• Malaria
  • Medical Aid Films and Econet are transforming malaria health education in Zimbabwe

    Roughly 50% of Zimbabwe’s population live in areas with a high risk of malaria transmission. In response to the need for improved awareness about the disease, Medical Aid Films have been working with Econet Wireless on an innovative project to reach health workers and communities with vital information on their mobile phones. With over 9 million subscribers, Econet Wireless is Zimbabwe's biggest mobile operator, reaching over 65% of the mobile market.

    “This is an extraordinary opportunity to share free, easy-to-access information through animated films, which people can watch on their phones and share again and again, to improve knowledge and save lives.” Mr Douglas Mboweni, CEO Econet Wireless Zimbabwe.

    Produced with Zimbabwe’s Ministry of Health and Child Care and a team of experts, the mobile-friendly animations focus on the prevention, diagnosis and treatment of malaria and are available in English, Shona and Ndebele.

    The animations are available to watch for free on the zero-rated Econet Health website, with the link disseminated via blast SMS to all subscribers. They will also be shared with communities across Zimbabwe, supporting training and awareness-raising work of Zimbabwe’s National Malaria Control Programme.

    “We are extremely proud to be working with Econet on this project – a fantastic example of the public and private sectors coming together to improve access to vital health information for people across Zimbabwe”. Chair of Medical Aid Films Board of Trustees, Richard Meredith 

    The films address Malaria Prevention, Diagnosis and Treatment.

  • India’s Kolkata sets up three vector disease control centres

    Two diseases transmitted by mosquitoes, malaria and dengue, are priorities for India’s Kolkata, capital of West Bengal. They’re challenges for Africa too.

    Seen as a precautionary measure to combat dengue and malaria, The Times of India has a report saying three eHealth centres opened in New Town in 2016. Run by the New Town Kolkata Development Authority (NKDA) these will be centres for controlling dengue, malaria and other vector-borne diseases. Each one has doctors in charge on a time share. There’s para-medicals in each centre too, trained in using the equipment donated by a private company under their corporate social responsibility.

    Jointly launched programmes are part of the service. They aim to create awareness of vector-borne diseases, conduct blood tests and take first level preventive care during monsoons when these diseases break out and spread.

    Is this initiative a proactive model for Africa’s health systems?  Using eHealth to extend and integrate the role of health centres in this way may be worthy of review.

  • EXASOL joins Zambia’s Visualize No Malaria campaign

    Africa continues to bear the brunt of the global burden of malaria. In 2015, an estimate from WHO says 88% of global cases and 90% of global deaths occurred on the continent.

    Malaria can have severe socio-economic impacts on populations. It’s a cause of household poverty as it results in absenteeism from daily activities of productive living and earning an income. It also prevents many children from attending school, diminishing their capacity to realise their full potential.

    Malaria is preventable and curable. Increased efforts are dramatically reducing the malaria burden in many countries.

    Zambia has undertaken an ambitious campaign to eliminate malaria by 2020. To support its efforts EXASOL, an in-memory analytic database developer, and PATH, an international nonprofit organisation and global leader in health and innovation, have announced a partnership to support the Zambian government’s campaign says, an article in IT News Africa.

    “Data analytics is often discussed as a way for business to derive value from the data they hold, whether that is to increase profitability or serve customers better,” said Aaron Auld, CEO, EXASOL. “But data can also unlock important information that can help organizations such as PATH improve the way they address Malaria. This ultimately shows the value of data in saving lives.” EXASOL joins Visualize No Malaria, a partnership between Zambia’s Ministry of Health, PATH, Tableau, and several technical partners including Alteryx, Mapbox, DataBlick, Twilio, DigitalGlobe, and Slalom.

    EXASOL‘s contribution includes providing access to its database in the cloud on Amazon Web Services. It’ll enable the Visualize No Malaria team to perform complex, real-time analysis and queries of Big Data.

    Allan Walker, a volunteer with expertise in data analytics and visualisation, is helping PATH’s Visualize No Malaria team to create analyses that estimate where malaria cases are more likely to occur and find relationships between mosquito vectors and human carriers of the disease.

    The team’s project involves loading complex geospatial data into EXASOL’s database to model geological features in Zambia’s Southern Province, such as elevation, slope and hydrological features such as topographic wetness and stream power. It shows if land is dry or wet, and if water is still or moving.

