tag:blogger.com,1999:blog-71343263402879981772024-02-07T12:47:15.490-05:00magnets and miraclesand microbes...Anonymoushttp://www.blogger.com/profile/17149262513856557921noreply@blogger.comBlogger2125tag:blogger.com,1999:blog-7134326340287998177.post-67164518751472492042016-04-25T09:38:00.000-04:002017-05-12T19:26:49.613-04:00End malaria for good<div dir="ltr" style="text-align: left;" trbidi="on">
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"Global trends have given us a clue that if control and prevention measures are carried out vigorously throughout the globe, malaria can be made a thing of the past"</blockquote>
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<tr><td class="tr-caption" style="text-align: center;"><span style="background-color: white; color: #757575; font-family: "georgia" , sans-serif; font-size: 12px; line-height: 24px;">Illustration: Ratna Sagar Shrestha/ THT</span></td></tr>
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We assume life can be shut down to abyss any time in the unseen future. Natural calamities also agonize us as we just experienced the Gorkha earthquake last year. We stress over being bitten to death by snakes or stung by scorpions while hiking around the outskirts of the city on the very sunny day of an weekend. Numerous stories of mishaps on roads and air give chills to the bones while taking off for anywhere. We take the above mentioned gruesome statements as great threats to humanity. However, we always fail to count the greatest threat of humanity of all time in this list. Mosquito, the deadliest animal with minuscule shape and size comfortably flying around you, yes you guessed it right: it is the number one killer. Let’s not forget Dengue Hemorrhagic Fever, West Nile fever, Chickungunya, Yellow Fever and Zika: including malaria, all are transmittable by the bite of different species of mosquito responsible for the high number of death toll each year.<br />
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The World Health Organization (WHO) estimated the total number of illnesses and 400, 000 deaths due to malaria in 2105 AD. Sub-Saharan Africa alone experienced more than 90% of the total fatality associated with malaria and among them, 350,000 were children who were yet to celebrate their fifth birthday.<br />
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In the recent report, WHO estimates that nearly half of the total population of the world live in the area where malaria transmission is high. WHO has listed 95 countries as malaria transmission territories which include countries of Sub-Saharan Africa, Latin America, Asia and to a lesser extent some countries of the Middle East are also included in this list.<br />
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The high risk areas of Nepal are represented by foothills and river belts, forest fringe areas, forests of Terai area, inner valleys and some Terai districts. Low risk area basically lie in plain cultivated outer Terai, mountain and mountain river valleys.<br />
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In order to curtail the disease burden, early case diagnosis and prompt treatment accompanied by effective means of controlling malaria transmission become necessary. For a nation, it not only requires a lot of investment for the prompt management of the burden of malaria but also it needs a vigorous strategy and improved malaria surveillance system to get rid of the otherwise unceasing burden of malaria.<br />
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The Millennium Development Goals (MDGs) aimed to halt and reverse transmission and incidence of malaria by 2015. Although MDG related to malaria was not achieved in all countries but it resulted in 60% reduction of malarial mortality rate globally. Thanks to the increased control and prevention measures more than 6 million lives have been saved globally since 2001. Malaria trend seen in Nepal is steeply declining though some major outbreaks are reported. In the decade of 2002 to 2012 AD, Nepal made significant progress in controlling malaria as the total confirmed malaria cases declined to 84%. The decreased trend of malaria cases with zero death since 2012 AD has been observed. Government has scaled up the access of on the spot diagnostic apparatuses (RDTs), anti-malarial drugs, massive coverage of Long Lasting Insecticide Bednets (LLINs) distribution in endemic districts and increased socio-economic status of vulnerable communities and people in order to control malaria in the country. Because of the socio-political upheaval Nepal is experiencing, attainment of the targets of all indicators of MDGs could not be made. In September 2015, United Nations Sustainable Development Summit adopted Sustainable Development Goals (SDGs) with seventeen broad agendas and are expected to be more effective than the MDGs.<br />
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Nepal has taken a long term malaria control strategy and sets a long term vision of a malaria-free nation by 2026 AD which accords with SDG-3 that aspires to ensure the good health and well-being to all by ending epidemics of malaria, tuberculosis, HIV/AIDS and other communicable diseases by 2030 AD. WHO has also launched Global Technical Strategy for Malaria (2016-2030 AD) with the ambitious yet achievable aim of reducing malaria cases and deaths associated with it by at least 90%, eliminating malaria from at least 35 countries and preventing further resurgence of it on malaria free countries.<br />
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In order to celebrate the incredible progress made on controlling malaria, 25 April is marked as World Malaria Day. The theme for this year is “End Malaria for Good” to recognize success of MDGs and reflects on the agendas of SDGs. For the low income and middle income countries, the efforts of elimination of malaria should be made along with with the alleviation of poverty. Prompt treatment, vector control, easily accessible healthcare facility and highly effective surveillance system are necessary for the elimination of malaria which is possible only when the country has been brought out of the vicious cycle of poverty.<br />
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Retrospective trends of global malaria situation have given us a clue that if control and prevention measures are carried out vigorously throughout the globe, malaria can be pushed back to the history. This, as aimed by SDGs 3, could be possible if we could make the halt the epidemics of malaria, tuberculosis, HIV/AIDS and other communicable disease. By doing so we could save the lives of hundreds of thousands of children and let them experience a better Earth of tomorrow.<br />
