The Vaccination to fight Malaria is introduced in Malawi - Seeker's Thoughts

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Friday, 10 May 2019

The Vaccination to fight Malaria is introduced in Malawi

Key facts
·       Malaria is a life-threatening disease caused by parasites that are transmitted to people through the bites of infected female Anopheles mosquitoes. It is preventable and curable.
·       In 2017, there were an estimated 219 million cases of malaria in 87 countries.
Malaria
·       The estimated number of malaria deaths stood at 435 000 in 2017.
·       The WHO African Region carries a disproportionately high share of the global malaria burden. In 2017, the region was home to 92% of malaria cases and 93% of malaria deaths.
·       Total funding for malaria control and elimination reached an estimated US$ 3.1 billion in 2017. Contributions from governments of endemic countries amounted to US$ 900 million, representing 28% of total funding.
Source- WHO

The World Health Organization (WHO) states that, in 2016, there were an estimated 216 million cases of Malaria in 91 countries.  And killed 445,000 of them. Most malaria deaths killed babies and young children.

In the U.S, the centers for disease control and Prevention (CDC) report 1,700 cases of malaria annually. Most cases of malaria develop in people who travel to countries where malaria is more common.
It is evident that Malaria is a life-threatening disease.

What is Malaria?

Malaria is a disease caused by a parasite, transmitted by the bite of infected mosquitoes.
It’s typically transmitted through the bite of an infected Anopheles mosquito. Infected mosquitoes carry the Plasmodium parasite. When this mosquito bites, the parasite is released into the bloodstream.
Once the parasites are inside the body, they travel to the liver, where they mature. After several days, the mature parasites enter the bloodstream and begin infecting red blood cells.
Within 48 to 72 hours, the parasites inside the red blood cells multiply causing to burst open.

Symptoms of Malaria

The parasites continue to infect red blood cells, resulting in symptoms that occur in cycles that last two to three days at a time.
A malaria infection is generally characterized by recurrent attacks with the following signs and symptoms:
1.       Moderate to severe shaking chills
2.      High fever
3.      Sweating
Other signs and symptoms may include:
1.       Headache
2.      Vomiting
3.      Diarrhea

Where does Malaria Spread?


Malaria is typically found in tropical and subtropical climates where the parasites can live.  The six highest burden countries in the WHO African region (in order of estimated number of cases) are: Nigeria, Democratic Republic of the Congo, United Republic of Tanzania, Uganda, Mozambique and Cote d'Ivoire. These six countries account for an estimated 103 million (or 47%) of malaria cases.
Countries-effected-by-Malaria-2010-WHO


Types of malaria mosquitos

There are four kinds of malaria parasites that can infect humans:
1. Plasmodium vivax
2. p. ovale
3. p. malariae
4. p. falciparum

Note – p falciparum causes a more severe form of the disease and those who contact this form of malaria have been a higher risk of death. An infected mother can also pass the disease to her baby at birth. This is known as congenital malaria.
Malaria can also be transmitted through:
- An organ transplants
- A transfusion
- Use of shared needles or syringes.

First Vaccination to Treat Malaria


The World Health organisation has announced in April 2019 that 360,000 children in a year in three African countries will receive the world's first malaria vaccine as part of a large-scale pilot project.
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Malawi has started vaccinating children under 2 years of age on 23rd April 2019. The country is the first of three in Africa in which the vaccine, known as RTS, S will be made available to children up to 2 years of age; Ghana and Kenya will introduce the vaccine.
The vaccine offers partial protection from the disease, with clinical trials finding that it prevented approximately 4 in 10 malaria cases according to WHO.
It is a World Health Organization-coordinated three country pilot programme where the risk of malaria is high.

 It’s to vaccinate 360,000 children and give them partial protection against disease. children will be vaccinated on time with 4 required doses.