    The team also uses time-series regression models of population density and mobility, and meteorological models of precipitation and temperature to establish relationships with epidemiological data. The analyses can then be used by Zambian decision-makers to focus on probable malaria outbreak areas then respond quickly to new cases. This data can be life-saving for many communities. Other African countries battling  malaria can benefit too.

  • South Africa’s mHealth to help prevent malaria

    Malaria continues to be a global public health problem. Statistics from the Centre for Disease Control and Prevention (CDC) show that 3.2 billion people living in 106 countries and territories are at risk of malaria transmission. In 2015, approximately 214 million clinical episodes and 438, 000 malaria deaths were recorded according to the World Malaria Report 2015.

    The World Bank has estimated that in Africa, half the population may be at risk, with 47% exposed to medium and high risk. To address the challenge, a report from the University of Pretoria says researchers at the Institute for Sustainable Malaria Control (UP ISMC) use satellite data to predict malaria outbreaks and mHealth to control and monitor the disease. The predicting techniques include Geographical Information Systems (GIS) and satellite imaging to detect environmental factors associated with emerging malaria risks. The team uses the data to improve the accuracy and reliability of predicted malaria outbreaks. The forecasts can look ahead by as much as three to six months. Predications have proven accurate, and shown to be 90% effective.

    In 2015, UP ISMC in collaboration with French National Centre for Space Studies, the South African National Space Agency, South African Weather Service and other stakeholders initiated the Remote Sensing for Malaria Control in Africa Programme. It uses satellites to collect data on variables that associated with malaria, and carried out in the northern part of the Vhembe district, Limpopo province, across the border in Matabeleland South province and in Zimbabwe. It’s being extended to Maputo, Mozambique, particularly in Namaacha near the Swaziland, Mozambique and South African borders. This means that malaria outbreaks can be detected and early-warning systems triggered to aid in the fight against malaria.

    An article in eHealthNews says UP ISMC uses mSpray and Malaria Buddy apps. Malaria Buddy, avails data on malaria risk, prevention and symptoms for travellers in areas where malaria’s endemic.  mSpray focuses on malaria control data management for annual indoor residual spraying programmes, a chosen method for malaria control in locations at risk. Previously, during malaria seasons, spray workers would go into homes and spray walls manually. However, there was no clear database recording on the substances used and no centralised digital database to access to establish if spraying was effective and safe. The new malaria programme hopes to address many of these shortfalls.

  • mHealth help diagnose malaria

    Malaria’s Africa’s fourth biggest killer. It takes between 25% to 40% of outpatient visits, and 20% to 50% of hospital admissions, depending on the African country. Making diagnosis easier and quicker’s a step forward in combating the disease and easing healthcare demand. A report in Disrupt Africa says Brain Giitta, a Makerere University graduate, has developed Matibabu, a non-invasive device  with a smartphones to diagnose malaria.

    His company thinkIT is developing the technique where light sensors can read blood oxygen content through people’s skin. Plasmodium, the parasite, in affected people changes red blood cells’ shape and chemical properties and contain hemozoin, a crystal-like substance. Matibabu looks for these differences compared to uninfected blood. Users insert a finger into the device, plugs it into a smartphone, select “start diagnosis” on the phone, and wait for the diagnosis. About a minute later, it’s available.

    The device helps malaria disease management by providing simple, cost-effective and early diagnoses. Benefits include:

    Reduces the number of people who suffer malaria’s severe effectsReduces medicationShorter treatment timesNo need for trained health workersPrevents appearance of symptomsReduces malaria’s large socio-economic burden.

    thinkIT financed Matibabu development with grants and partnerships that include the Resilient Africa Network and Merck, and prizes from competitions. It’s now seeking finance for further development to reach markets before the first quarter of 2018. Potential customers are domestic and foreign. They include individuals, hospitals, health ministries and NGOs. Uganda’s the primary market, then Sub-Saharan Africa. It can soon be part of Africa’s eHealth plans.

  • Will GM mosquito trials start in Florida?

    Genetic Modification (GM) technology’s being applied to mosquitos with malaria in laboratories, described in an eHNA post. Scientists are also moving ahead to trials for the GM Aedes aegypti mosquitos, an urban dweller, to carry a gene causing their offspring to accumulate a toxic protein and die before adulthood, reducing mosquito populations that transmit dengue, Zika, and chikungunya viruses.

