Progress in Southeast Asia is threatened by the emergence of drug resistant parasites and hampered by systemic challenges. This commentary proposes seven concrete actions to address these issues and accelerate malaria elimination in the region.
Improved pharmacovigilance to monitor and promote the safety of the WHO recommendation is needed. The successful application of the Primaquine Roll Out Monitoring Pharmacovigilance Tool (PROMPT) demonstrates its potential as an important tool to rapidly generate locally acquired safety data and support pharmacovigilance in resource-limited settings.
Author: Brown J, Darteh S, Gosling R, Hwang J, Kunene S, Malambe C, Maphalala G, Mkhonta N, Mwandemele A, Ntshanlintshali N, Pace C, Pan S, Poirot E, Soble A, Stergachis A, Vilakati S, Vittinghoff E
Publication date: July 2016
Source: Malaria Journal
Single low doses of primaquine, when added to artemisinin-based combination therapy, might prevent transmission of Plasmodium falciparum malaria to mosquitoes. A single dose of 0·25 mg/kg primaquine, given alongside dihydroartemisinin–piperaquine, was safe and efficacious for the prevention of P falciparum malaria transmission in boys and men who are not deficient in G6PD
Author: Baber I, Bousema T, Brown JM, Chen I, Diawara H, Dicko A, Gosling R, Hwang J, Keita S, Koita F, Lanke K, Mahamar A, McCulloch C, Niemi M, Nosten F, Pett H, Poirot E, Sanogo K, Soumare HM, Traore SF
Publication date: June 2016
Source: The Lancet Infectious Diseases
This article outlines some of the barriers to single low-dose (SLD) primaquine use to stop P. falciparum transmission. In-country key informants revealed that the WHO weight-based recommendation to use SLD primaquine is challenging to implement in actual field settings, due in part to safety concerns involving G6PD deficiency and drug-drug interactions, among other factors.
Despite some substantial knowledge gaps, MDA has been used successfully to control and eliminate Plasmodium falciparum and P. vivax malaria in the past, and should be considered as part of a comprehensive malaria elimination strategy in aspecific settings.
Seasonal increases in malaria continue in hotspots in Zanzibar. Mass screening and treatment (MSAT) may help reduce the reservoir of infection; however, it is unclear whether rapid diagnostic tests (RDT) detect a sufficient proportion of low-density infections to have impact on subsequent transmission. This study found that highly sensitive point-of-care diagnostic tools for detection of all human malaria species are needed to make MSAT an effective strategy in malaria pre-elimination settings.
Author: Abass AK, Al-Mafazy AW, Ali A, Bergström B, Björkman J, cook J, Garimo I, Gosling R, Mårtensson A, McElroy P, Molteni F, Msellem M, Ramsan M, Vonk M, Xu W
Publication date: November 2014
Source: Journal of Infectious Diseases
Foci of artemisinin drug resistance have been identified in the Greater Mekong subregion (GMS) of the Asia Pacific, threatening the major gains made in malaria control and potentially creating a parasite pool that is more difficult to treat and eliminate. … A sustainable solution is the rapid elimination of all Plasmodium falciparum parasites from the GMS.
A background paper by the UCSF Global Health Group’s Malaria initiative examining the major enabling factors and roadblocks in the management of malaria elimination activities. The paper discusses how to effectively manage the shift from malaria control to elimination at the national level, borrowing from management techniques used in the private sector.
Author: Case P, Chandramohan D, Gosling J, Gosling R, Gueye C, Koita K, Newby G, Tulloch J, UCSF Global Health Group Malaria Elimination Initiative, Wegbreit J
Publication date: January 2014
Source: UCSF Global Health Group Malaria Elimination Initiative
A report of a meeting held in London in March 2012, discussing the existing evidence on the ability of primaquine to block malaria transmission, defining the roadblocks to the use of primaquine in Africa and to developing a roadmap to enable its rapid, safe and effective deployment.
A report on the state of malaria in countries in Asia, the Pacific, Americas, Middle East, and Europe, highlighting the major burden that still exists in some countries, while others are on the brink of eliminating malaria.