UNICEF held a photography workshop with 20 students in South Africa’s poorest province.

Part II of II: UNICEF held a photography workshop for 16 young people in the West Bank of the Occupied Palestinian Territory.

Part I of II: UNICEF held a photography workshop for 16 young people in the West Bank of the Occupied Palestinian Territory.

Nineteen of Mongolia's 21 provinces continue to face emergency conditions caused by heavy snow and extreme cold.

Distributed Medical Image Analysis and Diagnosis through Crowd-Sourced Games: A Malaria Case Study.

PLoS One. 2012;7(5):e37245

Authors: Mavandadi S, Dimitrov S, Feng S, Yu F, Sikora U, Yaglidere O, Padmanabhan S, Nielsen K, Ozcan A

Abstract
In this work we investigate whether the innate visual recognition and learning capabilities of untrained humans can be used in conducting reliable microscopic analysis of biomedical samples toward diagnosis. For this purpose, we designed entertaining digital games that are interfaced with artificial learning and processing back-ends to demonstrate that in the case of binary medical diagnostics decisions (e.g., infected vs. uninfected), with the use of crowd-sourced games it is possible to approach the accuracy of medical experts in making such diagnoses. Specifically, using non-expert gamers we report diagnosis of malaria infected red blood cells with an accuracy that is within 1.25% of the diagnostics decisions made by a trained medical professional.

PMID: 22606353 [PubMed - as supplied by publisher]

Infectious diseases. Can new chemistry make a malaria drug plentiful and cheap?

Science. 2012 May 18;336(6083):798-9

Authors: Kupferschmidt K

PMID: 22605729 [PubMed - in process]

Preventing Malaria.

JAMA. 2011 Jun 15;305(23):2402

Authors: Friedrich MJ

PMID: 22603105 [PubMed - as supplied by publisher]

Integrated rapid-diagnostic-test reader platform on a cellphone.

Lab Chip. 2012 May 17;

Authors: Mudanyali O, Dimitrov S, Sikora U, Padmanabhan S, Navruz I, Ozcan A

Abstract
We demonstrate a cellphone-based rapid-diagnostic-test (RDT) reader platform that can work with various lateral flow immuno-chromatographic assays and similar tests to sense the presence of a target analyte in a sample. This compact and cost-effective digital RDT reader, weighing only ∼65 g, mechanically attaches to the existing camera unit of a cellphone, where various types of RDTs can be inserted to be imaged in reflection or transmission modes under light-emitting diode (LED)-based illumination. Captured raw images of these tests are then digitally processed (within less than 0.2 s per image) through a smart application running on the cellphone for validation of the RDT, as well as for automated reading of its diagnostic result. The same smart application then transmits the resulting data, together with the RDT images and other related information (e.g., demographic data), to a central server, which presents the diagnostic results on a world map through geo-tagging. This dynamic spatio-temporal map of various RDT results can then be viewed and shared using internet browsers or through the same cellphone application. We tested this platform using malaria, tuberculosis (TB) and HIV RDTs by installing it on both Android-based smartphones and an iPhone. Providing real-time spatio-temporal statistics for the prevalence of various infectious diseases, this smart RDT reader platform running on cellphones might assist healthcare professionals and policymakers to track emerging epidemics worldwide and help epidemic preparedness.

PMID: 22596243 [PubMed - as supplied by publisher]

Malaria surge feared.

Nature. 2012;485(7398):293

Authors: Maxmen A

PMID: 22596131 [PubMed - in process]

Iron status, malaria parasite loads and food policies: Evidence from sub-Saharan Africa.

Econ Hum Biol. 2012 Apr 30;

Authors: Bhargava A

Abstract
This brief article investigates the consequences of improving children's iron status for malaria parasite loads by analyzing data from Cote d'Ivoire, Zambia, and Tanzania; the treatment of iron deficiencies has been argued to flare up malaria in under-nourished populations. The data from a randomized controlled trial in Cote d'Ivoire showed statistically insignificant effects of the consumption of iron-fortified biscuits on children's malaria parasite loads. Second, nutrient intakes data from Zambia showed insignificant correlations and associations between children's iron and folate intakes and malaria parasite loads. Third, malaria parasite loads did not change significantly for Tanzanian children receiving anthelmintic treatment; malaria loads were lower for older children and for those using bed nets. Overall, the evidence from sub-Saharan African countries suggests that small improvements in iron status achieved via suitable food policies are unlikely to have detrimental effects for children's malaria parasite loads.

