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Column: What do health professionals in Europe know about malaria? ‘Part I: European statistics’

April 10, 2014 - 20:00 -- Ingeborg van Schayk

Four years ago, after working for six years as a hospital and pre-hospital emergency doctor in Spain, I accepted a position as a remote site doctor in Sierra Leone. Until then malaria was an obscure, almost phantasmagorical, condition to me.

Column: Where do you hang a mosquito net in the bush?

April 2, 2014 - 19:22 -- Bart G.J. Knols
So you live in DR Congo. Your youngest child has visited the health post today, she is diagnosed with malaria. You were lucky that there was somebody at the clinic today. They gave you a blister with drugs. It is not quite clear how you got the first capsule into this two year old, but you managed. She is asleep now, safely under a mosquito net that was donated to you last year.
All of a sudden you hear noise outside. Gunshots, men running, men screaming. You know what this means. You, your family, you have to run. NOW.

Column: Social values & beliefs: the key to successful malaria prevention?

March 23, 2014 - 08:46 -- Ingeborg van Schayk
Do social norms and cost sharing matter in obtaining community buy in and adding value to health commodities? An excerpt from the field with emphasis on community based participatory methods and insecticide treated bed net (ITN) usage.

Are in vitro antimalarial assays a waste of time?

March 22, 2014 - 08:59 -- Pierre Lutgen

by Patrick Engeu Ogwang and Pierre Lutgen

Most of the assessments on the antimalarial efficacy of a molecule are made in vitro. In the case of plant material the first step is generally the extraction with an organic solvent. The extract is then lyophilized, frozen and stored for subsequent trials.

In memoriam: Ernst-Jan Scholte (1974 - 2014)

March 20, 2014 - 19:00 -- Bart G.J. Knols

It is with great sadness that I report the passing of my friend, colleague and my former PhD student Dr. Ernst-Jan Scholte, yesterday, 16 March 2014. Although obituaries are normally written for scientists that died at an old age and had a massive track record in our field, I feel the urge to commemorate and remember this great person in front of you all at MalariaWorld. He became only 40 years of age - after fighting cancer for a year.

Ernst-Jan first contacted me in 1998 when he was still a biology student at the Wageningen University. At that time I was working in Nairobi for the International Centre of Insect Physiology and Ecology (ICIPE). Ernst-Jan (or EJ as many called him) wanted to study mosquitoes and do an internship with me for six months. He was lucky. Within a week after he arrived in Kenya we undertook a wonderful safari to the border with Tanzania, visiting and hiking in a Masai area where I had previously worked on tsetse flies. EJ loved it from day one. He fell in love with Africa, its people and its wildlife, and was extremely motivated in his work. I will never forget the nights we camped out in the bush together...

New: Book on architecture and health (notably malaria)

March 20, 2014 - 18:14 -- Bart G.J. Knols
Early nomadic shelters, including caves, animal skin tents, and igloos, were used for protection against the wind, rain, snow, sunlight, and other forces of nature. These basic homes also provided defence against predators and were used to store a few important possessions. They were temporary, and proximity to a water source was of prime importance.

Free International Innovation publication with special focus on malaria

March 20, 2014 - 18:00 -- MESA Alliance

International Innovation, has recently published an edition called 'Parasites of poverty: how international research is tackling the global threat of tropical disease'. In this edition there is a special focus on malaria: 'break the life cycle stop the spread."

Column: Out of sight, out of mind? How has imaging advanced our understanding of Plasmodium infected erythrocytes?

March 12, 2014 - 21:57 -- Bart G.J. Knols
Being a lab-based malaria researcher in a non-endemic country, I’ve been really interested by the columns that our colleagues ‘in the field’ have shared; looking at vector populations, elimination strategies and experiences of disease themselves. My perspectives of malaria are rather different however, and I hope to share more of a laboratory angle in my contributions to MalariaWorld this year. With that in mind, where better to start than the microscope and how most of us first come ‘face to face’ with Plasmodium spp? 
A bit of history
Much of our knowledge of Plasmodium parasites has come from the ability to visualize them (reviewed by [1]). The first description of the causative agents of malaria by Laveran in 1880 was made possible by 400x magnification of infected blood samples, and detected the pigment we now know as haemozoin. Since then the Giemsa stain, developed in 1904, has made it possible to differentiate between species, and remains the clinical gold standard to diagnose infection... 

Updated version of book freely available

March 5, 2014 - 11:51 -- Bart G.J. Knols

The freely available book titled "Artemisia annua,Artemisinin, ACTs & Malaria Control in Africa: Tradition, Science and Public Policy", has been updated by the author, Dana Dalrymple, and has been expanded with an Annex (Annex 7), titled: "The Early Role of Novartis in ACT Development" (pp. 189-192).

