Study raises red alert on spread of untreatable malaria with choice drug

There is a red alert that malaria is becoming untreatable with the drug of choice, Artemisinin Combination Therapy (ACT), and the vector, mosquitoes, is becoming resistant to the recommended insecticide, pyrethroids, in more parts of the world.

According to a study published yesterday in the journal, The Lancet Infectious Diseases, a lineage of multidrug resistant Plasmodium falciparum malaria parasites (superbugs), has widely spread and is now established in parts of Thailand, Laos and Cambodia, causing high treatment failure rates for the main falciparum malaria medicines, ACTs.

Also, United Kingdom (UK) doctors reported last week Thursday that a key malaria treatment has failed for the first time in patients being treated in the region.

A team at the London School of Hygiene and Tropical Medicine said it was too early to panic. But it warned things could suddenly get worse and demanded an urgent appraisal of drug-resistance levels in Africa.

However, according to the report, most of the patients were treated with the combination drug: artemether-lumefantrine.In Nigeria, although there are reported cases of treatment failures with ACTs, the National Malaria Elimination Programme (NMEP) insisted that the country has not confirmed any case of malaria resistant to the drug-of-choice, ACTs.

According to The Lancet Infectious Diseases, the emergence and spread of artemisinin drug resistant Plasmodium falciparum lineage represents a serious threat to global malaria control and eradication efforts.

The authors warned that malaria parasites resistant to both artemisinin and its widely used partner drug, Piperaquine, are now spreading quickly throughout Cambodia, with fitter multidrug resistant parasites spreading throughout western Cambodia, southern Laos and northeastern Thailand.

Worried that the further spread of these multidrug resistant parasites through India to sub-Saharan Africa would be a global public health disaster, the study authors called for accelerated efforts in the Greater Mekong Sub-region and closer collaboration to monitor any further spread in neighbouring regions.

Also, a genetic analysis of mosquito populations in Africa showed that recent successes in controlling malaria through treated bednets has led to widespread insecticide resistance in mosquitoes.

Expensive malaria drugs are not better, experts warn Nigerians

A lack of political commitment by the federal and state governments is slowing down progress in the national fight against malaria even as Nigeria has made steady progress in reducing incidents of malaria deaths, the implementation partners of the Global Fund for Malaria programme have said.

The partners also warned Nigerians against patronising expensive malaria drugs, thinking they work better.

The partners, the National Malaria Elimination Programme and the Society for Family Health, say that foreign donors, instead of the Nigerian government, are leading the national fight against malaria.

The Global Fund intervention is currently operational in 24 of Nigeria’s 36 states.

Experts say malaria deaths have reduced significantly across the world with Africa still accounting for 80 per cent of global burden and 90 per cent of all deaths due to malaria.

Malaria deaths decreased significantly from 935,000 in 2000 to 438,000 in 2015, according to World Health Organisation figures.

Speaking at an interactive forum for editors of online publications and bloggers, Godwin Ntadom of the National Malaria Elimination Programme said Nigeria and the Democratic Republic of Congo share about 41 per cent of the global malaria burden.

According to Mr. Ntadom, socio-economic improvements such as houses with screened windows and air conditioning combined with vector reduction efforts were measures that led to the elimination of malaria in North America in the early 19 century.

“Use of DDT and efficient management of the environment resulted in the eradication of malaria in Europe and South America in the 1950s,” he said.

“Sub-Saharan Africa demonstrated the least commitment due to ignorance (causes and how to prevent malaria); inadequate resources; weak political commitment and poor communication.”

The partners plan increased communication to change attitudes and behaviours as well as to encourage increased environmental measures to eliminate the breeding grounds for mosquitoes.

Ernest Nwokolo, Malaria Programme Director at the Society for Family Health, advised citizens to look out for drugs with the green leaf indicator. He said donors had subsidised majority of malaria drugs with the green leaf sign for the benefit of citizens, urging people not to be misled into buying the higher priced drugs in the erroneous assumption that they are of superior quality.

“This is the biggest deception we are seeing in our country,” Mr. Nwokolo said.

“The Private Sector Procurement Mechanism means that the global fund pays money to the manufacturer. If the drug is supposed to cost one dollar, they pay 95 cents,” he said.