    An article in Science says Oxitec, a UK biotech firm that can control insects that spread disease and damage crops, wants to trial the GM project in Florida. Since 2009, it’s been releasing mosquitoes in small area field trials in the Cayman Islands, Malaysia, Brazil, and Panama. Oxitec has reported reductions in mosquito populations of over 90%. The GM gene isn’t 100% lethal. Oxitec says about 4% of offspring survive.

    The US Food and Drug Administration (FDA) has approved the project in the Florida Keys Mosquito Control District, but there’s local resistance. Evidence and concerns raised by Florida residents and mosquito experts include:

    Could a GM mosquito bite a Floridian? It’s possible because Oxitec will release only males, which don’t bite, but up of 0.2% of released mosquitos are femaleCould a GM mosquito transfer genes to a human, or make them sick? It’s highly unlikely, because mosquitoes have been feeding on people and other animals for millennia without evidence of DNA transfers, and there’s a negligible risk that GM mosquitos’ saliva will have any toxic or allergenic effects on peopleCould genes from the Oxitec strain spread to wild mosquitoes? If the 4% of offspring that beat the GM gene live long enough and are healthy enough to mate, they’ll introduce the GM gene into the wild populationCould mosquitoes become resistant to the Oxitec strategy? They could if surviving larvae carried genetic variants that protect them from Oxitec’s GM gene.

    Despite legitimate concerns, GM technology seems to have an increasing role in vector-borne diseases prevalent in Africa. It’s important that eHealth for surveillance’s in place to track the changes and progress.

  • Can GM mosquitos eradicate malaria?

    About 6% of all deaths in Africa are due to malaria. A report in Science How Stuff Works describes a project at the University of California, Irvine, led by Prof Anthony James to use Genetic Modification (GM) to neutralise malaria transmission. The team put 1,200 GM mosquitoes and 1,200 unmodified mosquitoes in a cage with mice infected with malaria. The 50:50 mix after nine mosquito egg cycles changed to 70% GM mosquitoes slowly replace unmodified mosquitoes. The researchers thinks that GM probably weakened the malaria-resistant mosquitoes, but that they gained a survival advantage because the parasite couldn't develop in their gut, so they lived longer and laid more eggs than their malaria-infected counterparts.

    It’s not a solution yet. Several issues need resolving. Only females of specific species of mosquitoes of the Anopheles genus transmit malaria through Plasmodium, a one-celled parasite. Most females don’t pick up the parasite, so GM for mosquitoes to replace unmodified ones and reduce malaria transmission, they have to survive them when parasites aren't present.

    GM worked when mosquitos collected the parasite. To succeed, they needed to be work when it’s not part of their food sources. Other issues are that so far, GM only works with parasites that infect mice. Concerns about the risks of releasing tens of thousands GM creatures into the environment need addressing too. It’s never been done before, so the long-term, actual ecological implications aren’t known

    It’s estimated that it’ll take another ten years before GM mosquitos can be used. In the meantime African countries have to rely more on mHealth and related technologies to combat the dreadful disease. eHNA has a recent report on one of these initiaitives. 

  • University of Pretoria develops malaria-combating technology

    Malaria is a very real life-threatening disease that kills thousands of people annually. It accounts for about 6% of all deaths in Africa. Sub-Saharan Africa carries a disproportionately high share of the global malaria burden. In 2015, WHO said the region had 88% of global malaria cases and 90% of malaria deaths.

    Malaria’s preventable and curable, and increased efforts are dramatically reducing the malaria burden. Researchers at the University of Pretoria Institute for Sustainable Malaria Control (UP ISMC) has turned to satellite data to track malaria outbreaks and smartphone apps to control and monitor the disease, says an article in IT-ONLINE.

    Satellites help the team to predict malaria outbreaks using Geographic Information Systems (GIS) and advanced satellite imaging to identify the environmental factors that allow mosquitos to breed, thrive and spread malaria. Outbreaks can now be predicted with increasing accuracy. “Using remote sensing as part of an early-warning system for outbreaks, we can forecast malaria occurrences from three to six months in the future,” says UP ISMC doctorate student Abiodun Morakinyo Adeola. “Our predictions using his model have been correct nine out of 10 times in all five Mpumalanga communities which formed part of the study.”

    The university been helping to predict outbreaks and involved in developing an mHealth app to control the disease. mSpray focuses on malaria control data management for the annual Indoor Residual Spraying (IRS) programme. It was developed at the University of California Berkeley (UCB) with input from researchers at the UP ISMC, specifically Prof Riana Bornman.

