Mobile Phone Technologies Used to Help Track Malaria Outbreaks

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On the heels of the United Nations Social Innovation Summit, HP and nonprofit organization Positive Innovation for the Next Generation (PING) are launching a collaboration to improve the quality and efficiency of disease surveillance in Botswana through mobile health monitoring technology that can enhance protection and prevention against major malaria outbreaks.

“We’re focused on addressing health and development problems by not only using technology in an innovative way, but also by creating more problem solvers in the local population. By combining our socially active core with innovation and business acumen from HP, and the scale of government organizations, we can achieve the greatest opportunity for lasting social change,” says PING operations director Katy Digovich.

Advancing the country toward its goal of malaria elimination, the initiative uses HP webOS and cloud computing technology to enable health workers to more efficiently predict, observe and minimize the harm caused by outbreaks.

According to Gabriele Zedlmayer, vice president, Office of Global Social Innovation at HP, “there is tremendous opportunity for mobile technology to transform public health services in both developing and developed markets. The full potential of applying mobile and cloud services to advance healthcare has yet to be reached, and we’re committed to applying our technology expertise to help address some of the world’s most difficult global health challenges.”

In partnership with the Clinton Health Access Initiative (CHAI) and mobile network provider MASCOM, the program equips healthcare workers in Botswana with HP Palm Pre 2 smartphones to collect malaria data, notify the Ministry of Health about outbreaks and tag both data and disease surveillance information with GPS coordinates. This data will contribute to a first-ever geographic map of disease transmission in the country, enabling faster response times and better measurement of malaria cases to monitor treatment and scale up the distribution of mosquito nets.

The program’s year-long pilot phase is the largest mobile health pilot program in Botswana, running throughout the malaria season. Future programs are planned to reach additional outbreak-prone diseases in the region.

  • Data analysis in the cloud: The initiative enables healthcare workers to collect data via a webOS application on a mobile device, upload the data over a mobile network, and analyze and share the data via the cloud. Through this system, analysis now takes hours rather than weeks to complete.
  • Rapid outbreak notification: When an outbreak is detected, healthcare workers can quickly upload specific case and location information from their mobile devices in the field. Health officers in the area and members of the Ministry of Health then receive a text message alerting them of the outbreak, enabling rapid deployment of preventative measures to reduce disease transmission.
  • Higher accuracy with real-time surveys: Through the flexibility and ease of development on the webOS platform, a surveillance application enables health workers to perform real-time surveys from the field. Health workers are able to enter accurate, context-rich data through pictures, video, audio, GPS coordinates, qualitative and quantitative information about the case.

In the next phase of the program, HP and PING plan to develop a cloud-based health services package for consumers in Botswana, creating a sustainable system for delivering even more health-related information to users over mobile networks.

Advancing health monitoring

Despite progress in disease eradication, the World Health Organization reports that more than 780,000 people died from malaria-related illnesses in 2009, most of them children under the age of five. In Africa, 75 million people, or 10 percent of the population, are at risk to contract malaria.(1) Mobile technology has the potential to drastically improve malaria surveillance by speeding data collection and generating more context-aware information about outbreaks.

Health initiatives in Africa

As part of the company’s global social innovation program, HP aims to enrich society by using the breadth and scale of its technology to drive structural, systemic improvements in health access and delivery.

In addition to the collaboration with PING, HP has alliances with African social enterprise mPedigree to fight counterfeit malaria drugs through an innovative mobile phone and cloud services solution; nonprofit organization mothers2mothers to help prevent HIV transmission from mothers to infants; and the CHAI to greatly improve the speed of HIV diagnosis for infants in Kenya.

Source:  BusinessWire

Hewlett-Packard To Test Mobile Technology in Botswana Clinical Trials

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For years Hewlett-Packard has been equated with computers and printers. The company is looking to be a player in a new era of mobile health monitoring.

H.P. said on Monday that it was beginning a yearlong clinical trial in Botswana that will equip doctors and nurses with Palm Pre 2 smartphones and an application that is designed to collect information about malaria outbreaks.

Read more, via NYTimes.com.