PMID: 22595491 [PubMed - as supplied by publisher]

Identifying an essential interaction between malaria parasites and erythrocytes unlocks the door to promising vaccine targets.

Pathog Glob Health. 2012 Mar;106(1):64

Authors: Nolan T

PMID: 22595278 [PubMed - in process]

Quality and safety of integrated community case management of malaria using rapid diagnostic tests and pneumonia by community health workers.

Pathog Glob Health. 2012 Mar;106(1):32-9

Authors: Hamer DH, Brooks ET, Semrau K, Pilingana P, Macleod WB, Siazeele K, Sabin LL, Thea DM, Yeboah-Antwi K

Abstract
OBJECTIVES: To assess the quality and safety of having community health workers (CHWs) in rural Zambia use rapid diagnostic tests (RDTs) and provide integrated management of malaria and pneumonia.
DESIGN/METHODS: In the context of a cluster-randomized controlled trial of two models for community-based management of malaria and/or non-severe pneumonia in children under 5 years old, CHWs in the intervention arm were trained to use RDTs, follow a simple algorithm for classification and treat malaria with artemether-lumefantrine (AL) and pneumonia with amoxicillin. CHW records were reviewed to assess the ability of the CHWs to appropriately classify and treat malaria and pneumonia, and account for supplies. Patients were also followed up to assess treatment safety.
RESULTS: During the 12-month study, the CHWs evaluated 1017 children with fever and/or fast/difficult breathing and performed 975 RDTs. Malaria and/or pneumonia were appropriately classified 94-100% of the time. Treatment based on disease classification was correct in 94-100% of episodes. Supply management was excellent with over 98% of RDTs, amoxicillin, and AL properly accounted for. The use of RDTs, amoxicillin, and AL was associated with few minor adverse events. Most febrile children (90%) with negative RDT results recovered after being treated with an antipyretic alone.
CONCLUSIONS: Volunteer CHWs in rural Zambia are capable of providing integrated management of malaria and pneumonia to children safely and at high quality.

PMID: 22595272 [PubMed - in process]

Infertility resulting from transgenic I-PpoI male Anopheles gambiae in large cage trials.

Pathog Glob Health. 2012 Mar;106(1):20-31

Authors: Klein TA, Windbichler N, Deredec A, Burt A, Benedict MQ

Abstract
OBJECTIVES: Anopheles gambiae is the primary vector of malaria in sub-Saharan Africa and is a potential target of genetic control programs. We determined the capacity of male A. gambiae created by germline transformation to introduce infertility into stable age-distribution populations. We also determined effects of the transgenes on life history.
METHODS: Stable age-distribution populations of A. gambiae mosquitoes were established in large indoor cages. Male mosquitoes carrying an I-PpoI homing endonuclease gene were introduced at ×5 and ×10 release rates where they competed with target male mosquitoes for matings. Similar trials were conducted in small cages with an additional ×1 release level.
RESULTS: Infertility was successfully introduced into all target populations. In supporting experiments, complete female infertility was observed in all strains and species of the A. gambiae complex to which transgenic males were mated. Life history experiments demonstrated that reductions in I-PpoI male vigor exist in the form of reduced adult male emergence, longevity and competitiveness.
DISCUSSION: A. gambiae I-PpoI males are capable of introducing high levels of infertility in target populations in indoor cage trials. This was accomplished despite losses of vigor resulting from the HEG transgene. These results motivate further trials of sexually I-PpoI A. gambiae in outdoor cage and field trials.

PMID: 22595271 [PubMed - in process]

Epidemiology of Burkitt's lymphoma in Northwest Province, Cameroon, 2003-2010.

