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  • Reply to: Stable malaria incidence despite scaling up control strategies in a malaria vaccine-testing site in Mali   2 days 1 hour ago
    If you read between the lines of this paper from Malaria Journal it depicts a catastrophic failure not only in Mali. Up to 2010 many research papers and reviews claimed that there was a decrease of malaria incidence in many countries thanks to ACTs and ITNs A massive swamping of Africa by western medicine gadgets was launched by sales organisations like Global Fund or UNICEF or WHO. But since 2013, most papers and reviews report a stagnation or increase of malaria incidence in many countries. In attached paper look for example at references 18, 21. I have several more of these available on file depicting malaria increases since 2010. My opinion : pyrethroids and artemisine derivatives are immunodepressive and their massive use may lead to an increase in malaria infections. Furthermore resistances against ACTs and pyrethroids are building up everywhere rendering their use futile and dangerous. What bothers me in this paper is that the Dogons of Bandiagara in Mali are used as guinea pigs for clinical trials on malaria vaccines. Why not run these tests with Lutetians, Tirolians, Bostonians, Menapians or other Caucasians ?
  • Reply to: Stable malaria incidence despite scaling up control strategies in a malaria vaccine-testing site in Mali   3 days 21 hours ago
    In reading the paper, I am concerned about several issues. First, the intervention is not properly described. In the text it seems to comprise of a single LLIN net being issued to each infant born in the City, which does not comprise any real coverage, supported by passive case detection. If this is the only anti-vector action, then there is no real intervention and one would not expect transmission to be interrupted. So I am not surprised that malaria is still rampant. Second, the paper purports to measure incidence which is expresses as an annual incidence rate. How was this calculated? Incidence is measured over a unit of time, was the rate given truly measuring 1-3 infections per year. or whatever is expressed. As transmission is so seasonal in Mali why isn't it measured monthly or seasonally, it seems the data are available as shown in Fig.2. To measure incidence there needs to be a denominator, the number of people in the population and numerator, the number of cases acquired per unit of time (week, month or year). I cannot really see how the number was calculated. I don't think the result is misleading but the more or less stable transmission pattern is not surprising
  • Reply to: Stable malaria incidence despite scaling up control strategies in a malaria vaccine-testing site in Mali   4 days 3 hours ago
    You have to treat the problem not the symptoms otherwise malaria will never be eradicated .
  • Reply to: Column: In the heat of the moment - by Jenni Lawton   1 week 3 days ago

    Dear Nayna,
    Thanks very much for your thoughtful comments!

    - I absolutely agree that free education would make an enormous benefit to communities across the world and especially would benefit the developing countries whose endemic diseases cripple their own populations. But how to encourage governments to invest in open access to education when in many places (England included) it often seems that those from privileged backgrounds are more likely to have these opportunities and are precisely the people then making such policy decisions?

    - As Bart & Inga mentioned in their blog this week, it is poignant that the international community has only recently begun to respond to the frightening Ebola outbreak, despite warnings from the scientific community much earlier. Understanding more about malaria and other infectious diseases is crucial for developing therapeutics, which the research community has been striving to do since the discovery of these pathogens. Nonetheless, many potential parasite and vector control measures that we already know of fail to be implemented in a coherent manner, which our colleagues are urging governments and those financing large-scale initiatives to improve. This is a problem in the UK as well, where scientific advice is often sought and then ignored in policy making (see an excellent book by Mark Henderson: “The Geek Manifesto”). Perhaps the scientific community needs dedicated advocates who are able to promote the most effective strategies to the policy makers?

    - Dr Manuel Lluberas recently pointed out that many of the measures that were historically successful in malaria control today would not be allowed due to tight regulations and safety fears (http://www.malariaworld.org/blog/column-will-current-global-malaria-programme-pass-cochrane-review). [In fact the successful first uses of Zmapp™ were only permitted by the WHO due to the enormous mortality associated with this Ebola outbreak. A safety and efficacy trial has just begun, with GSK hoping to begin delivering treatment to health-workers in West Africa before the end of this year (http://www.theguardian.com/society/2014/sep/17/ruth-atkins-first-british-volunteer-injected-trial-ebola-vaccine-oxford)]. Of course these restrictions have been imposed for safety reasons but as costs of developing new drugs and / or vaccines soar, there may come a point where such rigorous testing is not financially sustainable. Then we would have to weigh the possible adverse risks of new therapeutics against the likely ravages of disease without them.

    - I wonder what our MW colleagues think?

    Finally, may I just say that however people are feeling after the No vote, Scotland’s referendum has been an unusual example of widespread political engagement in a world where too few people have the opportunity to vote in democratic elections, and those that do often fail to bother. We are very lucky to be able to have a voice and the access to education when sadly these should not be down to luck at all.

    Best wishes,
    Jenni

  • Reply to: Column: In the heat of the moment - by Jenni Lawton   1 week 4 days ago

    Thank you Jenni for an excellent account of the Scottish contribution to mosquito and malaria research, especially the part played by the provision of free education available in Scotland. If only free education was available to peoples of many more/ALL countries! Now that Scotland has voted 'No' to independence, how do you see us all contributing and working together to eliminate vector borne diseases? How can we all best work together? It's an excellent first communication!