HIV Antiretrovirals May Help Fight Malaria

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Bed nets and insecticides form the cornerstone of malaria prevention, with antimalarial drugs being used mainly to treat people who become ill with the disease. The drugs do have some protective effect, but it quickly wanes. Now a study in Uganda suggests that an antiretroviral drug given to HIV-infected children can boost the preventive power of a key malaria drug. [Read more…]

Researches Say Hydroxychloroquine Can Help Treat Cancer

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Researchers say a drug commonly used to treat malaria and rheumatoid arthritis has also proved effective in treating some aggressive cancers.   When scientists administered hydroxychloroquine, an anti-malarial drug, together with known cancer drugs, they found it stopped the growth of cancerous tumors in two-thirds of the patients.

Scientists know that human cancer cells grow by getting energy from adjacent tumors, where cells have begun to self-destruct.

The spread of cancer is accelerated by the death of these cells.

“This process called autophagy, which literally means to self-eat, is present in all cells,” said Dr. Ravi Amaravadi. “But what we are finding in our research is that cancer cells have a very high level of autophagy even before any treatment, and so they are poised to take on the damage from existing cancer therapies and simply break down the damaged parts to fuel further growth.”

Dr. Ravi Amaravadi spoke to us via Skype. He is a cancer specialist at the University of Pennsylvania School of Medicine. His group treated patients by combining conventional cancer medications with the anti-malarial drug, hydroxychloroquine.  The compound is known to inhibit autophagy and researchers hoped it could stop cancer cells from growing.

In clinical trials, scientists found that hydroxychloroquine paired poorly with some cancer drugs.  But it worked well with others, such as Temsirolimus, in helping to halt tumor growth – a so-called “stable disease” rate –  in patients with melanoma, an aggressive skin cancer.

“And when Temsirolimus [a cancer drug] was tested in melanoma, it had zero percent stable disease rate,” said Amaravadi. “And when we combined with hydroxychloroquine malaria drug, the stable disease rate went up to 76 percent so that’s a very big difference.”

Researchers used a high dose of hydroxychloroquine to block autophagy, much higher than what’s normally used to treat rheumatoid arthritis or malaria. The dosage has not yet proved harmful.

Dr. Davide Ruggero at the University of California, San Francisco, is also studying the growth of cancer cells. He says the results of the research with hydroxychloriquine are promising.

“This is a great discovery because we know that the compounds are not toxic – have already been used,” said Ruggero.

But Dr. Amaravadi warns that oncologists should not use the anti-malaria drug outside of clinical settings. He says hydroxychloroquine has severe side effects when combined with some cancer drugs. So the knowledge of which compounds work well together is critical.

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Source: VOA News

Open Source Drug Discovery for Malaria

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Dr Matthew Todd

Dr Matthew Todd. Photo courtesy of University of Sydney.

In open source drug discovery all data and ideas are freely and immediately shared, and anyone may participate at any level.

Dr Mat Todd, from the University of Sydney’s School of Chemistry, recently led a meeting titled Open Source Drug Discovery for Malaria, to discuss the application of the open source model to discovering drugs to treat malaria.

“The open nature of the work means there are no patents and that any technology is both academically and commercially exploitable by whoever wishes to do so,” said Dr Todd.

Drug research on malaria using scientists around the world who share data in real time, unencumbered by patents, is Dr Todd’s ambition.

While no drug has so far been discovered using open source, Dr Todd led a project that used the open source approach to create a new way to produce medicine now used worldwide for the treatment of Bilharzia, a terrible parasitic disease that afflicts millions of the world’s poorest people.

His innovation won Dr Todd the Emerging Research category of the NSW Science and Engineering Awards in 2011.

Research and development of new drugs is normally done in a closed way by pharmaceutical companies, who fund the research in order to own the resultant medicines.

“This makes business sense, as there are huge profits to be made from new pharmaceuticals,” said Dr Todd.