“The manufacturer sells the drug to people we call first-line users, who buy at five cents. When they come into the country we discuss with them so that they sell the drugs at nothing more than N100 and adult dose at N120. The drugs have a sign- a green leaf logo”.

Dr. Nwokolo said malaria drugs with the green logo are produced by the same company that produces expensive malaria drugs, and accused pharmacies of “maximising” the ignorance of the people..

“Because you do not know about that, when you go to these pharmacies, they will sell the costly ones because they make a gain.

“People prefer the expensive ones because when the pharmacist brings the cheaper one for N200, and the expensive one, the person will ask for the expensive one because ‘he wants to know what he is buying.”

Pneumonia replaces malaria as number one child killer disease in Nigeria – Report

Pneumonia has overtaken malaria as the number one killer disease among children under the age of five in Nigeria.

A report by the International Vaccines Access Centre (IVAC) revealed that the disease was responsible for 127,000 child deaths in the country last year.

This was disclosed on Monday in Abuja at an event held to mark the World Pneumonia Day

“Pneumonia is now the leading cause of child deaths in Nigeria, a position previously held by malaria over the years. In 2015, about 17 per cent (127,000 deaths) and 10 per cent (75,000) of all under-five deaths were caused by pneumonia and diarrhoea, respectively”, the report stated.

To assist Nigerians in the treatment of Pneumonia, a drug manufacturing company, GSK, said it has placed a 10-year price freeze on drugs for the disease as the country graduates from the Global Alliance for Vaccinations International (GAVI) funds.

“We are supporting the immunization programme, we are providing the vaccines that are used for the prevention of pneumonia in children”, Medical Director of GSK, Lana Odunuga, said.

“And one of the things I highlighted, part of our own support is actually to make sure that even at a time when Nigeria graduates from GAVI fund, which will eventually happen, Nigeria will still be able to access the vaccines at the same price at which they are getting it now.

“In addition to that, we have also tried to make it possible to reduce the cost a child pays for vaccines in Nigeria by one dollar,” he stated.

Mr. Odunuga however said that the country was on the right track in dealing with pneumonia.

How To Check Malaria By Urinating On A Stick, Researcher Reveal

New research has shown you don’t have to go through the pain of a needle prick to test if you have malaria—you can just pee on a stick.

In a clinical trial, published in the journal of Clinical Microbiology this November, researchers set up the newly-introduced urine malaria test (UMT) against standard tests for malaria across six Lagos hospitals.

Their aim was to compare how sensitive UMT was to the malaria parasite, and whether it could specifically a case of fever as being linked to the presence of the malaria.

They enrolled 1,691 people over age two for the study. Some 566 of them already had higher than 37.5-degree-centigrade fevers and 1,125 did  not have a fever but reported a history of fever in the previous 48 hours.

Among all participants combined, UMT detected malaria in 419 people, compared with 341 who tested positive in microscopy tests or other standard tests.

Among patients who actually had a fever, UMT detected malaria in 231 people, compared by 204 cases detected by microscopy.

Among 566 patients who had fever, UMT was sensitive in 85 out of every 100 cases and specific in 84% of them.

It was even more sensitive and specific among children under age five, comparable to figures obtained for standard existing tests, the researchers found.

They said testing for malaria using urine performed better among patients with a fever, who are its intended targets—and is so specific, chances of it not catching a malaria parasite is about four in 100.

“The UMT is the first non-invasive malaria test clinically evaluated on a large scale at the population and community levels,” the researchers reported.

“This indicates that the UMT could aid in the clinical management of suspected malaria cases. For example, upon receiving a negative UMT result for a suspected malaria case, the clinician now knows this patient’s probability of having malaria parasites detectable by microscopy is unlikely – only 4%. In contrast, a positive UMT result would indicate the probability of detecting malaria parasites in this patient by microscopy is 59%.”

Credit: dailytrust

 

FG, Dangote Foundation join force against malaria in Nigeria.

Federal Government of Nigeria and Dangote Foundation have jointly launched a Document tagged “Engaging the Private Sector to Eliminate Malaria in Nigeria”.

