Showing posts with label malaria. Show all posts
Showing posts with label malaria. Show all posts

Sunday, January 25, 2015

Hobson's Choice

Hobson's choice is a free choice in which only one option is offered. As a person may refuse to take that option, the choice is therefore between taking the option or not; "take it or leave it".

There is no fear but the fear of hunger. Mosquito nets are widely considered a magic bullet against malaria — one of the cheapest and most effective ways to stop a disease that kills at least half a million Africans each year. An insecticide-treated mosquito net, hung over a bed, is the front line in the battle against malaria. It’s also the perfect mosquito-killing machine. The gauzy mesh allows the carbon dioxide that people exhale to flow out, which attracts mosquitoes. But as they swarm in, their cuticles touch the insecticide on the net’s surface, poisoning their nervous systems and shutting down their microscopic hearts. But many are not using their mosquito nets as global health experts have intended. Across Africa, from the mud flats of Nigeria to the coral reefs off Mozambique, mosquito-net fishing is a growing problem, an unintended consequence of one of the biggest and most celebrated public health campaigns in recent years.

Isabel Marques da Silva, a marine biologist at Universidade Lúrio in Mozambique explained “That’s why the incidence for malaria here is so high. The people don’t use the mosquito nets for mosquitoes. They use them to fish.”

“I know it’s not right,” Mr. Ndefi said, “but without these nets, we wouldn’t eat.”

“It’s simple economics,” said Carl Huchzermeyer, a fisheries manager for African Parks, a conservation organization in Bangweulu. “You could spend two days making a basket out of reeds, or just use a mosquito net.”

Scientists now worry about the collateral damage: Africa’s fish. But the unsparing mesh, with holes smaller than mosquitoes, traps much more life than traditional fishing nets do. The Malagasy word for these nets is “ramikaoko,” or the thing that takes all things together. A “real” net costs about $50, an enormous expense in a place where many people survive on a few dollars a day. Scientists say that could imperil already stressed fish populations, a critical food source for millions of the world’s poorest people. Many of these insecticide-treated nets are dragged through the same lakes and rivers people drink from, raising concerns about toxins. One of the most common insecticides used by the mosquito net industry is permethrin, which the United States Environmental Protection Agency says is “likely to be carcinogenic to humans” when consumed orally. The E.P.A. also says permethrin is “highly toxic” to fish. Most scientists say the risks to people are minimal, because the dosages are relatively low and humans metabolize permethrin quickly. But with coldblooded animals, it’s a different story. In many places, fish are dried for hours in direct sunlight on treated mosquito nets. Direct sunlight can break down the insecticide coating. Anthony Hay, an associate professor of environmental toxicology at Cornell University, said fish could absorb some of the toxins, leaving people to ingest them when they eat the fish. “We think we have a solution to everybody’s problems, and here’s an example of where we’re creating a new problem.”

“If you’re using freshly treated nets in a smallish stream or a bay in the lake, it’s quite likely you’re going to kill fish you don’t intend to kill,” said Dan Strickman, a senior program officer for the Bill and Melinda Gates Foundation, which has invested heavily in malaria research and development. “That’s definitely an environmental hazard.
Recent hydroacoustic surveys show that Zambia’s fish populations are dwindling. Harris Phiri, a Zambian fisheries official, blamed deforestation, rapid population growth and the widespread use of mosquito nets.
“They are catching very small fish that haven’t matured,” Mr. Phiri said. “The stocks won’t be able to grow.”

People fishing with mosquito nets tend to be those without boats or even tackle, often women and children, the most dispossessed. They work from shore, tugging the nets through shallow waters, precisely where many species spawn, creating another potential problem: the slow, steady destruction of sensitive aquatic breeding grounds.

Jeppe Kolding, a Danish fisheries ecologist, has challenged the conventional wisdom. He advocates a “balanced harvest” approach that calls for catching more juvenile fish and sparing some of the adults, arguing that mosquito-net fishing may not harm fish stocks as much as widely believed.  “Fish are more like plants than other animals,” he said, “in that they disperse millions of seeds.” But even he acknowledges that, for fishing purposes, it would be much better if the nets used were not treated with toxic chemicals.

Madagascar’s industrial shrimp catch plummeted to 3,143 tons in 2010 from 8,652 tons in 2002. Madagascar recently banned the use of mosquito nets at Antongil Bay, a crucial shrimping area.

Big companies like BASF, Bayer and Sumitomo Chemical design the nets. They are manufactured at about $3 apiece, many in China and Vietnam, shipped in steel containers to Africa, trucked to villages by aid agencies, and handed out by local ministries of health, usually gratis. The World Health Organization says the nets are a primary reason malaria death rates in Africa have been cut in half since 2000. But at the end of the line, in poor areas where little goes to waste, mosquito nets become many other things: soccer balls and chicken coops, bridal veils and funeral shrouds. Mosquito nets are literally part of the fabric of a community.

