Breakthroughs Blog: Malaria

In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week. A new study found a significant link between forest loss and the timing of Ebola outbreaks. Previous research had already established an association between deforestation patterns and outbreaks hotspots, but this study is the first to connect it to a timeline. Researchers tracked both deforestation events and nearby Ebola outbreaks and found a two-year gap between the event and the outbreak, suggesting there is a delayed, but causal link between deforestation and the emergence of the virus. This discovery may allow scientists to set up early warning systems and aid in the overall prediction of future outbreaks. New evidence has strengthened theories surrounding the role of antibody-dependent enhancement (ADE)—or an antibody-facilitated attack that makes infection more deadly—in severe dengue complications. This evidence suggests individuals infected on more than one occasion with different serotypes—or variants—of dengue may develop a life-threatening infection called dengue hemorrhagic fever/dengue shock syndrome (DHF/DSS), due to antibodies produced from the first infection binding with the virus during the second infection to allow it to more easily enter cells and reproduce. A study of more than 600 children found those with multiple dengue infections of different serotypes had a 7.64 times higher risk of developing DHF/DSS. This evidence sparked a debate about ADE, since genetics, T-cells, and innate immunity all play critical roles in disease complication. Scientists at Stanford University have created a crowd-sourced, cell-phone-based mosquito-monitoring platform to build a network of mosquito surveillance and a global map of mosquito distribution. The platform—Abuzz—will allow citizen scientists—or participants—to use their cell phones to record and submit the buzzing sound of a mosquito. The system then identifies the species using the particular sound of the buzz and plots on a map where and when the mosquito was sighted. The system is compatible with most cell phones—not just smartphones—which opens up the platform to many more people who may not have access to costly technology. If enough contributions are submitted from around the world, Abuzz could create a map of the locations of dangerous species, which the scientists hope could be used to improve mosquito control efforts.

In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week.  Researchers at MIT are working to create an all-inclusive vaccine for infants that can protect against diphtheria, whooping cough, polio, measles, meningitis A, B, and C, and more. The researchers have designed a promising micro-particle that could combine all of these vaccines into one single shot. The shot has not yet been tested on humans, though results were promising in a trial on mice. If this micro-particle proves effective and safe in human trials, this all-inclusive vaccine will be useful for infants in developing countries—as reducing the  number of vaccines necessary for infants in low-resource settings means fewer clinic visits. Mobile technology has the potential to help save the lives of newborns and their mothers in Tanzania. Researchers and phone developers are hoping to reduce rates of maternal mortality by launching a new service called “Text to Treatment” that uses toll-free texting to provide women with information that facilitates access to treatment centers. For instance, this service allows users to send money for travel to free clinics. Similarly, the “Mobilising Maternal Health” program also aims to provide better access to health care services by connecting women to transportation services, such as ambulance taxis and other travel to free clinics. Both of these programs have saved lives, with a 40 percent increase in female patients visiting treatment centers due to the “Text to Treatment” service and 30 percent reduction in maternal deaths due to the “Mobilising Maternal Health” program. These services have the potential to help bridge the rural-urban divide that impacts access to timely, high-quality health care for new mothers. Researchers at the University of Alberta, Canada have discovered the malaria parasite uses tagged carbohydrates to avoid detection and continue the spread of the disease in humans—especially in the liver. The researchers believe if treatments can be improved to account for the tagged carbohydrates, then these solutions may weaken the parasite to the point where it cannot survive within the host. They also believe these findings may help improve malaria vaccine design. Malaria remains one of the leading killers in the developing world, with about 650,000 annual deaths due to the disease.

In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week. The only existing tuberculosis (TB) vaccine—the bacille Calmette-Guerin (BCG) vaccine—has proven to be more effective than previously thought, delivering protection against the disease for around 20 years. The London School of Hygiene and Tropical Medicine led a study that found half of those individuals who were given the vaccine at ages 12 or 13 were protected against TB for at least 20 years. The vaccine was thought to deliver protection for only 10 to 15 years. These findings strenthen the case for administering BCG to children in low- and middle-income countries with high TB rates. The Tanzanian government has announced that in 2018 the country will begin using Zipline drones to deliver essential medical technologies to citizens in the capital city of Dodoma. The drone service can deliver everyday goods like food, but can also deliver live-saving medicines and vaccines, and contraceptives like condoms. Technology in low-resource and rural parts of the world has been used in the past to help diagnose and track diseases, but these technologies have proven challenging to deliver due to rugged terrain or geographic isolation. The Zipline drones are the first of their kind and can deliver products within a 50-mile radius. The Tanzanian Ministry of Health is working to add three more drone locations within the nation. The University of North Carolina Chapel Hill is studying the efficacy of a rapid diagnostic tool for malaria in very rural areas of Uganda. Researchers testing the low-cost tool in these areas and found that it could perform diagnoses with high specificity and sensitivity for both uncomplicated and severe malaria. This level of accuracy in diagnosis may allow health professionals to prioritize treatment for cases that may be more life threatening than others. Accurately diagnosing children who contract a severe form of malaria makes it possible to prioritize cases and potentially save lives.

In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week. Novartis has launched patient testing of a new anti-malaria compound with the hopes of staving off the development of further drug-resistance. The experimental compound—KAF156—will be tested in combination with another medicine in children and adults across nine countries in Africa and Asia over the next few months. In recent years, there have been increasing reports of malaria parasites that have become resistant to the standard treatment regimens against malaria, spurring the need for new treatment options from different classes of antimalarial compounds. Novartis expects to complete phase 2b studies of the compound by late 2019. It remains too early to tell whether the product will eventually reach market. A strain of gut bacteria taken from the diaper of a baby could hold promise in saving the lives of thousands of newborns in poor regions. Scientists conducting a large clinical trial in India found that babies who were fed a probiotic strain of Lactobacillus bacteria for a week were 40 percent less likely to develop a deadly infection called sepsis, which kills 600,000 newborns per year in India and other nearby nations. Babies who took the probiotic also had fewer cases of pneumonia, diarrhea, and ear infections. Researchers believe this probiotic—which costs only US$1—could be a “game changer” in advancing the health of infants in poor nations. Scientists at Harvard University are genetically engineering relatives of Mycobacterium tuberculosis (TB) in the hopes if speeding development and clinical trials to develop a better TB vaccine. The only currently available TB vaccine is partially effective in children and performs poorly in adults, so scientists are working to develop other vaccine candidates. However, performing clinical trials on vaccines is challenging because a typical clinical trial involves observing large numbers of people over long periods of time to monitor results in a small subset of people that naturally come into contact with the microbe. Alternatively, “challenge studies” infect people on purpose, so are faster and less expensive, but these studies are only possible if the disease can be detected and treated easily. TB can take time to detect and many months to treat, so is not appropriate for this type of study. The team at Harvard is working to genetically modify TB so it can be safely given to people as part of challenge trials, and thus help speed vaccine development.