Paediatr Int Child Health. 2012;32(2):82-5

Authors: Lewis N, Young J, Hesseling PB, McCormick P, Wright N

Abstract
BACKGROUND: Burkitt's lymphoma (BL) is an aggressive non-Hodgkin's lymphoma endemic to regions of Africa. Cases are thought to be typically found in low-lying, humid regions where malaria is rife.
AIMS AND OBJECTIVES: To investigate the clinical characteristics of BL, its incidence and relationship with malarial incidence in Northwest (NW) Province, Cameroon.
METHODS: Data on BL were collected from the three tertiary referral centres for BL treatment in NW Province, Cameroon. Data on malaria were collected from the Delegation of Public Health in Bamenda, NW Province. Data were collected between March and May 2010.
RESULTS: 471 cases of BL were identified. The St Jude's stage of patients at presentation was as follows: stage I, 14·4% (43/299); stage II, 8·4% (25/299); stage III, 69·9% (209/299); stage IV, 7·4% (22/299). The incidences of BL per 100,000 children <15 years of age from 2005 to 2009 were as follows: 2005, 3·01 (29); 2006, 2·02 (20); 2007, 2·45 (25); 2008, 2·38 (25); 2009, 3·06 (33). The average incidence in NW Province was 2·58. In the Ndop plain, Ngo-Ketunjia, the incidences of BL were as follows: 2005, 10·3 (10); 2006, 3·00 (3); 2007, 1·95 (2); 2008, 2·84 (3); 2009, 4·60 (5). The average incidence was 4·54/100,000 children <15 years of age. Statistical analysis demonstrated a sinusoidal distribution of malaria cases throughout the year (P<0·00), with a peak incidence on 10 April. Conversely, no sinusoidal distribution of BL cases was demonstrated throughout the year (P = 0·09).
CONCLUSION: No relationship was demonstrated between an acute malarial infection and BL. Significant clustering was found, with the low-lying Ndop plain of Ngo-Ketunjia having an incidence of BL nearly twice that elsewhere in the region. The study demonstrates that the incidence of BL in NW Province, Cameroon remains one of the highest documented in the world.

PMID: 22595214 [PubMed - in process]

Cytochrome 1A1 and 1B1 gene diversity in the Zanzibar islands.

Trop Med Int Health. 2012 May 18;

Authors: Cavaco I, Piedade R, Msellem MI, Bjorkman A, Gil JP

Abstract
Amodiaquine (AQ) is a 4-aminoquinoline widely used in the treatment of malaria as part of the artemisinin combination therapy (ACT). AQ is metabolized towards its main metabolite desethylamodiaquine mainly by cytochrome P450 2C8 (CYP2C8). CYP1A1 and CYP1B1 play a minor role in the metabolism but they seem to be significantly involved in the formation of the short-lived quinine-imine. To complete the genetic variation picture of the main genes involved in AQ metabolism in the Zanzibar population, previously characterized for CYP2C8, we analysed in this study CYP1A1 and CYP1B1 main genetic polymorphisms. The results obtained show a low frequency of the CYP1A1*2B/C allele (2.4%) and a high frequency of CYP1B1*6 (approximately 42%) followed by CYP1B1*2 (approximately 27%) in Zanzibar islands. Genotype data for CYP1A1 and CYP1B1 show a low incidence of fast metabolizers, revealing a relatively safe genetic background in Zanzibar's population regarding the appearance of adverse effects.

PMID: 22594779 [PubMed - as supplied by publisher]

The effect of health education intervention on the home management of malaria among the caregivers of children aged under 5 years in Ogun State, Nigeria.