 

This is a private sector initiative that would explore resources from private investors towards eradicating malaria in the country.

 

Malaria has been described as one of the major causes of death of Women and Children in the country, it accounts for 60 % of out patients visits and 30 % of hospital admissions in Nigeria. An estimated 1.1 Billion US Dollar is lost annually in Nigeria due to malaria treatment cost. It is the major cause of absenteeism in the work place.

 

Launching the Document in Lagos on Monday 14th November, 2016, the Minister of Health Prof. Isaac Adewole said that the present administration was determined to work with private sector not only in malaria control but also in the other health challenges in Nigeria.

 

He said: “Working with you today to launch this important document is a welcome development, it is important that we embark on this initiative, it would increase efficiency and ensure that we deliver”.

 

The Minister worried that despite the large volume of mosquito nets distributed in the country; the prevalence of malaria is still high which clearly indicated that most of those who received the nets declined to use it.

 

Speaking on local production of Mosquito nets, Adewole urged private investors to consider the possibilities of producing mosquito nets in the country.

 

He said “We cannot afford to be importing net, this net can be produced in Nigeria and the market is huge. We need about 30 million nets every year in Nigeria. A net has a life span of about 3years and if you compute on the bases of 1 net for two people Nigerian would need 90 million nets over 3 years so every year we need to replace 30 million nets, so there is a huge market apart from opportunities for export.

 

In his remarks, the Chairman Dangote Foundation who is also the Malaria Ambassador in Nigeria, Alh Aliko Dangote said that Private sector had an important role to play in mobilizing resources towards Malaria Elimination Programme in Nigeria.

 

Alhaji Dangote said that Private Sector Health Alliance in Nigeria which he is the funding patron and Co-founder focused on mobilizing the private sector across the country under one coordinated platform to leverage on private sector capabilities, advocacy, innovation and resources to complement government efforts in the fight against malaria.

 

He added that Mr. Bill Gates and Other Prominent Business leaders have collaborate with Health Alliance to provide resources in the fight against malaria in Nigeria.

 

“Through my foundation we continue to contribute funds to support the government on National Malaria Elimination Programme and other NGOs directly involved in the fight against malaria. I would continue to engage government and partners to advocate for increased commitment towards addressing the financing gaps that hinder the elimination of malaria in Nigeria”. He said.

 

Dangote said as Malaria Ambassador in Nigeria, he would lead by example through provision of comprehensive malaria education and treatment to all his staff at all his business locations across the country.

 

He further pledged to support the Save One Million Lives Initiative programme launched recently by the Federal Government of Nigeria.

 

Earlier, in his presentation, the National Coordinator, National Malaria Elimination Programme, Dr. Abdu Bala Muhammed, who was represented by Deputy Director, Dr. Aro Modiu Aliu, said that Private Sector could support the fight against malaria through communications (educational messages), Capacity building, information Technology to improve disease surveillance, Direct funding, purchase of malaria commodities amongst others.

Malaria outbreak: Sokoto treats 2000 in eight days.

No fewer than 2,000 patients have been treated at the malaria camp set up by the Sokoto State Government at the Murtala Specialist Hospital, Sokoto in the last eight days.

The State Commissioner for Health, Dr. Balarabe Kakale, on Tuesday said that there was an outbreak of malaria in some parts of Sokoto North Local Government, especially the Gandu area and its environs.

He said that the state government provided 10 ambulances to convey patients with the ailment from their homes to the camp.

He said, “The camp was fully equipped, staffed and provided with free drugs, as well as medicament. The camp has 10 medical doctors, 25 nurses, 10 laboratory scientists and 15 medical records officers, among others.”

Kakale also stated that the camp has adequate stocks of antimalarial drugs, intravenous fluids, antibiotics and other medicament to cater for the patients.

He said, “It is heart-warming that zero mortality was recorded out of the over 2000 cases at the camp.

“Over 60 per cent of these cases had severe cases of malaria, with majority of them as out-patients, while only 17 are now responding to treatment at the camp. The rest were fully treated and discharged as the situation had been brought under total control.”

The Commissioner disclosed that the fatality from the outbreak still remain five contrary to some media reports.