The book is attached to this blog. We are grateful to Dr. Dalrymple to make this updated version available for free to MalariaWorld subscribers.

The MW team.

Column: Problems on the Horizon

March 2, 2014 - 22:08 -- Bart G.J. Knols
As an avid observer of malaria transmission patterns, I am becoming worried about sustaining the advances that have developed over the past ten or so years. There is no doubt that the advent of insecticide treated bednets has provided a vehicle for various interested parties to exploit as a means of vector control, and this has happened in huge numbers. Tens of millions of LLINs have been delivered to various governments, NGOs and other interested parties, and this is still happening. But when it comes to monitoring the effects of this intervention, when it comes to careful evaluation of the programmes, there isn’t much to hear...

Can malaria be suppressed in the Congo River Basin without developing the Grand Inga Dam?

February 28, 2014 - 12:50 -- William Jobin


Despite real progress in much of Africa, the two big elephants left in the room are Nigeria and the Congo. Because of poor infrastructure, continuing civil war, and very unstable political conditions, it is hard to imagine how we can attack malaria in the Congo. Although the US PMI has added them to their list, we all know it will be a long time before anything significant can be organized there.

Organizing indoor spray programs or bednet distribution takes a stable MOH, and is difficult in the midst of civil war.

World Health Day (7 April) about vector-borne diseases

February 24, 2014 - 19:50 -- Bart G.J. Knols

This year World Health Day has its focus on vector-borne diseases, including malaria. The World Health Organization has set specific goals for this day, and is asking the international community working on malaria and other vectors to pay special attention towards protection from vector-borne diseases.

Avez-vous travaillez avec le PMI en Afrique ? Have you worked with US Presidential Malaria Initiative for Africa?

February 21, 2014 - 13:00 -- William Jobin

Chers Confreres et Colleagues,

The US Presidential Malaria Initiative (PMI) began in 2005 in Angola. I helped start it, along with 2 other consultants for RTI the US contractor, and 3 malariologists from the Angolan Ministry of Health. Since then PMI has expanded to cover 21 countries in Africa. The contract passed from RTI to Abt Associates, and others.

If you do simple math, that means we have accumulated about 1,000 person years since then, in Africa, fighting malaria. What a tremendous resource! Are you one of those people?

The inherent waste in ephemeral methods such as bednets or indoor spraying, compared to the accumulating benefit of land reclamation

February 18, 2014 - 14:06 -- William Jobin

When Martinho Somandjinga, Manuel Lluberas, Joaquim Canelas and I started the US PMI in Angola in 2005, the excitement and pride of our accomplishments carried us along for the first couple of years. Sure we spent over two million dollars in one small province each year, but it seemed worth it.

Column: If they are lazy, are we stupid?

February 16, 2014 - 21:15 -- Bart G.J. Knols
The following is an actual quote from an investigator/professor (who shall remain anonymous) working in a malaria-endemic region whilst referring to the local riverine population, in a relaxed while-drinking-a-beer environment: “They could have less malaria, but they’re just too lazy to build proper houses”.
I don’t know about you, but for me that was the spark for a 30 minute argument that ruined the relaxed while-drinking-a-beer environment of that afternoon! The thing is, I find it difficult when I have to sit and listen to educated men and women from a variety of backgrounds and in a position to actually have their opinions on malaria heard (WHO, big regional Hospitals or small local district health centers, professors and researchers at universities or NGO workers) being asked the question of why malaria hasn’t been eliminated so far and hear that, in some way, it is the fault of individuals living in malaria endemic areas. Usually the arguments for that go somewhat like: they don’t clean their gutters or other possible mosquito breeding grounds; they don’t close the gaps between the wooden boards of their houses or between the roof and the walls, they don’t sleep under bednets, they insist in staying outdoors after dark, they don’t use insect repellent or have fans in their houses, etc, etc… I’m sure you’ve heard it all before, if you haven’t thought it yourself...

This has to be fuel for debate... or not?

February 10, 2014 - 21:28 -- Bart G.J. Knols

As the Keystone symposium on the science of malaria eradication has come to an end, the one thing I regret is that I wasn't there to participate. It undoubtedly must have been an exciting meeting, which is clear from the messages we received from the MESA group (read them here).