Scientists Offer 2020 Vision of Vaccines for Malaria, TB & HIV/AIDS

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Collectively, malaria, TB & HIV/AIDS cause more than five million deaths per year – nearly the entire population of the state of Washington – and represent one of the world’s major public health challenges as we move into the second decade of the 21st century. In the May 26, 2011, edition of the premier scientific journal Nature, Seattle BioMed Director Alan Aderem, Ph.D., along with Rino Rappuoli, Ph.D., Global Head of Vaccines Research for Novartis Vaccines & Diagnostics, discuss recent advances in vaccine development, along with new tools including systems biology and structure-based antigen design that could lead to a deeper understanding of mechanisms of protection. This, in turn, will illuminate the path to rational vaccine development to lift the burden of the world’s most devastating infectious diseases.

According to Aderem, a systems biology pioneer who recently joined Seattle BioMed to incorporate that approach with the Institute’s infectious disease research, new conceptional and technological advances indicate that it will be possible to develop vaccines for the “big three” infectious diseases within the next 10 years. “Success will be largely dependent on our ability to use novel approaches such as systems biology to analyze data sets generated during proof-of-concept trials,” he explained. “This will lead to new insights such as the identification of correlates of protection or signatures of immunogenicity and the acceleration of large-scale clinical trials.” Aderem added that innovative, new clinical and regulatory approaches will also accelerate the pathway to much-needed vaccines.

The article discusses the strengths and criticisms of the systems biology approach, with the key strength of the approach lying in its ability to capture and integrate massive amounts of biological data to visualize emergent properties that are not demonstrated by their individual parts and cannot be predicted from the parts alone. “The power of systems biology comes from its capacity to predict the behavior of an entire biological system,” Aderem said. “From there, we can optimize vaccine candidates and predict whether a drug or vaccine candidate can work before it moves into large scale, very expensive clinical trials.”

Systems biology can also be used to speed the often lengthy clinical trial experience. Aderem and Rappuoli estimate that in trials of new vaccines for malaria, TB and HIV/AIDS, only one hypothesis has been tested every eight years in the past three decades. “We cannot afford this approach if we want to have an impact on disease in a reasonable timeframe,” Aderem said. “We can accelerate clinical development by performing more efficacy trials and by improving their design using systems biology approaches to test several hypotheses in parallel and having an adaptive design to expand the outcomes that prove most promising.”

Aderem and Rappuoli also debunk one of the key criticisms of systems biology – that it is overly reliant on computation. “Much of this comes from a misunderstanding on the role of computers in systems biology,” Aderem explained. “Computers are not expected to come up with biological insights from the outset, but are meant to facilitate an integration of discovery science with hypothesis-driven science to yield a holistic description of a biological system.”

While progress has been made over the past few years in the development of novel vaccines against the three most challenging infectious diseases in the world, Aderem and Rappuoli conclude that innovative design of clinical trials, testing several vaccines in parallel and getting early information using systems biology approaches will accelerate vaccine development and increase understanding of the human immune system.

Source: Seattle Biomedical Research Institute (Seattle BioMed)

Nigeria Government May Ban Mono-Therapy Malaria Drugs

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Nigeria’s Federal Government has hinted that in the near future, it would ban all mono-therapy drugs used in malaria treatment in Nigeria as they are no longer effective following resistance of the drugs by Nigerians.

The Minister of Health, Professor Oyebuchi Chukwu dropped the hint during a dinner with journalists held in Lagos. The dinner was part of activities commemorating World Malaria Day, which is marked April 25th every year. Mono-therapy malaria drugs contain only Artemisinin and are commonly used in treating malaria.

Read more, via allAfrica.com.

Insecticidal Building Panels May Help Fight Malaria

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GreenWorld Development, Inc. has announced that the company is  in joint venture discussions to build affordable and environmentally friendly housing in Sub-Sahara Africa that would employ a unique technology to ferment and impregnate building panels and building blocks with anti-mosquito repellents.

“Malaria remains to be a major threat to mankind worldwide, especially in Africa,” GreenWorld-CEO Leo J. Heinl says. “In Kenya, every year 34,000 of children in the age of five and younger die because of Malaria – about 100 per day. We at GreenWorld trust that this technology will become a major step in the fight against malaria.”

The repellent will be made available to building contractors, government and health organizations.

