Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Dramatic fall in malaria in The Gambia raises possibility of elimination in parts of Africa

31.10.2008
The incidence of malaria has fallen significantly in The Gambia in the last 5 years, according to a study carried out by experts there with support from scientists based in London.

The findings from the study, which was funded by the UK Medical Research Council, appear in today’s Lancet, and raise the possibility of eliminating malaria as a public health problem in parts of Africa.

Malaria is a major cause of illness and death in Africa, including The Gambia. Investigations into ways of controlling malaria have been underway in The Gambia for more than 50 years and, since 2003, efforts to deliver malaria interventions to pregnant women and children under 5 – including intermittent preventive treatment, the use of insecticide-treated bed nets (ITNs) and indoor residual spraying - have been stepped up considerably.

The authors sought to investigate the changes that have occurred in The Gambia over the past nine years, their potential causes, and public health significance. They analysed original records in order to establish the numbers and proportions of malaria inpatients, deaths and blood-slide examinations at one hospital over nine years (January 1999-December 2007) and at four health facilities in three different administrative regions over seven years (January 2001-December 2007). They obtained additional data from single sites for haemoglobin concentrations in paediatric admissions and for the age distribution of malaria admissions.

At each of the four sites with complete slide examination records, they found that the proportions of malaria-positive slides had decreased by 82%, 85%, 73% and 50% respectively between 2003 and 2007. Meanwhile, during the same period at the three sites with complete admission records, the proportions of malaria admissions fell by 74%, 69% and 27%. Proportions of deaths attributed to malaria in two hospitals fell by more than 90%.

The team also recorded a substantial shift in the average age of children who were admitted to one hospital with malaria after 2004, with far fewer under 5s being admitted after that year. The average age until 2004 was similar to that recorded ten years previously, so the finding of a trend towards older ages of malaria cases was new. A more substantial decrease of malaria admissions in younger children is likely to be largely due to increased use of ITNs, since this intervention is targeted at children under 5, but it may also reflect a situation in which children are taking longer to acquire immunity.

The team considered possible reasons for the decrease of malaria in The Gambia. Changes in rainfall cause some fluctuations in malaria from year to year, but could not account for the progressive reduction recorded since 2003, while socio-economic changes, improvements in communications and access to education may also have helped, although these factors tend to have a more gradual impact rather than the rapid changes reported at the different sites. A change in chemotherapy is likely to have played a substantial role – until 2004, chloroquine alone was mainly used but as parasite resistance to this drug had increased to high levels, the first-line treatment of choice became sulphadoxine plus pyrimethamine (SP) combined with chloroquine, from early 2005 onwards. SP has prophylactic as well as curative properties which may have been important.

The most substantial change in measures to prevent malaria has been the increase of coverage of ITNs, which thanks to well-publicised initiatives from the Global Fund, UNICEF and WHO increased threefold between 2000 and 2006 (49% of under 5s in The Gambia are now reported to be sleeping under ITNs – the highest reported coverage in Africa).

David Conway, of the London School of Hygiene & Tropical Medicine, who is based at the Medical Research Council Laboratories in Banjul in The Gambia, is one of the study’s authors. He comments: ‘These findings support the proposal that increased investment in malaria interventions in Africa can have a major effect on reducing morbidity and mortality from the disease. We need to consider the possibility of future elimination of malaria from some areas in Africa, but we also emphasise the importance of continuous surveillance, and there is no room for complacency with this disease’.

Lindsay Wright | alfa
Further information:
http://www.lshtm.ac.uk

More articles from Health and Medicine:

nachricht Routing gene therapy directly into the brain
07.12.2017 | Boston Children's Hospital

nachricht New Hope for Cancer Therapies: Targeted Monitoring may help Improve Tumor Treatment
01.12.2017 | Berliner Institut für Gesundheitsforschung / Berlin Institute of Health (BIH)

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Electromagnetic water cloak eliminates drag and wake

Detailed calculations show water cloaks are feasible with today's technology

Researchers have developed a water cloaking concept based on electromagnetic forces that could eliminate an object's wake, greatly reducing its drag while...

Im Focus: Scientists channel graphene to understand filtration and ion transport into cells

Tiny pores at a cell's entryway act as miniature bouncers, letting in some electrically charged atoms--ions--but blocking others. Operating as exquisitely sensitive filters, these "ion channels" play a critical role in biological functions such as muscle contraction and the firing of brain cells.

To rapidly transport the right ions through the cell membrane, the tiny channels rely on a complex interplay between the ions and surrounding molecules,...

Im Focus: Towards data storage at the single molecule level

The miniaturization of the current technology of storage media is hindered by fundamental limits of quantum mechanics. A new approach consists in using so-called spin-crossover molecules as the smallest possible storage unit. Similar to normal hard drives, these special molecules can save information via their magnetic state. A research team from Kiel University has now managed to successfully place a new class of spin-crossover molecules onto a surface and to improve the molecule’s storage capacity. The storage density of conventional hard drives could therefore theoretically be increased by more than one hundred fold. The study has been published in the scientific journal Nano Letters.

Over the past few years, the building blocks of storage media have gotten ever smaller. But further miniaturization of the current technology is hindered by...

Im Focus: Successful Mechanical Testing of Nanowires

With innovative experiments, researchers at the Helmholtz-Zentrums Geesthacht and the Technical University Hamburg unravel why tiny metallic structures are extremely strong

Light-weight and simultaneously strong – porous metallic nanomaterials promise interesting applications as, for instance, for future aeroplanes with enhanced...

Im Focus: Virtual Reality for Bacteria

An interdisciplinary group of researchers interfaced individual bacteria with a computer to build a hybrid bio-digital circuit - Study published in Nature Communications

Scientists at the Institute of Science and Technology Austria (IST Austria) have managed to control the behavior of individual bacteria by connecting them to a...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

See, understand and experience the work of the future

11.12.2017 | Event News

Innovative strategies to tackle parasitic worms

08.12.2017 | Event News

AKL’18: The opportunities and challenges of digitalization in the laser industry

07.12.2017 | Event News

 
Latest News

Multi-year submarine-canyon study challenges textbook theories about turbidity currents

12.12.2017 | Earth Sciences

Electromagnetic water cloak eliminates drag and wake

12.12.2017 | Power and Electrical Engineering

Liver Cancer: Lipid Synthesis Promotes Tumor Formation

12.12.2017 | Life Sciences

VideoLinks
B2B-VideoLinks
More VideoLinks >>>