MALARIA FIELD KIT BETTER THAN LAB!

MALARIA FIELD KIT BETTER THAN LAB!

Erle Frayne D. Argonza

Who knows what is in store in the future of such diseases as malaria? Better diagnostics could address the prevention aspect, and simple kits such as what can be brought as mobile tools to the field just might prove to do better than orthodox means offered by laboratory methods.

Improvements in the process are proving to be effective in the area of human behavior and industrial processes. Outright renovations on lab technologies just may not be the right response, but again the renovations on the processes involved.

Such a process intervention can integrate even the socio-behavioral aspect into it to constitute a more integrated approach to healthcare management. Below is a report on such an intervention initiative for malaria.

[Philippines, 01 August 2011]

Source: http://www.scidev.net/en/news/simple-measures-could-improve-malaria-diagnostic-kits-.html

Simple measures 'could improve malaria diagnostic kits'

Gozde Zorlu

11 July 2011 | EN

Rapid diagnostic tests (RDTs) for malaria could be greatly improved by a few simple measures, say researchers.

These include providing better information for health workers on how to use them effectively in the field and how to spot common errors, according to a study published in Malaria Journal last month (15 June).

"Inaccurate test results and poorly designed RDT kits were found to be limitations in the use of rapid diagnostic tests in malaria-endemic countries," Philippe Gillet, the lead author and a researcher at the Institute of Tropical Medicine in, Belgium told SciDev.Net.

The first Cochrane review of the tests — published last week (6 July) by the global non-governmental organisation the Cochrane Collaboration — found them to be "very accurate" when compared with laboratory-based microscopy or polymerase chain reaction tests. After analysing data from 74 studies it concluded that RDTs identify malaria correctly in 19 out of 20 cases.

But such reviews may overlook problems faced by health workers in real-life settings, said Piero Olliaro, a co-author of the review, who works on the Special Programme for Research and Training in Tropical Diseases at the WHO.

In 2007, more than 70 million such tests were carried out worldwide. They offer an easier and faster alternative to laboratory-based techniques that are often lacking in remote areas.

When used properly, RDTs can save lives and slow down drug resistance, because only people with confirmed malaria are treated.

For the Malaria Journal article, Gillet and his team analysed the accuracy of 873 tests from a Mozambique hospital.

They found a range of problems, including false-negative results in patients with high parasite densities because the display was too faint to see. Meanwhile, where health workers replaced the buffer — a liquid solution needed to run the tests — with water or buffer from another kit, three-quarters of tests gave false-positive results.

The study recommends providing better information about these limitations, providing more than one buffer in the kit, and including a warning in information leaflets.

David Bell, head of the malaria diagnostics programme at the Foundation for Innovative New Diagnostics, said manufacturers should explore the problems of faint displays "to ensure the tests work across the whole likely range of parasite densities".

An earlier study by Gillet's team, also published in Malaria Journal (13 February), found that information on the packaging, labelling and information leaflets in 42 RDT kits from 22 manufacturers was difficult to read and often incorrect or incomplete.

"For a test to provide an accurate diagnosis, it has to be prepared properly and it has to be interpreted properly — and to do this you need very good instructions," said Bell. "What might be good instruction in a laboratory may not be adequate for a village health worker who has a different level of literacy and training."

Gillet suggested that the WHO or the European Union could demand improvements as part of the pre-qualification process, which certifies the quality of the tests and is needed for UN agencies to distribute them.

Olliaro agreed: "There is room for improvement to make these tests more user-friendly and perform better, particularly in the hands of health workers confronted with multiple tasks".

Link to the first study in Malaria Journal

Link to full the second study in Malaria Journal

Link to full Cochrane review

References

Malaria Journal doi: 10.1186/1475-2875-10-166 (2011)
Malaria Journal doi: 10.1186/1475-2875-10-39 (2011)
Cochrane Database of Systematic Reviews doi: 10.1002/14651858.CD008122.pub2 (2011)

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MALARIA D’APES & MONKEYS

MALARIA D’APES & MONKEYS

Erle Frayne D. Argonza

We have a new alarming development concerning malaria spread. Gorillas and monkeys might just happen to be the dreaded carriers of the disease, a news that could cause chagrin on the legendary Tarzan.

This analyst has no fondness for Tarzan philosophy, but is more focused on highlighting risks to communities caused by a diversity of factors such as diseases. Being a development worker for long, I contracted malaria while doing field work and almost died of the falciparum disease in 1982.

We have no evidence yet of malaria being transmitted to humans by monkeys even though we do have species of monkeys among our diverse fauna. But Africa has shown less resiliency to that possibility, as shown in the report below.

[Philippines, 18 July 2011]

Source: http://www.scidev.net/en/news/primate-malaria-in-africa-may-be-jumping-species.html

Primate malaria in Africa may be jumping species

Rachel Mundy

7 July 2011

A malaria parasite from gorillas has been found in an African monkey, suggesting it has jumped species and may be able to transfer to humans.

The finding has led some malaria experts to suggest that if transfer between monkeys and apes has occurred then monkey-to-human malaria transmission may already be happening. They have called for more research to quantify the risks.

"The evidence is sufficient to warrant further investigation into the possibility that these parasites may also jump to humans," said Beatrice Hahn, a professor of medicine at the University of Alabama at Birmingham, United States. "We need to screen humans who live in flying range of mosquitoes that also bite primates, to establish whether they are susceptible to the primate parasites."

Wild forest-living gorilla populations are known to harbour a parasite strain that is closely related to the human malaria parasite Plasmodium falciparum. And macaque monkeys in South-East Asia carry another malaria parasite, Plasmodium knowlesi — a potential threat to humans.

But this is the first time that a P. falciparum strain similar to the one that causes human malaria has been found in an African monkey — the spot-nosed guenon from Gabon (Cercopithecus nictitans).

The fact that "the genetic differences from the human strain are so slight" raises the possibility that monkey and ape malaria may be transmitted to humans, said François Renaud, a researcher at the French National Centre for Scientific Research, in Montpelier, and co-author of the study published in the Proceedings of the National Academy of Sciences (5 July).

As humans come into closer contact with apes and monkeys as a result of deforestation, commercial hunting and population growth, the opportunity for the parasites to be transmitted to humans will increase.

"One single successful cross-species transmission event has the potential to result in a major human pandemic," Hahn, who was not involved in the study, told SciDev.Net. 


But David Conway, professor of biology at the London School of Hygiene & Tropical Medicine, United Kingdom, said the reservoir of malaria in African monkeys must be very small, given the low prevalence found in this study.

"Hopefully, monkey malaria will start to be recognised as an important area of research, but when examining the public health significance for humans, it is important to put the risk into context. Normal human malaria has a much higher prevalence, except in parts of South-East Asia where this has been reduced and the importance of malaria from monkeys has become more noticeable," Conway said.

Looking for human infections with monkey malaria is "like looking for a needle in a haystack", he said, adding that "there is every chance that human infections are occurring occasionally in the forest".

"In this particular case, the vector of malaria is the key determinant in determining any public-health risk," Conway said. "Identifying which species of mosquitoes transmits each parasite strain is a neglected area of research that needs additional funding."

Link to abstract in PNAS

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Come Visit E. Argonza’s blogs & website anytime!

Social Blogs:

IKONOKLAST: http://erleargonza.blogspot.com

UNLADTAU: http://unladtau.wordpress.com

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COSMICBUHAY: http://cosmicbuhay.blogspot.com

BRIGHTWORLD: http://erlefraynebrightworld.wordpress.com

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ARTBLOG: http://erleargonza.wordpress.com

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