The toxin, which the company says is not dangerous to humans, will need to be replenished every 2 years.

GreenWorld Development, Inc. develops products to support the “Smart Green Economy.”  The company’s main focus is pharmaceutical/healthcare, carbon emission technologies and trading, R&D in alternative, sustainable, innovative, competitive and environmentally friendly technologies along with emerging market consultancy.

Source: BusinessWire

Wolbachia Bacteria Reduce Parasite Levels and Kill the Mosquitos that Spreads Malaria

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Wolbachia are bacteria that infect many insects, including mosquitoes. However, Wolbachia do not naturally infect Anopheles mosquitoes, which are the type that spreads malaria to humans. Researchers at the Johns Hopkins Bloomberg School of Public Health found that artificial infection with different Wolbachia strains can significantly reduce levels of the human malaria parasite, Plasmodium falciparum, in the mosquito, Anopheles gambiae. The investigators also determined that one of the Wolbachia strains rapidly killed the mosquito after it fed on blood. According to the researchers, Wolbachia could potentially be used as part of a strategy to control malaria if stable infections can be established in Anopheles.

“This is the first time anyone has shown that Wolbachia infections can reduce levels of the human malaria parasite (Plasmodium falciparum) in Anopheles mosquitoes,” said Jason Rasgon, PhD, senior author of the study and associate professor with the Johns Hopkins Malaria Research Institute and the Bloomberg School’s W. Harry Feinstone Department of Molecular Microbiology and Immunology.

For the study, Rasgon and his colleagues infected Anopheles gambiae mosquitoes with two different Wolbachia strains (wMelPop and wAlbB). After infection, Wolbachia disseminated widely in the mosquitoes and infected diverse tissues and organs. Wolbachia also seemed to actively manipulate the mosquito’s immune system to facilitate its own replication. Both Wolbachia strains were able to significantly inhibit malaria parasite levels in the mosquito gut. Although not virulent in sugar-fed mosquitoes, the wMelPop strain killed most mosquitoes within a day after the mosquito was blood-fed.

“These experiments show that Wolbachia could be used in multiple ways to control malaria, perhaps by blocking transmission or by killing infected mosquitoes,” said Rasgon.

Worldwide, malaria afflicts more than 225 million people. Each year, the disease kills nearly 800,000, many of whom are children living in Africa.

In addition to Rasgon, the authors of “Wolbachia infections are virulent and inhabit the human malaria parasite Plasmodium falciparum in Anopheles gambiae” include Grant Hughes and Ping Xue of the Johns Hopkins Malaria Research Institute, and Ryuichi Koga and Takema Fukatsu of the National Institute of Advanced Industrial Science and Technology in Tsukuba, Japan.

Funding was provided by the Johns Hopkins Malaria Research Institute and the National Institute of Allergy and Infectious Diseases. The study is published in the May 19, 2011 edition PLoS Pathogens.

Source: Johns Hopkins Bloomberg School of Public Health

Researchers Find Gene That Fights Severe Malaria in Children

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Scientists have discovered a genetic variant in children that significantly reduces their risk of developing a life-threatening form of malaria.

Children with the unusual, or variant, gene have a 30 percent lower risk of developing cerebral malaria than those without the gene. Cerebral malaria is the most serious form of the parasitic illness that causes very high fever and coma, and leads rapidly to death in the 20 to 50 percent of people whose brains become infected.
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The mosquito-borne illness affects almost 300 million people every year. But most of the one million deaths occur in children under the age of five.

Researchers at Germany’s Bernhard Nocht Institute for Tropical Medicine and Kumasi University in Ghana identified the protective gene in a study involving more than 6,000 children. Called FAS, the gene is responsible for a molecule involved in the programmed cell death of some white blood cells, which are immune system cells that attack and destroy microbes that invade the body.

Researchers think that children who develop a life-threatening form of malaria have a hyper-immune response to the parasite. But youngsters with the FAS variant have increased expression of the molecule, called CD95, which appears to promote a greater number of immune system cell suicides—thus a less intense and ultimately survivable immune reaction to malaria.

At least that’s the theory, according to Kathrin Schuldt, a biologist and co-author of the study. Schuldt says children who are vulnerable to cerebral malaria are constantly bitten by mosquitoes that carry the parasite.

