprise and should not be a cause for concern, but should remind the world to remain vigilant,” said FAO chief veterinary officer Juan Lubroth, adding that humans who become ill with influenza A(H7N9) constitute no threat to poultry. “In fact, we have no evidence that affected people could transmit the virus to other species, including birds. The highest risk of virus introduction is uncontrolled live poultry trade between affected and unaffected areas.” People, on the other hand, become infected following close contact with infected live poultry, mostly in live bird markets or when slaughtering birds at home. WHO risk assessments show that should in- fected people from affected areas travel internationally, community level spread is unlikely since the virus does not have the ability to transmit easily among humans. “Such ‘imported’ THe year in which the A(H7N9) virus was first reported in China. 2013 human cases, like the one reported in Malaysia last week, have been found in the past in previously unaffected areas of China, like Guizhou, Taiwan Province of China and Hong Kong SAR, and we will continue to see this in the not too distant future again. To date the virus has not been found in poultry populations outside affected areas in China,” Mr Lubroth said. Birds that have contracted A(H7N9) do not show clinical signs, which renders early detection of the virus in poultry more difficult. FAO, therefore, urges countries to adapt their surveillance programmes to include this recently emerged virus. One of the main recommendations is to target surveillance at critical points of entry, where direct or indirect live poultry trade with infected areas might occur. In order to reduce human exposure to zoonotic pathogens in general, biosecurity measures should be introduced or reinforced at live bird markets, including frequent cleaning and disinfection, establishing market rest days with no poultry present and applying good hygiene standards. With the support of USAid, FAO is assisting a number of member countries to prepare for a potential introduction of A(H7N9) into their poultry populations. Human infections with a new avian influenza A (H7N9) virus were first reported in China in March 2013. While some mild illnesses in human H7N9 cases have been seen, most patients have had severe respiratory illness, with about onethird resulting in death. BRIEFS WHO urges Uganda to strengthen TB control Although the World Health Organisation recently accredited Uganda for its management of tuberculosis, the global health body says the country needs to strengthen TB care and control among children and HIV-positive patients. The Global Tuberculosis Report 2013 Supplement, released last month, states that while the treatment success rate was 77 per cent in 2011, barely half of HIV-positive TB patients received ARTs in 2012. The number of cases of resistance is much higher than the number of patients started on secondline treatment.This warrants an emergency response to drugresistant TB. Kenyan govt to fund palliative care centres Cabinet Secretary for Health James Macharia. Picture: File The Kenyan government has announced it will allocate funds in the coming financial year to public palliative cancer treatment centres. Health Cabinet Secretary James Macharia said this will guarantee proper medical care for cancer patients who have often had to travel abroad to seek treatment. Cancer-related deaths are on the rise in the country. Uganda’s health ministry launches sickle cell lab The Ugandan Ministry of Health and the Sickle Cell Association of Uganda have launched the national sickle cell survey and screening laboratory aimed at helping victims of sickle cell anaemia, especially children. Uganda has a large burden of sickle cell anaemia but little attention has been paid to it. About 20 per cent of Ugandans are at risk of having a child born with the disease — about 33,000 babies are born with sickle cell anaemia each year. Lack of resources a challenge to researchers Lack of resources, training and funding opportunities are the most cited obstacles facing young researchers in the developing world, according to a survey by the Global Young Academy (GYA), a group that supports young scientists. The GYA sresearchers assessed the needs of young researchers around the world. They found that researchers in the developing world lack resources on several fronts, including research grants and training opportunities.
February 24th 2014
March 10th 2014