“However, there are a number of diseases that simply do not interest pharmaceutical companies, because there’s little money to be made from these drugs. These diseases are normally ones affecting developing nations, such as malaria,” explained Dr Todd.

Taking his open source approach to finding a new drug for malaria, Dr Todd predicts that it will have the greatest benefits in the early phases – from the discovery of biologically active compounds, to improving these compounds through chemical synthesis and biological evaluation.

“Drug discovery is a complex process involving many different stages and the open source method has huge potential for improving the early phases before clinical trials have commenced.”

“I can also see the open source approach being really effective in the process chemistry phase, where we create an efficient chemical synthesis of the new drug on a large scale,” explained Dr Todd.

“I see the discussion as part of a wider series of discussions about how we’re doing science, and research more generally, in a very different way… not just about the malaria problem itself and how to tackle it, but also some of the problems that come up as we move to new science methods, and open innovation and open science,” said Professor Mary O’Kane, Chief Scientist and Engineer of NSW, who opened the meeting.

Source: University of Sydney

Blood Smear Technique

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Blood films are made by placing a drop of blood on one end of a slide, and using a spreader slide to disperse the blood over the slide’s length. The aim is to get a region where the cells are spaced far enough apart to be counted and differentiated.

The slide is left to air dry, after which the blood is fixed to the slide by immersing it briefly in methanol. The fixative is essential for good staining and presentation of cellular detail. After fixation, the slide is stained to distinguish the cells from each other.

Source: Wikipedia (http://en.wikipedia.org/wiki/Blood_film)

Mobile Phone Text Messaging: Tool for Malaria Control in Africa

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Across many malaria-endemic areas in rural Africa, the communication gap between managers, health workers, and patients is a significant barrier to efficient malaria control. The rapid expansion of mobile network coverage and the widespread availability of basic handsets have the potential to substantively bridge the communication gap. Text messaging, as the least-expensive mobile phone function found on all handsets, could improve the delivery of health services and health outcomes.

Six major areas of malaria control in which deficiencies are apparent and text messaging interventions could be beneficial are:

  1. Disease and treatment effectiveness surveillance
  2. Monitoring of the availability of health commodities
  3. Pharmacovigilance and post-marketing surveillance of the safety and quality of antimalarial drugs
  4. Health worker adherence to guidelines
  5. Patient adherence to medication regimen
  6. Post-treatment review

Text messages transmitting information from the periphery of the health systems to malaria control managers are in the first three malaria control areas: (1) disease and treatment effectiveness surveillance, (2) monitoring of the availability of health commodities, and (3) pharmacovigilance and post-marketing surveillance of the safety and quality of antimalarial medicines. Future projects in these three areas should demonstrate responses to data signals and comparative advantages with routine information systems.

Text messages in the second three areas transmit information to health workers and patients to support the management of malaria patients by improving (4) health workers’ adherence to guidelines, (5) patient adherence to medicines, and (6) post-treatment review. Future priorities in these areas are cost-effectiveness evaluations, qualitative research, and studies measuring impact on the processes of care and health outcomes.


Funding: DZ is supported by the Wellcome Trust project grant [#084253]. RWS is supported by the Wellcome Trust as Principal Research Fellow [#079080]. AOT is supported by the Worldwide Antimalarial Resistance Network (WWARN) through a Bill & Melinda Gates Foundation grant [#48807.01]. All authors acknowledge support from the Wellcome Trust core grant [#092654/Z/10/A]. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing interests: The authors have declared that no competing interests exist.