“So the immune response is constantly on a very high level trying to eliminate the pathogen from the body. And so what we found with this naturally occurring variant, these children probably have a regulation in their immune response which down-regulates the immune response to a certain level and therefore is kind of protective,” Schuldt said.

Humans never develop full immunity against malaria, but they can gain a partial immunity to the parasite, which is why the disease is less severe in adults. But children can become quite sick because they have had less exposure to the disease.

Schuldt says her goal now is to figure out the underlying mechanism for the protective effect of the genetic variant. Then, Schuldt says, it may be possible to develop drugs to protect children from this fatal form of malaria.

An article on the protective malaria gene is published in the on-line journal PLoS Genetics.

Source: VOA News

Research Could Lead to Mosquitoes Being Susceptible to Diseases They Transmit

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Mosquitoes are becoming more resistant to current pesticides. That’s troubling to Kansas State University biologist Kristin Michel, as it means malaria and other mosquito-borne diseases will continue spreading. A recent grant from the National Institutes of Health may change all that.

Michel, an assistant professor of biology, is using the nearly $1.5 million grant for the four-year study, “The function(s) of serpin-2 in mosquito immunity and physiology.” Findings from this investigation into the role of the serpin-2 molecule in Anopheles gambiae — the African malaria mosquito — could stop the transmission of malaria and other mosquito-spread diseases by making mosquitoes susceptible to the very diseases they transmit.

As principal investigator, Michel and her laboratory team are focusing on definitively understanding the role of serpin-2 in the mosquito’s body. Serpins are a group of similarly structured proteins that can inhibit a group of enzymes that break down proteins called proteases. Serpin-2 controls certain proteases that create immunity against bacteria and fungi in the mosquito.

“Current insecticides used for controlling vector-borne diseases are chemicals that target an insect’s nervous system,” Michel said. “Because serpin-2 relates to a mosquito’s immunity, it could act as a novel insecticide target.”

Attacking this molecule could avoid or disrupt a response from the mosquito’s immune system that would otherwise protect the insect, she said.

The idea for the research came from a previous project conducted by Michel and fellow Kansas State researchers. By removing serpin-2 from the mosquitoes’ bodies, the researchers noticed melanization is affected. In insects melanin is used to encompass foreign objects that enter their body, like bacteria and parasites. This process prevents the insect’s immune system from constantly fighting the foreign body. It also causes pseudo-tumors in the mosquitoes once serpin-2 is removed.

“We don’t really quite understand yet why this happens, but we do know that the mosquito’s immune response is totally overamplified,” Michel said. “Instead of melanizing parasites or bacteria, the mosquito’s body attacks itself, getting melanotic pseudo-tumors throughout it.”

These pseudo-tumors appear as black dots on the insect’s thorax and abdomen. Afflicted mosquitoes that do not initially die from the tumors steadily lose interest in blood feeding over time.

“So what we’re going to do with this grant is to find out which proteases — since it’s most likely more than one — are being inhibited by serpin-2 for this whole process to occur,” Michel said. “Right now we have very little information about the cloud of proteases that float around in the insect, with regards to what they do and how they interact.”

Finding the proteases will require lots of detective work as more than 50 proteases are potentially being inhibited by serpin-2. However, Michel said, the most time-consuming portion may be collecting enough material from the mosquitoes to sample, as one mosquito yields about 0.1 microliters of bodily material.

Several co-investigators are also lending their expertise to the study. Michael Kanost, university distinguished professor and head of the department of biochemistry, is helping with expression of proteases and in vitro testing. Christopher Culbertson, associate professor of chemistry, is building microfluidics technology that will allow for better plasma analysis from the mosquitoes, potentially helping with the sample sizes. Scott Lovell, director of the protein structure laboratory at the University of Kansas, will use X-ray crystallography to visualize how serpin-2 binds to the proteases it inhibits.

“By the end of the study we really hope to say serpin-2 is a perfect target for an insecticide that prevents the mosquito’s immunity,” Michel said. “The next step will be then to find such chemicals. That’s where we’re hoping to take this research.”

via Newswise.

