Getting to zero
Malaria Zero was recently launched as a
collective effort to eliminate malaria on the island of Hispaniola (which
includes Haiti and the Dominican Republic) by 2020. CDC (represented by
DPDM) is leading the consortium of partners, working in collaboration with the
Haiti National Malaria Control Program and supported by funding from the Bill
and Melinda Gates Foundation to the CDC Foundation. Malaria Zero will implement
an evidence-based plan for elimination in the region that will also generate
knowledge to support global malaria eradication.
In support of Haiti’s new National Strategic Plan, Malaria
Zero efforts will focus on research to establish the evidence base for
effective approaches and strengthening surveillance and laboratory capacity.
In September, partners will launch a household survey and operational
research to identify initial geographic areas with high malaria transmission
for the first phase of delivering focal mass drug administration.
Stomping out malaria
DPDM staff provided remote training on basic entomology to
Peace Corps Volunteers in Senegal, as part of Peace Corps’ Stomp Out Malaria
Programs, continuing the strong existing interagency collaborations around
malaria. The Stomp Out Malaria program mobilizes more than 3,000 Peace Corps
Volunteers across Africa to teach families about the importance of sleeping
under insecticide-treated bed nets, educate expectant mothers about
preventative treatments for healthy birth, and reinforce other malaria prevention
Combining efforts in
DPDM staff working on malaria and lymphatic filariasis (LF) elimination activities in
Haiti are working together on assessment activities using a multiplex bead assay (MBA). The MBA provides a robust approach to the
simultaneous analysis of antibody responses to multiple antigens. In the public
health context, this assay platform has the potential to generate an
epidemiologic snapshot of community exposures to various infections of interest.
Approximately 16,000 filter paper bloodspots were collected as part of LF
transmission assessment surveys in 2015 and are being analyzed for responses to
LF, malaria, trachoma and yaws. Results from the MBA will provide critical
information to guide the malaria and LF programs in Haiti.
capacity in Ethiopia
The President’s Malaria Initiative (PMI) Ethiopia team
participated in the 7th Ethiopian Malaria Research Network’s Symposium in
Jimma, Ethiopia, together with other PMI partners and malaria researchers from the
major Ethiopian universities to discuss emerging malaria issues. The team also partnered with the CDC Ethiopia
Field Epidemiology Training Program (EFETP) and the Ministry of Health’s EFETP
on a malaria and mentorship training program. The training was conducted in
Bishoftu, Ethiopia in March with 130 participants including EFETP residents,
EFETP academic advisors, selected malaria focal EFETP residents, and WHO field
staff. The training will help strengthen Ethiopia’s capacity to address malaria and other
public health threats.
Two birds with one stone?
DPDM staff collaborated with the World Health Organization (WHO) to draft guidance for integrated monitoring and evaluation for LF and onchocerciasis, and identify key research gaps that need to be addressed in order to fully integrate the activities for the two diseases. Research gaps include the serologic threshold for transmission of onchocerciasis, whether LF-onchocerciasis evaluation should be a community-based survey or a school-based one, and what age group of children should be used for assessments for both diseases.
Contributing to a stronger global health workforce
DPDM, as part of a WHO Working Group on Capacity Strengthening (WGCS) of the Strategic Technical Advisory Group for Neglected Tropical Diseases, reviewed capacity-strengthening activities in each WHO geographic region. The WGCS was established in 2012 to: i) identify existing capacity-strengthening efforts for Neglected Tropical Disease (NTD) programs; ii) recognize gaps in capacity-strengthening efforts; iii) advise, standardize, and support the implementation of training curricula; and iv) harmonize efforts to increase contributions to fill identifiable gaps and needs. Initial efforts have focused on the development of region-specific training materials. Strategic approaches to disseminate materials and to integrate NTD capacity-strengthening activities more fully into national health plans are still needed.
