one of the most important diseases in world history is malaria. The weaker forms tend to result in chronic malaise/fatigue, but the severe form, falciparum malaria, can be fatal, especially to children and those without immunity.
When I was in Zimbabwe, two of our nuns (one European, one local) developed cerebral malaria:
The local tribe had no resistance since they traditionally lived in the highlands where it wasn't a problem; so when the Europeans displaced some of them to take over their land, they were resettled in a nice, fertile area as a replacement. What was not noticed was that this new area was at a lower altitude, so there were many deaths from malaria in those resettled.
We tested all those from outside our area for malaria, but didn't see many cases due to the altitude.
But when I worked in Liberia, we had many cases, and even though I was on chloroquin prophylaxis, I developed malaria which we treated with an antibiotic.
The problem is that the most virulent strain of malaria has developed resistance to many anti malarial medicines.
From the CDC:
Chloroquine-resistant P. falciparum first developed independently in three to four areas in Southeast Asia, Oceania, and South America in the late 1950s and early 1960s.
Since then, chloroquine resistance has spread to nearly all areas of the world where falciparum malaria is transmitted. P. falciparum has also developed resistance to nearly all of the other currently available antimalarial drugs, such as sulfadoxine/pyrimethamine, mefloquine, halofantrine, and quinine. Although resistance to these drugs tends to be much less widespread geographically, in some areas of the world, the impact of multi-drug resistant malaria can be extensive. Most recently, resistance to the artemisinin and non-artemisinin components of artemisinin-based combination therapy has emerged in parts of Southeast Asia, impacting the efficacy of this vital antimalarial class.
thanks to the greens, the use of DDT, which was cheap and non toxic to humans, was essentially banned and it took time to replace spraying with more toxic insecticides.
Thanks to the Gates foundation, the push to use mosquito nets and to drain standing water where the mosquitos breed, has helped.
But you need a multi factorial approach, so vaccines will also help: even if they aren't perfect, they will lower the death rate in infants and of course if the parasite can't live in most of the local humans, the spread will go down.
late last year there were reports of a malaria vaccine. the hope about this was that it would hit the falciparum form, that is most lethal and is more resistant to anti malarial medicines.
But now the BBC (and Lancet) reports initial studies suggest 70 to 80 percent protection.
A good discussion here: Start at 9 minutes if you are in a hurry.
No comments:
Post a Comment