topnaman | Malaria blog

The evidence just keeps piling up with this new report from Africa Fighting Malaria and a series of papers in Malaria Journal (1, 2, and 3). Not only is the availability and cost falling short of goals as we’ve discussed (here, here, here and here), the patient-centered outcomes which actually matter, are likely far worse. In addition to flaws [...]

Key to the theory behind antimalarial treatment is understanding the stage-specific actions of drugs and on a related note their mechanisms of action. The life cycle of malaria is complex and most drugs intervene on limited portions of it. I came across this beautiful figure in a 1962 article from the Bulletin of the World [...]

The parasite clearance curve and, the more commonly used, parasite clearance time is a measure of the reduction of parasite density over time or the time until the patient is parasite free, after beginning treatment. Interest in parasite clearance has peaked as a means to gauge artemisinin resistance (previously discussed here and here) as combination therapies [...]

Truly beautiful studies – well designed, well thought, even examined cost and service delivery – were recently conducted for regular, presumptive antimalarial treatment (using SP and amodiaquine) of children in Mali and Burkina Faso in settings where treated bed-nets are already in use (PLoS Medicine – open access!). The intervention was effective at reducing clinical burden – [...]

 (image credit: Lasker Foundation) Congratulations to Dr Tu Youyou for her well-deserved Lasker award (considered a precursor to the Nobel prize) in clinical sciences (hat tip: Mariam). Dr Youyou recieved the honor for her painstaking work screening traditional Chinese herbs for antimalarial properties as part of military project 523 (more on the military and malaria here). The [...]

No. According to a recent report by the Evidence to Policy Initiative (funded by the Gates Foundation which in turn also supported the ACT subsidy idea) . The conclusions are no surprise (see here and here for previous discussions on the idea of selling subsidized artemisinin combination therapy in pharmacies). The summary points were: Pilots [...]

The Affordable Medicines Facility for malaria (AMFm, previously introduced here) may go down as one of the largest failures in public health history. Subsidizing effective antimalarials (namely artemisinin-combination therapies) for sale through private vendors (largely the wide-spread pharmacy/drug kiosk) is an untested idea for increasing access – yet is backed by more than $225 million [...]

It worked. Really well. Vivax malaria can relapse from liver stages (hypnozoites) adding to patient burden and further transmission. In tropical settings, upwards of 50-80% of patients may relapse within 1-3 months of the primary infection. Treating the dormant liver stages, which are unaffected by standard therapies, requires 14 days of treatment with primaquine. Adherence [...]

The combined gametocidal effect of primaquine plus artemisinin-combination therapy (ACT) to reduce post-treatment transmission of P. falciparum malaria is a key operational research question for malaria treatment (previously discussed here). And the evidence of adding primaquine, particularly in areas of low to medium transmission, keeps piling up. Smithius et al. report results from a massive [...]

Malaria articles on Karen Grepin’s blog – while only a few malaria dedicated blogs exist, some development and health blogs have a nice collection of posts including this one. Assessment of malaria elimination in Zanzibar (old news) – even with a balanced outlook will it guide future actions – or are those predetermined by who’s [...]