Eur J Med Res. 2012 May 17;17(1):11

Authors: Fatungase KO, Amoran OE, Alausa KO

Abstract
ABSTRACT: BACKGROUND: Malaria is currently the most important cause of death and disability in children aged under 5 years in Africa. A health education interventional study of this nature is essential in primary control of an endemic communicable disease such as malaria. This study was therefore designed to determine the effect of health education on the home management of Malaria among the caregivers of children under 5 years old in Ogun State, Nigeria. METHODS: The study design was a quasi-experimental study carried out in Ijebu North Local Government Area of Ogun State. A multistage random sampling technique was used in choosing the required samples for this study and a semi-structured questionnaire was used to collect relevant information. The intervention consisted of a structured educational program based on a course content adapted from the national malaria control program. A total of 400 respondents were recruited into the study, with 200 each in both the experimental and control groups, and were followed up for a period of 3 months when the knowledge and uptake of insecticide treated net was reassessed. RESULTS: There was no statistically significant differences observed between the experimental and control groups in terms of sociodemographic characteristics such as age (P = 0.99), marital status (P = 0.48), religion (P = 0.1), and income (P = 0.51). The majority in both the experimental (75.0 %) and control (71.5 %) groups use arthemisinin-based combination therapy as first line home treatment drugs pre intervention. Post health education intervention, the degree of change in the knowledge of referral signs and symptoms in the experimental group was 52.8 % (P < 0.0001) while it was 0.2 % in the control group (P = 0.93). Tepid sponging improved by 45.0 %, paracetamol use by 55.3 %, and the use of herbs and other drugs were not significantly influenced in the experimental (P = 0.65 and 0.99) and control group (P = 0.89 and 0.88), respectively. Furthermore, there was a 55.7 % (P = 0.001) increase in the proportion of respondents using the correct dose of arthemisinin-based combination therapy in the home management of malaria and 23.9 % (P < 0.001) in the proportion using it for the required time. CONCLUSIONS: The study concludes that there is a shift in the home management of malaria with the use of current and effective antimalarial drugs. It also demonstrated the effect of health education on the promptness of appropriate actions taken among the respondents for early diagnosis and treatment. Early diagnosis and appropriate treatment can be guaranteed if caregivers are knowledgeable on prompt actions to be taken in the home management of malaria.

PMID: 22594678 [PubMed - as supplied by publisher]

Post-treatment haemolysis in severe imported malaria after intravenous artesunate: case report of three patients with hyperparasitaemia.

Malar J. 2012 May 17;11(1):169

Authors: Rolling T, Schmiedel S, Wichmann D, Wittkopf D, Burchard GD, Cramer JP

Abstract
ABSTRACT: Parenteral artesunate has been shown to be a superior treatment option compared to parenteral quinine in adults and children with severe malaria. Little evidence, however, is available on long-term safety. Recently, cases of late-onset haemolysis after parenteral treatment with artesunate have been reported in European travellers with imported Plasmodium falciparum malaria. Therefore, an extended follow-up of adult patients treated for severe imported malaria was started in August 2011 at the University Medical Center Hamburg-Eppendorf. Until January 2012, three patients with hyperparasitaemia (range: 14-21%) were included for analysis. In all three patients, delayed haemolysis was detected in the second week after the first dose of intravenous artesunate. Reticulocyte production index remained inadequately low in the 7 - 14 days following the first dose of artesunate despite rapid parasite clearance. Post-treatment haemolysis after parenteral artesunate may be of clinical relevance in particular in imported severe malaria characterized by high parasite levels. Extended followup of at least 30 days including controls of haematological parameters after artesunate treatment seems to be indicated. Further investigations are needed to assess frequency and pathophysiological background of this complication.

PMID: 22594446 [PubMed - as supplied by publisher]

Toll-like receptor 9 (TLR9) polymorphism associated with symptomatic malaria: a cohort study.

