Institute of Global Health Innovation

By Dr Michael Templeton, Reader in Public Health Engineering, Department of Civil and Environmental Engineering, Imperial College London

Wednesday, May 25^th 2016 marks Africa Day, the 53^rd anniversary of the founding of the Organisation of African Unity, the forerunner of the African Union. There have been so many wonderful developments in Africa in the last 53 years, but sadly the quality of life of many of the poorest people in Africa continues to be limited by the burden of a group of debilitating diseases known collectively as neglected tropical diseases (NTDs), which have afflicted millions of Africans since ancient times. Therefore, it is hugely exciting that in 2012 The World Health Assembly put forward an important resolution to not only control but completely eliminate one such NTD, schistosomiasis.

It has been estimated that 200 million people in developing countries, most of whom live in Africa, are infected with the parasite causing schistosomiasis, which manifests itself in a range of symptoms, including enlargement of the liver and spleen, anaemia, increased risk of bladder cancer, exacerbation of the transmission of HIV and its progression to AIDS, and in extreme cases seizures. The parasite lives within infected people, with aquatic snails acting as intermediate hosts and releasing cercariae (the larval form of the parasite) into water bodies, which then penetrate the skin of other people who come in contact with the contaminated water. Preventing people from coming into contact with contaminated water and preventing urine and faeces from passing into water bodies should stop this cycle, however most endemic countries lack adequate water and sanitation provision. Achieving the WHA’s ambitious elimination goal will therefore require a coordinated, multi-disciplinary strategy, involving mass preventive chemotherapy with the drug praziquantel but also improving access to water, sanitation and hygiene (WASH).   (more…)

Read Towards Eliminating Schistosomiasis in Africa – A Multi-Disciplinary Effort in full

By Professor Kathryn Maitland, Professor of Tropical Paediatric Infectious Diseases and Director of IGHI’s new Centre for African Research and Engagement (ICCARE).

Across large parts of sub-Saharan Africa the major rains have got underway; which typically means that in a few weeks, hospitals will witness a seasonal upsurge of admissions into the children’s wards. Most of these will be children suffering a new bout of malaria, with around ten percent of these malaria admissions having life-threatening complications such a coma (cerebral malaria), severe anaemia (requiring urgent life-saving transfusion) and rapid breathing (to try to compensate for the build up of acids in their bodies). Outcome remains poor. Despite implementation of the new fast-acting effective antimalarial drugs, in-patient mortality remains unacceptably high (~10%).

In many parts of the world, including several sub-Saharan African (sSA) countries, the scale-up of control efforts has led to substantial reductions in the burden of malaria since 2000.  The World Health Organization estimated that severe malaria killed up to 500,000 African children in 2013. Whilst the last decade has witnessed a transformation in the epidemiological landscape of malaria, with many areas reporting substantially less malaria. However, this has not occurred equally within or across countries in Africa. In parts of the continent, where the pattern of transmission has not changed appreciably, malaria continues to contribute most to the global disease burden (e.g. Nigeria, DRC, Uganda, Mozambique). Early optimism that the most promising malaria vaccine candidate developed to date (RTS,S) would reduce the burden of severe and fatal malaria has proved premature with the recent publication of long term follow up data reporting a waning vaccine efficacy after 20 months. There seems little prospect for further reducing the substantial mortality burden from severe malaria within the foreseeable future hospitalized with malaria serves as a “barometer” of how well local, national and regional malaria control is performing.   (more…)

Read World Malaria Day 2016: Africa, children and malaria in full

By Alison Reynolds and Dr Thomas Churcher from Imperial’s Malaria Modelling Research Group

World Mosquito Day (20th August) commemorates the discovery that mosquitoes transmit the parasite that causes malaria, made in 1897 by British doctor Ronald Ross.

A hundred and eighteen years later this transmission still continues, to some extent unabated. There have been huge successes in malaria control, most notably in recent years, though a child still dies every minute[1] from a disease which continues to ravage large swathes of Africa and Asia. Importantly these deaths are completely avoidable, as we have effective tools to treat malaria and stop people dying.

This is clearly illustrated by the wonderful work of French scientist Jean-Francois Trape, of Institut de Recherche pour le Developpement, Senegal. He, along with his team, has lived and worked in the community of Dielmo, Senegal for the last twenty years providing diagnosis and treatment for malaria whilst conducting research. Malaria was a huge killer in this village but since they arrived only three people have died of the disease and these deaths can be ascribed to older drugs not being as effective as those we have today.

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Read World Mosquito Day 2015: The burden of Malaria today in full