People know all too well the dangers of malaria yet also know loved ones will not last long without food.


Monday, December 29, 2014

Is West Africa's Challenge Ebola Or Malaria?

West Africa’s fight to contain Ebola has hampered the campaign against malaria, a preventable and treatable disease that is claiming many thousands more lives than the dreaded virus.
In Gueckedou, near the village where Ebola first started killing people in Guinea’s tropical southern forests a year ago, doctors say they have had to stop pricking fingers to do blood tests for malaria.

Guinea’s drop in reported malaria cases this year by as much as 40 percent is not good news, said Dr. Bernard Nahlen, deputy director of the U.S. President’s Malaria Initiative. He said the decrease is likely because people are too scared to go to health facilities and are not getting treated for malaria.
“It would be a major failure on the part of everybody involved to have a lot of people die from malaria in the midst of the Ebola epidemic,” he said in a telephone interview. “I would be surprised if there were not an increase in unnecessary malaria deaths in the midst of all this, and a lot of those will be young children.”

Figures are always estimates in Guinea, where half the 12 million people have no access to health centers and die uncounted.
Some 15,000 Guineans died from malaria last year, 14,000 of them children under five, according to Nets for Life Africa, a New York-based charity dedicated to providing insecticide-treated mosquito nets to put over beds. In comparison, about 1,600 people in Guinea have died from Ebola, according to statistics from the World Health Organization.

Malaria is the leading cause of death in children under five in Guinea and, after AIDS, the leading cause of adult deaths, according to Nets for Life.

read whole article here

Saturday, October 25, 2014

Beyond Ebola

The current focus on ebola should not let the impact of malaria (as well as other illnesses) and the campaign to develop a vaccine for malaria be forgotten about. While endeavouring to contain the present ebola epidemic,  Liberia's Foreign Minister Augustine Kpehe Ngafuan explains"As we and our many international partners struggle to douse the wildfire caused by Ebola, we have been left with inadequate resources, time and personnel to attend to other routine illnesses like malaria, typhoid fever and measles, thereby causing many more tangential deaths," he said. 

Malaria is associated with high mortality and morbidity especially among children under five and pregnant women.  Around 90 per cent of estimated deaths from malaria occur in sub-Saharan Africa and 77 per cent of these are in children under the age of five.

Data from the phase III vaccine trial programme shows hope that a malaria vaccine is just a step away.

Plant-based therapies have held the ace in the treatment of malaria from chloroquine obtained from the Quinine bark also called Cinchona tree to the artemisin from the Chinese salad plant, Artemisia annua. Unfortunately, the malaria parasite, Plasmodium falciparum, has begun to develop resistance to the WHO-endorsed treatment ACT, made from Artemisia annua.

  Nigerian researchers have discovered and validated local plants that treat malaria like World Health Organisation (WHO)-endorsed drugs such as Artemisinin-based Combination Therapies (ACTs), amodiaquine, mefloquine and sulphadoxine/pyrimethamine. A recent study published in Malaria Journal has identified medicinal plants such as Momordica charantia (bitter melon), Momordica balsamina (balsam apple), Ageratum conyzoides (goat weed), and Diospyros monbuttensis (Yoruba ebony or walking stick ebony) to be very efficacious in the treatment of drug resistant malaria. The results of the study showed sensitivity of 100 Plasmodium falciparum (malaria parasite) isolates to chloroquine, quinine, amodiaquine, mefloquine, sulphadoxine/pyrimethamine, artemisinin, Momordica charantia, Diospyros monbuttensis and Morinda lucida. The researchers concluded: "Natural products isolated from plants used in traditional medicine, which have potent anti-plasmodial action in vitro, represent potential sources of new anti-malarial drugs." 

Tuesday, January 17, 2012

the real drug problem

Malaria kills nearly a million people each year, mainly young children and pregnant women. Hopes of controlling malaria in Africa could be wrecked by criminals who are circulating counterfeit and substandard drugs, threatening millions of lives, scientists are warning. Large parts of Africa are threatened by the distribution of fake and poor quality anti-malarials made illicitly in China.

Some of the fake drugs contain artemisinin, but not enough to kill all the parasites in a child's body. Not only will the child struggle to recover, but the parasites that survive may become resistant to the drug and spread a form of the disease that ACTs (artemisinin combination therapy) will no longer cure. Analysis also showed some counterfeits contained a mixture of wrong active pharmaceutical ingredients, some of which may initially alleviate malaria symptoms but would not cure malaria. Worse still, these unexpected ingredients could cause potentially serious side effects, particularly if they were to interact with other medication that the patient was taking, such as anti-retroviral therapies for HIV.

It will be very hard for the affected African countries to tackle the problem, however. WHO has said that 30% of drug regulatory authorities don't function. They don't list which they are but logically they are likely to be in economically poor, malarious countries.

http://www.guardian.co.uk/society/2012/jan/16/fake-poor-quality-malaria-drugs-africa