Malar J. 2012 May 17;11(1):168

Authors: Omar AH, Yasunami M, Yamazaki A, Shibata H, Ofori MF, Akanmori BD, Shuaibu MN, Kikuchi M, Hirayama K

Abstract
ABSTRACT: BACKGROUND: In areas mesoendemic for malaria transmission, symptomatic individuals play a significant role as reservoirs for malaria infection. Understanding the pathogenesis of symptomatic malaria is important in devising tools for augmenting malaria control. In this study, the effect of TLR9 polymorphisms on susceptibility to symptomatic malaria was investigated among Ghanaian children. METHODS: Four hundred and twenty nine (429) healthy Ghanaian children, aged three to eleven years (3-11 years), were enrolled into a cohort study and actively followed up for symptomatic malaria for one year. Four TLR9 single nucleotide polymorphisms (SNPs) namely: rs187084 (C-1486 T), rs5743836(C-1237 T), rs352139 (G + 1174A) and rs352140 (G + 2848A) were genotyped by direct sequencing, and their attributable and relative risks for symptomatic malaria determined. TLR9 haplotypes were inferred using the PHASE software and analysed for the risk of symptomatic malaria. A luciferase assay was performed to investigate whether the TLR9 haplotypes influence TLR9 promoter activity. RESULTS: The rs352139 GG genotype showed a significantly increased relative risk of 4.8 for symptomatic malaria (P = 0.0024) and a higher mean parasitaemia (P = 0.04). Conversely, the rs352140 GG genotype showed a significantly reduced relative risk of 0.34 (P = 0.048). TLR9 haplotypes analyses showed that TTAG haplotype was significantly associated with reduced relative risk of 0.2 for symptomatic malaria (P = 4x10-6) and a lower mean parasitaemia (0.007), while CTGA haplotype had an increased relative risk of 3.3 (P = 0.005). Functional luciferase reporter gene expression assay revealed that the TTA haplotype had a significantly higher promoter activity than the CCG, CTG and TCG haplotypes. CONCLUSIONS: Taken together, these findings indicate a significant association of TLR9 gene polymorphisms with symptomatic malaria among Ghanaian children in Dangme-West district.

PMID: 22594374 [PubMed - as supplied by publisher]

Chiefs Urged To Protect Rights Of Women With HIV
Ghana
International Federation of Women Lawyers (FIDA), Ghana, has appealed to chiefs and queens in the Volta Region to use their authority and influence to protect the rights of HIV positive women in their communities. FIDA-Ghana made the call at an ...

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Iron Status Predicts Treatment Failure and Mortality in Tuberculosis Patients: A Prospective Cohort Study from Dar es Salaam, Tanzania.

PLoS One. 2012;7(5):e37350

Authors: Isanaka S, Aboud S, Mugusi F, Bosch RJ, Willett WC, Spiegelman D, Duggan C, Fawzi WW

Abstract
BACKGROUND: Experimental data suggest a role for iron in the course of tuberculosis (TB) infection, but there is limited evidence on the potential effects of iron deficiency or iron overload on the progression of TB disease in humans. The aim of the present analysis was to examine the association of iron status with the risk of TB progression and death. METHODOLOGY/PRINCIPAL FINDINGS: We analyzed plasma samples and data collected as part a randomized micronutrient supplementation trial (not including iron) among HIV-infected and HIV-uninfected TB patients in Dar es Salaam, Tanzania. We prospectively related baseline plasma ferritin concentrations from 705 subjects (362 HIV-infected and 343 HIV-uninfected) to the risk of treatment failure at one month after initiation, TB recurrence and death using binomial and Cox regression analyses. Overall, low (plasma ferritin<30 µg/L) and high (plasma ferritin>150 µg/L for women and>200 µg/L for men) iron status were seen in 9% and 48% of patients, respectively. Compared with normal levels, low plasma ferritin predicted an independent increased risk of treatment failure overall (adjusted RR = 1.95, 95% CI: 1.07 to 3.52) and of TB recurrence among HIV-infected patients (adjusted RR = 4.21, 95% CI: 1.22 to 14.55). High plasma ferritin, independent of C-reactive protein concentrations, was associated with an increased risk of overall mortality (adjusted RR = 3.02, 95% CI: 1.95 to 4.67). CONCLUSIONS/SIGNIFICANCE: Both iron deficiency and overload exist in TB patients and may contribute to disease progression and poor clinical outcomes. Strategies to maintain normal iron status in TB patients could be helpful to reduce TB morbidity and mortality.

PMID: 22606361 [PubMed - as supplied by publisher]