Reply to: Artequick: programmed for failure
Medecins sans Frontières run a large scale IPT trial in a refugee camp in Uganda with dihydroartemisinin-piperaquine (DP). The trial involved 13 537 children. Distributions of DP took place in March 2015, May 2015 and July 2015. Final impact was evaluated in September 2015. Average parasitemia raised from 6.6 in May to 18.7% in September. The authors qualify this as a positive impact of DP on malaria incidence!
(Mc Coldiron, E Lasry, R Grais, Malaria Journal 2017 16:218)
On may wonder why MSF persists in this mass drug administration. In a paper covering results from 2014 they had already concluded that “The low effectiveness of dihydroartemisinin–piperaquine (DHA–PPQ) for symptomatic cases indicates that PPQ is no longer able to complement the reduced potency of DHA to treat falciparum malaria and highlights the need for an alternative first-line treatment”. (G Falq, R van den Bergh, Malaria Journal 2016, 15(1) 446).
And this is not the first failure of Artekin in IPT. In a trial in Zambia no difference was found in the two treatment arms (Eisele TP, Bennett A, Silumbe K, Short-term Impact of Mass Drug Administration With Dihydroartemisinin Plus Piperaquine on Malaria in Southern Province Zambia: A Cluster-Randomized Controlled Trial. J Infect Dis. 2016 Dec 15;214(12):1831-1839).
There is serious concern over the widespread deployment of IPT and that this will enhance the spread of drug resistance
And it confirms that African children are guinea pigs for mass drug administration
Reply to: Progress with Sanaria’s Plasmodium falciparum sporozoite vaccines
The first results of the RTS,S vaccine already appeared in 1998 in a scientific paper. The conclusion was: Immune responses did not correlate with protection. Further optimization in vaccine composition will be required to induce longer-lasting protective immunity.
Stoute JA, Kester KE, Ballou Wr. Long-term efficacy and immune
responses following immunization with the RTS,S malaria vaccine.
J Infect Dis. 1998 178(4), 1139-44
Another randomised trial of the efficacy of RTS,S against natural P. falciparum infection in semi-immune adult men was run in The Gambia in 2001. Vaccine efficacy, adjusted for confounders, was 34%. Protection seemed to wane: estimated efficacy during the first 9 weeks of follow-up was 71% (46-85), but decreased to 0% (-52 to 34) in the last 6 weeks.
Bojang KA, Milligan PJ, RTS, S Malaria Vaccine Trial Team
Efficacy of RTS,S/AS02 malaria vaccine against Plasmodium
falciparum infection in semi-immune adult men in The Gambia: a
randomised trial. Lancet. 2001 Dec 8;358(9297):1927-34
In a trial of 2008, the rate of efficacy against the more clinically relevant end point of clinical malaria in children 1 to 4 years of age was 30%
Philip Bejon, John Lusingu, Ally Olotu., Efficacy of RTS,S/AS01E
Vaccine against Malaria in Children 5 to 17 Months of Age. NEJM
2008, 359, 2521-39
In 2009 vaccine efficacy over the 45-month surveillance period against a first or only episode of clinical malaria disease was 30.5% and the VE against all episodes was 25.6%
Sacarlal J, Alonso PL. Long-term safety and efficacy of the
RTS,S/AS02A malaria vaccine in Mozambican children. J Infect Dis.
2009 Aug 1;200(3):329-36. doi: 10.1086/600119.
In 2013 6,537 infants aged 6–12 wk and 8,923 children aged 5–17 mo were randomized to receive three doses of RTS,S/AS01. Vaccine efficiency against clinical malaria in infants was 27%, with no significant protection against severe malaria, malaria hospitalization, or all-cause hospitalization
Sanjeev Krishna, Academic Editor. Efficacy and Safety of the
RTS,S/AS01 Malaria Vaccine during 18 Months after Vaccination: A
Phase 3 Randomized, Controlled Trial in Children and Young
Infants at 11 African Sites. PLoS Med. 2014 Jul; 11(7):
To continuously raise false hopes by massive press releases is immoral. Who pays for all these guinea pigs: Bill Gates or GSK Wavre?
Reply to: Research: Risk factors associated with occurrence of placental malaria in a population of parturients in Abeokuta, Ogun State, Nigeria
I would say, this is a nice work, Well articulated. This should find a way to the end point (pregnant women) so that it will inform the kind of life they will live during pregnancy.
Reply to: Vitamin C and malaria: beware!
In the past when being treated for Bartonella, I had a positive response. Recently relapsed on just multiple Babesia strains (very biologically similar to Malaria, same drugs treat them both). I was doing well after only a few days on mepron and went back to do high dose IV Vitamin C to boost my immune system. I felt horrible for days after and was suspicious of the Vitamin C. Then I read this. WOW! It all makes sense now and thank god I saw this before I put the last nail in the coffin.
Reply to: The 2017 malaria avalanche
Times of India, 16 May 2017
According to the health report of the Ahmedabad Municipal Corporation (AMC)