A triple threat
Recent studies in Papua New Guinea and Ivory Coast have shown that the combined administration of albendazole, diethylcarbamazine (DEC), and ivermectin for the treatment of LF was safe and more effective than the standard combination of DEC and albendazole or DEC and ivermectin to rapidly eliminate early stage parasites from a person’s blood for up to two years following treatment. This new regimen could have a transformative impact on the global program to eliminate LF by reducing the number of rounds of mass drug administration (MDA) required to reach elimination targets. Further studies, called cohort event monitoring, are needed to establish the safety of this new regimen. The objective of these studies is to evaluate serious adverse events in 10,000 people exposed to the new regimen. DPDM is providing technical assistance to the Ministry of Public Health and Population (MSPP) in Haiti to implement this study in the commune of Quartier Morin in the Northern Region of Haiti.
It really does work!
DPDM staff presented results of the five-year Schistosomiasis Consortium for Operational Research and Evaluation (SCORE) study to Kenyan public health officials. The study demonstrated that school-based MDA has an impact similar to community-wide MDA on schistosomiasis rates and intensity, including evidence that both MDA approaches are effective in reducing transmission. However, MDA had less impact in some geographically related villages using either strategy. Additional studies are being designed to clarify why this is true.
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It’s that time of
As temperatures rise, so do U.S. cases of cyclosporiasis, an intestinal illness caused
by a microscopic parasite, and babesiosis, a parasitic infection spread by ticks. Individuals spending
time outside in the New England states or the upper Midwest may be at increased
risk this time of year. In recent years, the number of states reporting cases of babesiosis has
increased, and more states and individuals are taking proactive steps to prevent this
are currently helping investigate a case of babesiosis in a Northeastern state,
acquired by an individual who is transfusion-dependent. The patient lived in an
urban area and did not report taking part in outdoor activities or having known
tick exposures. In March the patient was hospitalized after a two-week history of
fever. DPDM confirmed the infection with
Babesia parasites. The blood collection agency is following up with
donors who provided blood for the patient’s transfusions in January and February. DPDM will test these
donors to help identify the source of the infection.
The warmer weather also coincides with summer vacations and
travel, including travel to areas with risk of acquiring malaria. DPDM continues to provide information to advise U.S. travelers about malaria. We encourage individuals
to take steps to help themselves and their families stay safe and healthy:
Visit your doctor 4-6 weeks before traveling.
If prescribed, take your antimalarial drugs as
directed. Encourage your family, friends, and colleagues to do the same.
(A recently published feature underscores the importance of
complying with medical instructions for taking antimalarial drugs as
directed before traveling abroad.)
- Prevent mosquito bites, especially at
- If you get sick during or after your
travel, it could be malaria: see a doctor immediately.
Experiences of a Community-Based Lymphedema Management Program
for Lymphatic Filariasis in Odisha State, India: An Analysis of Focus Group
Discussions with Patients, Families, Community Members and Program Volunteers.
million people are infected with the NTD known as LF, 17 million of whom have lymphedema (swelling of limbs). This
study documented significant social, physical and economic difficulties experienced
by individuals with lymphedema and their families, including marriage-related
issues, social stigma, and lost workdays.
Advanced Molecular Detection of Malarone Resistance
The rapid emergence of drug resistant malaria parasites
during the course of an infection remains a major challenge for providing
accurate treatment guidelines. This is particularly important in cases where malaria
treatment fails. Authors show the utility of using next generation sequencing techniques
for the early detection of a previously reported atovaquone proguanil (Malarone)
drug resistance associated mutation.
Detection of Onchocerca
volvulus in skin snips by microscopy and real-time polymerase chain
reaction: implications for monitoring and evaluation activities.
river blindness, is an NTD caused by the parasitic worm Onchocerca
volvulus. Second only to trachoma as an infectious cause of blindness
worldwide, onchocerciasis has been targeted for elimination in several African
countries by 2025. Effective diagnostic tools is are neededfor monitoring the
progress and impact of elimination programs. Authors show that PCR with melt
curve analysis can improve the sensitivity of skin biopsies for diagnosing
onchocerciasis and is an improved confirmatory assay for monitoring programs
that have begun to move toward elimination.
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Monica Parise, MD
will serve as the Acting Director for the Division of Parasitic Diseases and
Malaria until a permanent director is named. She is currently DPDM’s Deputy
Director for Science and Program.
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