Imperfect tools applied to control malaria may still lead to remarkable results

February 9, 2014 - 20:31 -- MESA Alliance

'The science of malaria eradication' Keystone Symposia

Wednesday  Feb 5th

The third day at the Keystone Symposium on The Science of Malaria Eradication was an action packed day of exciting discussions on vaccines and tools to measure transmission, with an interlude to the Mayan ruins of Mayapan, where the malaria community rhetorically climbed the 'Mayan pyramids' of eradication.

Column: Sleepless in the liver: would revisiting the past give any directions on how to deal with hypnozoite carriers of P. vivax?

February 6, 2014 - 20:51 -- Bart G.J. Knols
Many of the recent strategies to improve malaria control have been focusing on improving the detection of very low parasitaemias to identify asymptomatic carriers of Plasmodium sp. to reduce the infective reservoir. Although these strategies are extremely rational and sensible to tackle most of malaria infections, they will probably not be sufficient to achieve elimination for parasites that present relapses, as is the case for Plasmodium vivax. The need to look for new and sophisticated methods has been exhaustively stressed by researchers, however, at this time, revisiting a simple and efficient strategy successfully employed in the past could prove to be a path to be followed...

If malaria elimination is a stable state, how do we get there?

February 6, 2014 - 17:52 -- MESA Alliance

'The science of malaria eradication' Keystone Symposia

Tuesday Feb 4th

The Keystone Symposium on The Science of Malaria Eradication entered its second day of activities with a focus on drug based strategies and health systems research in the elimination context. The evidence for use of single dose primaquine to clear P. falciparum infections, the new K-13 artemisinin resistance marker, and how clearing asymptomatic infections in children can improve cognition and reduce transmission all featured in the animated discussions.

Uric acid: emerging as key factor in malaria

February 6, 2014 - 17:09 -- Pierre Lutgen

Plasmodium falciparum-infected erythrocytes contain large quantities of uric acid precipitates. These precipitates are present in the parasitophorous vacuole, in the cytoplasm, not in the food vacuole of the parasite. Uric acid precipitates are highly inflammatory molecules that are considered a danger signal for innate immunity and are the causative agent of gout. Hypoxanthine is a metabolic precursor of uric acid and is essential for Plasmodium growth. It is transformed by the xanthine oxidase into xanthine the true precursor of uric acid.

Malaria in Ethiopia, Jerusalem and Zanzibar

February 5, 2014 - 21:17 -- William Jobin

Malaria in Ethiopia, Jerusalem and Zanzibar

Eighth African Malaria Dialogue – Boston University USA 31 January 2014

Our informal African Malaria Dialogues started in the summer of 2012, meeting quarterly on the East Coast of the US in order to encourage interdisciplinary field research on African malaria. The dialogues are informally organized and participants cover their own costs for travel and meals. All are invited, and our next Dialogue will be in the Spring.

Please let me know if you wish to come. I will put you on our list.

'It always seems impossible until it is done' – Nelson Mandela

February 5, 2014 - 20:51 -- MESA Alliance

'The science of malaria eradication' Keystone Symposia
Monday Feb 3rd

From bioethical considerations, to mapping trends in malaria transmission with basic biology. From inspiring lessons in other eradication campaigns, to regulatory issues around tools which benefit populations, to novel genetic technologies which modify mosquitoes and the parasite life cycle. The first day of the Keystone Symposium on the science of malaria eradication set the scene for sharing and debating new discoveries and innovative approaches to malaria eradication.

Column: Nobody asked me, but …

February 4, 2014 - 19:52 -- Bart G.J. Knols
Malaria control is much more complicated and complex than can be highlighted within the confines of a few lines of text, but I need to share with you some of the things that make me wonder and keep me up some nights. I do not consider myself an alarmist, but as a public health entomologist there are a few things that concern me when I think of malaria control.

The World Malaria Report for 2013 paints an optimistic picture when it reports a fifty percent reduction in global mortality due malaria since 2000. However, the same report states that in 2012, “in 41 of the 103 countries reporting, which account for 80% of estimated cases, it is not possible to reliably assess malaria trends using the data submitted to WHO” as “information systems are weakest, and the challenges for strengthening systems are greatest, where the malaria burden is greatest.”...

Kick-off to the 'The science of malaria eradication' Keystone Symposia

February 3, 2014 - 21:05 -- MESA Alliance

Sunday Feb 2nd

'The science of malaria eradication' Keystone Symposia celebrated its first day of activities in Merida, Yucatan, with a workshop devoted to students and researchers from endemic countries that received a travel award to attend the meeting.  This workshop offered the opportunity to interact with a group of international experts that discussed the role of a dynamic biomedical research agenda, including aspects relating to therapeutics, vector biology and vaccines to interrupt transmission.


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