“The problem was then caused by the contamination of the environment, like water, food and air pollution. The heaps of refuse that hitherto dotted the affected areas been evacuated.

“All the drains were also de-silted and fumigated against mosquitoes. We have also sustained intensive campaigns on the need for the residents to ensure personal and environmental hygiene.”

The Wife of the President, Mrs A’isha Buhari, had on Monday flagged off a special medical outreach in Sokoto State, as part of her response to the malaria crisis in the state.

Represented by the Wife of the Speaker, House of Representatives, Mrs Gimbiya Dogara, she said that the gesture was under her Future-Assured Programme.

The outreach programme was being conducted in collaboration with ‘The Maryam Mairo Aminu Waziri Tambuwal Legacy Initiative’, the pet project of the Wife of Governor Aminu Tambuwal, Mrs Maryam Tambuwal.

Nigerian doctors treating ailing citizens for malaria without test – USAID

United States Government, Monday, accused medical practitioners in the country of treating ailing Nigerians for malaria without conducting required test on them.

The US, through the United States Agency for International Development, USAID, also condemned production of Chloroquine in the country for the treatment of malaria.

USAID Country Director, Michael Harvey, stated this at the launch of Nigeria Malaria Indicator Survey report in Abuja.

Harvey said despite millions of dollars spent on the disease in the country, the nation had remained too endemic with the condition, even on the continent where other smaller nations had contained it.

Nigeria’s Malaria elimination programme is coordinated by the Federal Ministry of Health through the National Malaria Elimination Programme, NMEP. The organisation (including other parastatals in the Federal Ministry of Health) was recently indicted by the Global Fund for grossly mismanaging funds released for eradicating malaria in the country.

Though President Buhari ordered the Economic and Financial Commission, EFCC, to probe the alleged corruption about five months ago, findings of the 2016commission have not been made public.

Harvey said at the launch of the survey: “What is striking is that there continues to be imported nets, and we do yet have an industry in Nigeria that is producing them at a cost Nigerians can afford. What is very clear from the report however is that there are some immediate to-do in our action list, first people are testing, to see if a fever is malaria.

“And, this is something that should be doable since affordable test kits are readily available either through the public sector or private sector at an affordable cost. Too many medical professionals are still treating without testing and this is easy to fix, but the men and women need to be taught about changing that culture in the Nigerian medical professional.

“Second, we are not treating malaria proper. I am surprise to find out when you travel around Nigeria Chloroquine is readily available and too readily prescribed as a treatment for malaria. Worst, this is actually a major public policy that we have to get on top of. We are still producing Chloroquine in Nigeria, a drug that has no beneficial use either for malaria or any other use.

We have some challenges, and for those who are in the front lines of providing health care to the poorest, and it is always important to bear the greatest burden. We must get on top of these short comings.”

US spends $100m on treatment of malaria, others in Nigeria

This year alone, the United States government has spent over $100m on the treatment of Neglected Tropical Diseases in Nigeria, the Director of USAID Mission in Nigeria, Michael Harvey, has said.

According to him, $6bn which was sourced from over 40 organisations has been spent on medications for the treatment of some diseases around the world, including Nigeria.

Among the diseases on which the $100m was spent are malaria, elephantiasis (a parasitic infection spread by some mosquitoes), river blindness (due to bites from infected black fly) and helminthiasis (caused by certain tiny worms).

Others are bilharzia, also caused by tiny worms found in dirty and stagnant water; as well as trachoma, a blinding disease.

He said that the fight against the different diseases? in Nigeria has so far achieved over 60 per cent success, alongside other innovative methods which have been initiated to fight the NTDs such as preventive medicines.

“The US government has committed $100m to fighting diseases in Nigeria in 2016 and so far, about 40 organisations, businesses ?and partners all over the world have committed over $6bn on medications across the world,” Harvey stated.

The CEO/President of the Carter Centre, Ambassador Mary Ann Peters, in her speech, said Nigeria was selected out of the 14 countries because of its populous size in Africa and the fact that it is most affected by all the diseases.

“Nigeria is the most affected of all the NTDs, hence the choice of Carter Centre. In stemming the tide of the diseases, 42 per cent of drugs and medications has been distributed in Nigeria and the treatments were delivered in about 20,000 villages,” she stated.