Researchers Discover Microbe That Could Help Fight Malaria

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Researchers have discovered a bacterium in the gut of the Anopheles mosquito which may someday be used to destroy and, therefore, prevent the spread of the disease-causing parasite.

The World Health Organization estimates 800,000 people die of malaria each year. The parasite that causes the disease is transmitted by the Anopheles mosquito. After the mosquito feeds on the blood of an infected individual, the parasite matures into an infectious stage in the insect’s gut.  From there, the parasite, known as Plasmodium falciparum, takes up residence in the mosquito’s salivary glands so it can infect the next person that’s bitten.

Researchers at Johns Hopkins School of Public Health in Baltimore, Maryland found the bacterium in the gut of the Anopheles mosquito among hundreds of so-called microbial flora that live harmlessly in the stomach of a group of Anopheles mosquitoes collected in an area of southern Zambia where malaria is rampant.

The microbe, which was in the guts of a small percentage of the mosquitoes, protected those insects against infection with the parasite.

Lead researcher George Dimopoulos says the protection seems to be a side-effect of the bacterium’s normal bodily function, adding that scientists would like to figure out a way to use the microbe as a weapon against malaria.

“Our study has shown that this bacterium produces free radicals, molecules that contain oxygen and that can cause damage to cells.  So, we believe that’s how this bacterium is killing the malaria parasite in the mosquito gut.  But we need to understand that mechanism in greater detail.”

To demonstrate the beneficial effect, the researchers used antibiotics to kill the bacterium in mosquitoes that contained it, and were then able to infect those mosquitoes more easily with the Plasmodium parasite.

They also introduced the bacterium into the guts of mosquitoes that didn’t have it. When they fed this group infected blood, the parasite was destroyed in nearly all of the insects.

Dimopoulos says researchers’ goal now is to figure out a way to introduce the microbe into large populations of Anopheles mosquitoes – perhaps through bait laced with their favorite snack.

“Mosquitoes need to feed on sugar every day.  And one can potentially expose mosquitoes in the field to these bacteria through sugar bait.”

The researchers noted that mosquitoes with the bacterium in their guts die sooner than those without it – when both groups are infected with the parasite. Since the malaria parasite lives in mosquitoes for about two weeks before maturing to an infectious stage, Dimopoulos says it’s good news that the stomach bacterium seems to shorten the insect’s lifespan, before it could potentially transmit the parasite to humans.

Source: VOA News

Equatorial Guinea Reduces Malaria in Children by 57% in Four Years

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The Republic of Equatorial Guinea has decreased the prevalence of the malaria parasite in children by 57% in just four years and has increased the number of children protected by bed nets or indoor spraying of insecticides from 4% to 95% in that same period, according to a report by Roll Back Malaria.

Research carried out on the Island of Bioko, funded by the government of Equatorial Guinea and a private consortium led by Marathon Oil Corporation, showed a reduction in infant mortality in nearly one third of the population. The program to control malaria is part of a broader effort by the government, through the Ministry of Health and Social Welfare, to improve public health in the West African nation.

The anti-malaria project is currently focused on the island of Bioko, where more than half the population of Equatorial Guinea lives, and has been extended to 2013 to develop local capacity and enable the campaign to reach the mainland. The project has won numerous high-profile awards for social responsibility and good citizenship.

The sixth report on Business Investing in Malaria Control: Economic Returns and a Healthy Workforce for Africa showcases how malaria control investment has significantly improved in Africa. “Companies in Equatorial Guinea, Ghana, Mozambique, and Zambia have worked to prevent malaria among their workers and workers’ dependents and have seen an excellent return on investment, with significant reductions in malaria-related illnesses and deaths, worker absenteeism, and malaria related spending.”

The Malaria Control Project is a fundamental part of the government-wide effort to meet the goals of the Horizon 2020 development plan set by President Obiang Nguema Mbasogo.

Equatorial Guinea has heavily invested in public health. The government has donated $1.5 million and a headquarters facility to the World Health Organization (WHO) to support research for global health. It has also provided technical assistance to the local United Nations Population Fund (UNFPA) to improve the effectiveness of its Assistance Program as well as the implementation of a host of health programs geared towards improving the health of Equatorial Guineans.

Source: Republic of Equatorial Guinea