Citation: Zurovac D, Talisuna AO, Snow RW (2012) Mobile Phone Text Messaging: Tool for Malaria Control in Africa. PLoS Med 9(2): e1001176. doi:10.1371/journal.pmed.1001176

Copyright: © 2012 Zurovac et al. This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Full Article: Mobile Phone Text Messaging: Tool for Malaria Control in Africa (PDF)

 

Blood-Feeding Patterns of Anopheles Mosquitoes in Bangladesh

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Blood-feeding patterns of mosquitoes are crucial for incriminating malaria vectors. However, little information is available on the host preferences of Anopheles mosquitoes in Bangladesh. Therefore, the objective of the present study was to determine the hematophagic tendencies of the anophelines inhabiting a malaria-endemic area of Bangladesh. [Read more…]

“Test and Treat” Model Offers New Strategy for Eliminating Malaria

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As researchers work to eliminate malaria worldwide, new strategies are needed to find and treat individuals who have malaria, but show no signs of the disease. The prevalence of asymptomatic or minimally symptomatic malaria can be as high as 35 percent in populations with malaria and these asymptomatic individuals can serve as a reservoir for spreading malaria even in areas where disease transmission has declined.

In a new study, researchers at the Johns Hopkins Malaria Research Institute found that a strategy of actively identifying undiagnosed malaria and then treating those with the disease resulted in significantly lower prevalence of malaria cases compared to a control group. Their findings are published in the February 3, 2012 edition of the journal PLoS ONE.

“New strategies are needed, particularly in areas of declining transmission. One strategy is to screen people for malaria and treat those who are infected, even those who are not sick enough to go to the clinic,” said lead author, Catherine G. Sutcliffe, PhD, an assistant scientist with the Johns Hopkins Bloomberg School of Public Health’s Department of Epidemiology. “Using artemisinin combination therapy can enhance this strategy, as treatment can reduce transmission to mosquitoes. In regions of declining transmission, the burden of malaria could be reduced to such an extent that elimination is achievable.”

The study was conducted in southern Zambia, with colleagues from the Johns Hopkins Malaria Research Institute in Macha. Researchers analyzed data from surveys conducted in 2007 and between 2008 and 2009. In both surveys, households were screened for malaria using rapid diagnostic tests and treated with artemisinin combination therapy when malaria was detected.

According to the new study, a proactive test-and-treat case-detection strategy resulted in a sixfold reduction in prevalence in 2008 and 2009, with the initial parasite prevalence at 4 percent. Test and treat showed a twofold reduction in 2007, when community prevalence was higher at 24 percent.

“Proactive case detection with treatment using artemisinin-combination therapy can reduce transmission and provide indirect protection to household members. If resources permit, this strategy could be targeted to hot spots to achieve further reductions in malaria transmission,” said William J. Moss, MD, senior author of the study and associate professor with the Johns Hopkins Bloomberg School of Public Health.

Worldwide, malaria afflicts more than 225 million people. The disease kills between 800,000 and 1 million people each year, many of whom are children living in Africa.

Authors of “Reduced Risk of Malaria Parastemia Following Household Screening and Treatment: A Cross-Sectional and Longitudinal Cohort Study” include Catherine G. Sutcliffe, PhD; Tamaki Kobayashi, PhD; Harry Hamapumbu; Timothy Shields, MA; Sungano Mharakurwa, PhD; Philip E. Thuma, MD; Thomas A. Louis, PhD; Gregory Glass, PhD; and William J. Moss, MD.

The Johns Hopkins Malaria Research Institute is a state-of-the-art research facility at the Johns Hopkins Bloomberg School of Public Health. It focuses on a broad program of basic science research to treat and control malaria, develop a vaccine and find new drug targets to prevent and cure this deadly disease.

The research was funded by the Johns Hopkins Malaria Research Institute.

Source: Johns Hopkins Bloomberg School of Public Health

Hitting Hotspots: Spatial Targeting of Malaria for Control and Elimination

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Current malaria elimination guidelines are based on the concept that malaria transmission becomes heterogeneous in the later phases of malaria elimination [1]. In the pre-elimination and elimination phases, interventions have to be targeted to entire villages or towns with higher malaria incidence until only individual episodes of malaria remain and become the centre of attention [1]. With increasing evidence of clustering of malaria episodes within villages, we argue that there is an intermediate step. Heterogeneity in malaria transmission within villages is present long before areas enter the pre-elimination phase, and identifying and targeting hotspots of malaria transmission should form the cornerstone of both successful malaria control and malaria elimination. [Read more…]