World Health Organization Seeks Funding for Emergency Response to Drug-resistant Malaria

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BANGKOK — The World Health Organization is warning that about $450 million is needed over the next three years to stop a strain of drug-resistant malaria from spreading beyond Southeast Asia to the rest of the world.

Researchers say the artemisinin-resistant strain has spread to Burma and Vietnam since it was first detected along the Cambodian-Thai border in 2008. In addition to sounding the alarm about drug-resistant malaria, the World Health Organization is rolling out an emergency response to what it terms a potentially serious global health threat. [Read more…]

Malaria Pills Vietnam

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QUESTION

I am travelling from Hanoi to Ho Chi Minh city via Haalong Bay, Hue and Hoi An, all are Costal areas. Should I take Malarone? I would prefer not to as I am trying to get pregnant.

ANSWER

In Vietnam, costal areas north of Nha Trang are considered malaria-free, as are the cities of Hanoi and Ho Chi Minh city. As such, it is only rural and costal areas closer to Ho Chi Minh city where you might be at risk. One option you have is to take mefloquine (Lariam) – it is safe to take while pregnant (or trying to get pregnant), and is effective in most areas of Vietnam. There is resistance to mefloquine in the Mekong Delta region, but it doesn’t sound like you will be travelling there, so this shouldn’t be a problem.

Malaria in Vietnam, Thailand, Bali

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QUESTION:

I am 5 months pregnant and I was thinking about going on holiday to Vietnam, Thailand, or Bali. What is the risk of malaria in this countries?

 

RESPONSE:

Malaria transmission occurs in all of the nations you mention, though certain areas within these nations are lower risk.

You can find out more about specific regions and local antimalarial resistance patterns at the CDC website.

You should certainly consult your prenatal doctor to discuss the variety of potential risks, in addition to malaria, associated with international travel in the developing world as you enter the third trimester of pregnancy. Malaria infection in pregnant women can be more severe than in nonpregnant women and can increase the risk for adverse pregnancy outcomes. For these reasons, and because no chemoprophylactic regimen is completely effective, women who are pregnant are usually advised to avoid travel to areas with malaria transmission if possible. If travel to a malarious area cannot be deferred, chemoprophylaxis is essential. Chloroquine containing medications are have not been found to have harmful effects on the fetus. For pregnant women travelling to areas where chloroquine resistance is present, mefloquine is usually recommended.

 

 

Malaria from Vietnam War

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QUESTION:

If my husband contracted malaria from serving in the Vietnam War but has never been treated for it, what are the symptoms that he might have experienced in the past that could have been caused by malaria but not diagnosed correctly?

Also is it possible that malaria infection could cause any type of birth defects to his children?

 

ANSWER:

Most people with primary malaria infection experience fevers, chills, sweats, muscle and joint aches, often accompanied by headache, nausea and diarrhea. While these symptoms resemble those of other illnesses that cause fever, these are often more severe in malaria and tend to recur in one, two, or three day cycles.

Certain forms of malaria can relapse  years after infection, and the symptoms of these relapses are similar to the initial (primary) infection.  Anemia, enlarged spleen, and low platelets are also common abnormalities in malaria. If your husband experiences any episodes of these symptoms, blood tests taken during fever might help determine if the malaria parasite is present. Other blood tests can determine if he’s been infected in the past.

While maternal malaria during pregnancy can increase the risk of poor pregnancy outcomes, malaria is not known to increase the risk of birth defects from father to child.

 

Use of Fish for Malaria Eradication

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QUESTION

Why is very little research being done on the possibility of mosquito fish being used as a means of controlling the hatching of new eggs?

ANSWER

Actually there is a lot of scientific literature on the use of fish as a biological control of mosquitoes, usually through consumption of the mosquito larvae or pupae while they are in freshwater. The most common species used for this purpose are the guppy (Poecilia reticulata) and the appropriately named mosquito fish (Gambusia affinis). Other fish groups, like cyprinodontids (i.e. Aphanius species), tilapia and minnows will also eat mosquito larvae.

In addition, other freshwater predators, such as copepods, have been shown to be highly effective in  killing mosquito in laboratory and field experiments, though results are sometimes inconsistent (see Lardeaux, 2008 “Biological control of Culicidae with the copepod Mesocyclops aspericornis and larvivorous fish (Poeciliidae) in a village of French Polynesia,” in Medical and Veterinary Entomology, vol 6, issue 1, pages 9-15, for a comparison of the anti-mosquito effect of these different groups).

The Lardeaux paper also describes the failure of the program: despite introduction of larvivorous animals, biting rates of mosquitoes did not significantly reduce, indicating some of the complications that can be associated with biological control programs.

However, in Vietnam, field studies have shown significant reductions of local Aedes mosquitoes associated with the presence of copepods in standing water sources, which shows the potential positive effects of incorporating natural biological control agents within part of an integrated vector control strategy (Nam et al., 2000 “National progress in dengue vector control in Vietnam: Survey for Mesocyclops (Copepoda), Micronexa (Corixidae) and fish as biological control agents,” in the American Journal of Tropical Medicine and Hygiene, vol 62, issue 1, pages 5-10).

Another example of successful introduction of fish as biological control agent comes from Ethiopia (Fletcher et al., 1992 “Control of mosquito larvae in the port city of Assab by an indigenous larvivorous fish, Aphanius dispar,” in Acta Tropica, vol 52, issue 2-3, pages 155-166).

Of Macaques and Men

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Plasmodium knowlesi —a new challenge in the Roll Back Malaria Program?

Deforestation oil palm Malaysia

Oil palm plantation in Malaysia: Such land-use change may be affecting malaria transmission. Photo courtesy of Yusmar Yahaya (http://www.flickr.com/photos/leafbug/4880638055/sizes/m/)

Mention of malaria often conjures images of infants hospitalized in Africa. Although most deaths from malaria are children under 5 in sub-Saharan Africa, there are many different types of malaria that put over half of the world’s population at risk in subtropical and tropical regions worldwide.

There have historically been four species of Plasmodium parasites that cause malaria humans.  P. falciparum is the most lethal species that infects humans, whereas P. vivax is the most widespread.  P. vivax and P. ovale also cause clinical symptoms and decreased economic potential in certain regions.

[Read more…]