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<a href="http://thehimalayantimes.com/opinion/end-malaria-good/" target="_blank">A version of this article appears in print on April 25, 2016 of The Himalayan Times.</a></div>
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Anonymoushttp://www.blogger.com/profile/17149262513856557921noreply@blogger.com0tag:blogger.com,1999:blog-7134326340287998177.post-80689570407843526592016-02-03T10:45:00.000-05:002017-05-12T19:27:19.638-04:00Zika spread: Serious concern<div dir="ltr" style="text-align: left;" trbidi="on">
<span style="background-color: white; font-family: "georgia" , sans-serif; font-size: 16px; line-height: 24px;">Most viruses, unlike bacteria, are merciless as they are obligate parasites. The pathogenicity of viruses, however, falls within a wide spectrum: benign to severe. In the world of infections, a group of viruses has recently been dubbed to have serious public health threat, which otherwise was known to have only milder effects. Zika virus, a member of family Flaviridae, has recently shown up causing outbreaks in South America with the disease Zika. The infection by this virus has been said to have links with a rare neurologic disorder called microcephaly, congenital malformation, in which normal growth of head as well as brain development of the fetus is impeded.</span><br />
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Zika virus is a cousin of Dengue Virus as both of them fall in same family. Besides these two, Japanese Encephalitis, West Nile and Yellow Fever viruses fall in the same category. There is distinct similarity in the way of transmission of all viruses of this category. Zika as well as Dengue viruses are transmitted by the bite of infected female mosquito of genus Aedes. However, West Nile virus is explicitly transmitted by the bite of blood sucking Culex mosquitoes. Although it is rare for Dengue, an infected mother can also transmit Zika during pregnancy or labor. Zika viruses are often misdiagnosed as Dengue infection because of similar yet milder spectrum of clinical symptoms both manifest. Like other flaviviruses, Zika virus consists of RNA as a hereditary material enclosed inside its icosahedral capsid.</div>
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Scientists had not expected Zika to impact public health on such a great scale as it was thought to be confined within the narrow equatorial belt across Africa. After the virus was accidentally discovered in 1947 in Uganda, milder enzoonic infections involving humans sporadically were found to be associated with Zika. These viruses, however, have gone beyond this region showing its pandemic potentiality by circulating throughout the globe now. According to Centers for Disease Control and Prevention (CDC), there have been several reported outbreaks so far in Africa, Southeast Asia, the Pacific Islands and the Americas. Recently Brazil, in South America, saw an unusual surge of Zika virus cases within the last two years. The virus has been found not only in the Americas but is circulating throughout Africa, in Mekong territories and possibly in the Indian subcontinent where antibodies against Zika have been reported in the serum of the diseased cases. It was believed that the clinical impacts of Zika Virus are milder and were not taken seriously before. It was found to cause milder fever, rashes, conjunctivitis, muscles and joint pain, yet not as prominent as those caused by the Dengue Virus. Only one in four infected people is said to come up with symptoms which generally fade away after 2 to 7 days.</div>
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Recently, Brazil observed a tenfold increase in the number of babies born with microcephaly and researchers suspect its link with the soaring number of cases with Zika virus in later years after they hosted the World Cup Football in 2014. Brazilian Ministry of Health suspects more than 3,500 cases acquired Zika within the last three months. Among these, more than 225 are confirmed of having this virus. Public health experts in Brazil claim that they have enough evidences to establish a causal relationship between microcephaly and Zika virus. They have found Zika virus particles in the amnoiotic fluid in pregnant woman carrying babies manifested with microcepahly. Scientists at CDC and Universidade Federal do Rio Grande do Norte (UFRN) investigated four cases with Bad Obstetric History. They detected Zika in the brains of two babies, who died within the first 24 hours of their life, with microcepaly. They also investigated two cases of miscarriage that were found positive for Zika virus in immune histo chemistry tests at a laboratory. In all four cases, mothers were presented with rashes and fever during pregnancy. However additional evidences are required for the confirmation of causal relationship.</div>
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World Health Organization (WHO) / Pan America Health Organization (PAHO) recommend public health authorities perform prompt surveillance of the cases that manifest neurologic syndromes in all age groups. Travel guidelines for pregnant women and those who wish to be pregnant warn them to avoid areas where the virus is circulating.</div>
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There is no case of Zika reported from Nepal yet. However, the possibility of viral circulation in Nepal cannot be ruled out. In India, there are reports of seropositive cases who demonstrate anti-Zika antibodies in their serum sample. Therefore, it is imperative for our public health authorities to facilitate researches for assessing any evidence of Zika in Nepal.</div>
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Since the virus is transmitted through the bite of Aedes mosquitoes, the wisest idea is to avoid their bites. Aedes bites outdoor during the daytime unlike those mosquitoes transmitting malaria or elephantiasis. Vector control is another effective measure to check viral transmission. Aedes vector breeds in a pool of clean water accumulated in discarded tyres, containers, flower vases, discarded cups etc. Removal of potential breeding habitats significantly reduces the occurrence of Aedes vector in the environment ultimately reducing viral transmission and incidence of infection.</div>
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<a href="http://thehimalayantimes.com/opinion/zika-spread-serious-concern/" target="_blank">A version of this article appears in print on February 02, 2016 of The Himalayan Times.</a></div>
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Anonymoushttp://www.blogger.com/profile/17149262513856557921noreply@blogger.com0