The Carter Centre championed the eradication of guinea worm in Nigeria towards the free certification from the diseases in 2013.

The organisation has pledged to continue its support towards the eradication of the NTDs and for which eight states have so far benefitted.

US to investigate illicit diversion of USAID-funded malaria products, funds.

The United States government yesterday said it would intensify investigation in the alleged diversion of USAID-funded malaria programmes and illicit sale of malaria products it has funded in Nigeria so far.

Head of Investigation, Office of the Inspector General, USAID, Jonathan Schofield, told journalists in Abuja at the relaunch of Make A Difference (MAD) malaria hotline that the investigation bureau entrusted with the task of probing such illicit activities relating to malaria programmes found some ‘troubling patterns’ in Nigeria.

He explained that the probe will only be restricted to US funded projects and will be in collaboration with Nigerian law enforcement agencies.

Jonathan said: “The US funded malaria programme is a specific tailored initiative we are now doing. We are working in many other countries around the world to look at illicit activities, including diversion, kick backs, including embezzlement of health programmes funds.

“There are patterns that we see in Nigeria that are troubling, we don’t know how deep they are, but with this project, we will focus on those patterns,” he said.

He stated that probe would extend to “The global funding to Nigeria given that one third of the global fund budget is contributed by the US government.

Jonathan informed journalists that though “the global fund focus on audit” In their investigation, he added that, “what we (Office of the Inspector General, USAID, offer is the law enforcement component.”

The MAD programme also included rewarding Nigerian whistleblowers who have vital and concrete information and facts about diversion of malaria products and funds to contact US authorities through 8099937319.

Jonathan explained that “the main objective is to obtain actionable information concerning their transmitted, resale or falsification of anti-malaria drugs and commodities within USAID President’s Malaria Initiative (PMI) funded countries.

Also speaking, National Coordinator of the National Malaria Elimination Programme (NMEP), Dr. Bala Muhammed, represented by a Director in the agency, Dr Godwin Ntadom, stated that “part of the problems we face in the fight against malaria is in the quality of medicines used in the treatment of Malaria in Nigeria.

“The continued availability of counterfeit impedes global efforts in the fight against malaria and as such results in treatment failure and even death,” Ntadom stated.

Etisalat, Cross River sign MoU on malaria reduction

Nigeria’s most innovative telecommunication company, Etisalat, and the Cross River State Government in partnership with Mediatrix Development Foundation have pledged to forge a close working relationship in the fight against the scourge of malaria in the State.

The partners made this commitment on Thursday at the official flag-off of the Etisalat Fight Malaria Initiative and signing of a Memorandum of Understanding that will see them coordinate efforts and resources to eradicate the menacing spread of malaria in the State.

Speaking about the partnership, Ikenna Ikeme, director, Regulatory & Corporate Social Responsibility, Etisalat Nigeria, said the telecommunication company identifies a healthy populace as a precursor to achieving economic growth, hence the alignment of its business growth strategy with societal goals such as health.

“A nation can only be economically buoyant if it has a vibrant and strong work force, and a healthy population; hence our identification of health as one of our key platforms for Corporate Social Responsibility.

As we play our part in the creation of a healthier nation, we enjoin all stakeholders to embrace technology and innovation in the fight against malaria.” he said.

Also speaking at the event, Dr. (Mrs) Linda Ayade, wife of the Cross River State Governor and founder of the partner NGO, Mediatrix Development Foundation, expressed delight in the capacity of the partnership to help fill the existing gap in the fight against malaria by providing the much needed support to the State structures in the health sector.

“I believe this is the beginning of a rejuvenated fight to end malaria for good in Cross River State. We are delighted that our efforts to check the effects of malaria in communities is yielding results and has attracted Etisalat to partner with us to strengthen existing state structures in the health sector,” she said.

The Etisalat Fight Malaria Initiative would facilitate the setting up of 40 Malaria Clubs in primary, secondary and tertiary institutions across the state with a mandate to reach approximately 25,000 people in the rural and urban areas, create a Malaria Hub of 2,650 peer educators and 3,150 Malaria Champions within two years.