The money for funding the vaccination

The programme is financed by the collaboration of three key global health funding bodies; Gavi (a public-private partnership Global vaccine alliance, Global Fund to fight AIDS, Tuberculosis and Malaria, and United (global health initiative that works with partners to end world's tuberculosis, HIV/AIDS, malaria and hepatitis C epidemics) Also, WHO, PATH and GSK will provide in-kind contribution.
The vaccine, RTS, S, also known as Mosquirix - It was created by a scientist at the British Drugmaker GlaxoSmithKline (GSK) in partnership with the Path malaria vaccine.

Has Malaria increased?

According to WHO, there was a 62% reduction in malaria deaths and 41% reduction in the number of cases, from 2000 to 2015, However, more recent data suggests that malaria is making a comeback, with 219 million in 2017, compared with 217 million in 2016.
It's a difficult disease to deal with.

The tools we have are modestly effective, but drugs and insecticides wear out; after 10, 20 years, mosquitoes become resistant.

There's a real concern that in 2020s cases are going to jump back up again - said by a professor of human genetics Adrian hill.



What step India has Taken to Eradicate Malaria

The Indian Council of Medical Research launched Malaria Elimination Research Alliance (MERA), With the aim of eliminating Malaria from India by 2030. it is a collective group of partners working on malaria control. It was launched on occasion of World Malaria Day 2019.

MERA India
It seeks to facilitate trans-institutional coordination and collaboration around a shared research agenda, which response to programmatic challenges, addresses gaps in available tools, and proactively contributes to targeted research.
It complements and not duplicates international efforts to eliminate Malaria on a national scale and simultaneously contributing to broader global agenda. It aims to prioritize, plan and scale up coordinated research to have an impact on population facing malaria risk and to eliminate malaria from India by 2030.
It holds importance for the Ministry of Health and Family Welfare because of operational research.

India and Malaria
Declining Trend: Malaria burden has declined in India by over 80% from 2.03 million cases in 2000 to 0.39 million in 2018, and Deaths caused by malaria also declined by over 90% from 932 deaths in 2000 to 85 in 2018.

This success of India in malaria control cases provided the foundation for leadership commitment towards eliminating malaria from India by 2030.

The WHO report also appreciated India's research for the decline in malaria. India's 'The National Vector Borne Diseases Control Program (NVBDCP), developed a comprehensive framework to achieve the overarching vision of "Malaria free India by 2030". NVBDCP's National Strategic plan recognized the critical role of research to support and guide malaria elimination efforts.

Genetic Engineering experiments to wipe out the malaria

London Reuter's scientists have succeeded in wiping out a population of caged mosquitoes in laboratory experiments using a type of genetic engineering known as a Gene Drive, which spread a modification blocking female reproduction.
A report published in the journal nature biotechnology, says scientists managed to eliminate the population in less than 11 generations, the technique in future could be used to control the spread of malaria, a parasitic disease carried by Anopheles gambiae mosquitoes.
The results mark the first time this technology has been able to completely suppress a population. The hope is that in future, mosquitoes carrying a gene drive could be released spreading female infertility within local malaria-carrying mosquito population and causing them to collapse.

Gene Drive Technology

Gene drive technologies alter DNA and drive self-sustaining genetic changes through multiple generations by overriding normal biological processes.

The technologies can be very powerful, but they are also controversial since such genetically engineered organisms released into the environment could have an unknown and irreversible impact on the ecosystem.

The technology used in this study was designed to target the specific mosquito species Anopheles gambiae that is responsible for malaria transmission in sub-Saharan Africa.
The World Health Organization has warned that global progress against malaria is stalling and could be reversed if momentum in the fight to wipe out was lost.

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Scientists stated the results showed the gene drive solution can work, offering hope in the fight against a disease that has plagued mankind for centuries., however, there is still more work to be done in both terms of testing the technology in larger lab-based and working for affected countries.

Conclusion

Malaria is one the most dangerous life threating infection, therefore to solve the malaria crises scientists should focus on the least risky and most effective solutions, not experiment with ecosystems with little regard for the potentially new environmental and health consequences.



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