mosquito

An anopheles mosquito

A new malaria vaccine – the first in history – has passed its trials recently, so we thought it might be a good idea to bring you all up to speed on it.  Malaria is a significant global public health issue, claiming over 600,000 lives a year, mostly children in sub-Saharan Africa, so anything that can make a dent in those statistics is a welcome development.

The new vaccine, RTS,S (also known as Mosquirix)  is produced by GlaxoSmithKline, with $200m of funding from the Bill and Melinda Gates Foundation, and is the culmination of a sixty year search for the Holy Grail of tropical medicine.  Because malaria is such a varied disease, it is notoriously hard to fight, but RTS,S works by introducing one protein from the parasite into the human immune system so that it will respond more rapidly to an infection.  In Phase III trials in seven African countries in children and infants it was found to significantly reduce the incidence of malaria for up to 18 months.  You can read the GlaxoSmithKlein press release here.

Malaria zones (source: Rpyal Perth Hospital)

Malaria regions (source: Royal Perth Hospital)

GSK hope to get the vaccine to market by 2016, and plan to sell it at a price which will cover the cost of production plus 5%, with profits being ploughed back in to product development.  It remains to be seen, of course, whether the cost will be low enough to be affordable to many countries which desperately need it.

As well as this prophylactic, there are also well-established preventatives such as malarone, a relatively expensive but highly effective prophylactic , and doxycycline, a mild antibiotic noted for its lack of serious side effects other than reducing tolerance to sunlight, which makes it problematic in the tropics.  Many adult prophylactics are not recommended for children, particularly Lariam, which has been linked to vivid nightmares, anxiety, depression and mood swings.  For more information visit the Interhealth website, but you should always seek bespoke medical advice from your GP or other medical adviser before taking anything to prevent or treat malaria, especially as strains of malaria differ across the world.

Effective prevention

Effective prevention

Of course, the best way to prevent malaria is not to get bitten by a mosquito in the first place.  Sleeping under impregnated mosquito nets, fitting mesh to windows, and keeping skin covered, particularly around sunset, are suitable barrier methods.  Having an electric fly killer also works, as does regular spraying of rooms with insect killer, though take care not to be in the room for a little while afterwards.  Burning mosquito coils and wearing insect repellent are less dangerous ways of deterring mosquitos.  There is also evidence that eating garlic works, or maybe that’s just wishful thinking!

One of the most effective ways of making sure that mosquitos are eliminated from your environment is to ensure that there is no standing water near your home.  That’s not easy during the rainy season, but mosquitos don’t travel far from their place of birth – some studies say as little as 100 metres.  If you can’t eliminate the water, introduce fish to it to eat the mosquito larvae, or add a small amount of paraffin to it to reduce the surface tension of the water which means the eggs fall through and drown.

Another method is to eliminate the mosquito’s food source – nectar and other plant sugars.  Many of us plant lawns or flower beds round our homes or offices to make them look nice, but that’s just building a mozzie diner.  Contrary to popular belief, mosquitos don’t feed on blood; the females use it for reproduction.  So by replacing your lovely green lawn and flower beds with gravel, you starve the mozzies.  If you must have the greenery, spray it regularly with an insecticide.

Sensible precautions could save thousands of lives a year.  But so could RTS,S.  And the best thing is that all of us who have moaned about our MS Windows over the years have indirectly contributed to its development.  Eat your hearts out, MAC users!

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Postscript

In a recent development, a new test for malaria has been discovered, which promises to be much more accurate than the current standard slide test.  For more information visit http://allafrica.com/stories/201312311173.html