    The IRS programme is the current preferred method for malaria control in risk areas. Until recently there was no centralised digital database to ensure that spraying was effective, regular and safe. “Previously, the spray workers would go into homes, spray the walls and fill in cards,” says Prof Tiaan de Jager, director of the UP ISMC. “Come the next malaria season, they would go back and spray, but there was no clear database recording what substance was use, where was sprayed or when.”

    Spray workers use mSpray to record information about pesticides sprayed, the number of structures sprayed, concentrations and application procedures on their mobile phones. The app reduces the time needed to record or access data and ensures a safer and more efficient IRS programme.

    The University launched another mobile app in early 2016, Malaria Buddy, in collaboration with Travel With Flair. It is available for Android and iOS and assists travelers to malaria-endemic areas with information on risk, prevention and symptoms.  The UP ISMC team and Travel with Flair are currently designing an updated version to include GPS technology to direct users to the nearest healthcare centre if symptoms are detected.

    Prof de Jager is enthusiastic about using mHealth to combat malaria. “We should continue to use cell phone technology as it is much more efficient than manual means to control malaria.”

  • A map helps Africa fight malaria

    Malaria causes about 6% of Africa’s deaths. Roughly have the HIV/AIDS death rate. The Malaria Atlas Project (MAP) says 663 million cases have been averted this century.

    Since 2000, an anti-malaria campaign included an unprecedented high coverage across sub-Saharan Africa. It recognised that the effect of malaria interventions across Africa’s varied epidemiological settings is poorly understood. The main limitations are a lack of reliable surveillance data and simplistic approaches underlying current disease estimates. Addressing these, and their effects on efforts to control the disease are vital to inform control planning.

    A MAP study in Nature quantified the attributable effect of controlling Africa’s malaria efforts. Between 2000 and 2015, infection prevalence and endemic from plasmodium falciparum, a protozoan parasite and a plasmodium species that causes malaria in people, halved. The incidence fell by 40%. Nets treated with insecticide were the most widespread intervention and the largest contributor to the improvements.

    The parallel bad news’s that malaria cases are still below target. Averting even more cases is the current challenges. These differ between countries. MAP a cluster of data sets that show the scale of malaria across all-Africa:

    Plasmodium falciparum parasite rate in 2-10 year oldsPlasmodium falciparum incidence rateInsecticide treated bed net coverageIndoor residual spraying coverageArtemisinin-based combination therapy coverage.

    MAP also has a heat map with access to each country’s data. All these combine into essential tools for countries to compare their anti-malaria challenges, and keep developing their strategies, plans and efforts. Alongside MAP, recent initiatives using the web for malaria information, reported by eHNA, might help to nudge malaria cases down a further notch or two. 

  • Malaria diagnoses using the web’s coming

    Malaria’s death rate in Africa is about half that of HIVAIDS, but at 6% of all deaths, it’s still high. Better diagnosis can help. A study by a team from Manchester in the UK, reported in the Journal of Medical Internet Research (JMIR), says an eHealth solution using a virtual microscope on the web’s on its way.

    It aims to comply with the reference standard for analysing the form and structure of samples, their morphology, to analyse blood films for malaria diagnosis. A big challenge of existing arrangements is supporting the skills needed for accurate morphological diagnosis.

    This study tested digital slides of blood infected with malaria using a virtual microscope on website and users with different access to training and computing facilities. The feasibility was established by users comparing their testing and recording performances with other users.

    High quality images and digital slides were prepared for 56 stained thick and thin blood films. They were combined using Adobe Photoshop’s photomerge function, then adjusting them to ensure the resolution and reproduction of essential diagnostic features. Digital Slidebox was used for digital microscope viewing and image annotation, with data gathered from participants.

    The results were:

    High engagement, with images viewed by 38 participants in five countries in a range of environments and a 75% mean completionParasite detection was 78%Species identification accuracy was53%, comparable with results of equivalent studies using glass slidesThe systems complies with the morphological features needed to diagnose malaria and recognise speciesData collection enabled users to compare performance with other users over time and for each individual caseParticipants were positive about the virtual microscope system, finding it easy to use and accessIncreased communication correlated with increased participation.

    Showing that high-quality digital images are effective offers new opportunities for Africa’s health systems. Their eHealth strategies can be updated to include this approach.