Category Archives: coinfection

Malaria News Weekend 2020-09-05/6

We are sharing more updates from newsletters and journal abstracts found online. Issues include mapping malaria in connection with climate change, COVID-19 possibly inhibiting reporting o malaria cases, co-infection with coronavirus and malaria or dengue, Plasmodium knowlesi in northern India, and the effect of sanitation campaigns on infectious diseases. Click on links to read details.

Malaria kills 400,000 people a year, A new map shows where climate change will make it worse

A new study examines the impact of climate change on malaria in Africa. The maps reveal which areas will become more – or less – climatically suitable. Of an estimated 228 million cases of malaria worldwide each year, around 93% are in Africa. This proportion is more or less the same for the 405,000 malaria deaths globally.

That’s why there are huge efforts underway to provide detailed maps of current malaria cases in Africa, and to predict which areas will become more susceptible in future, since such maps are vital to control and treat transmission. Mosquito populations can respond quickly to climate change, so it is also important to understand what global warming means for malaria risk across the continent.

If it is too warm or too cold, then either the malaria parasite or the mosquito that transmits the parasite between humans will not survive. This suitable temperature range is relatively well established by field and laboratory studies and forms the basis for current projections of the impact of climate change on malaria. Yet, surface water is equally crucial as it provides habitat for the mosquitoes to lay their eggs. See original article in Nature Communications.

Malaria Situation in the Peruvian Amazon during the COVID-19 Pandemic

Malaria Situation in the Peruvian Amazon during the COVID-19 Pandemic. This article was originally published in Am J Trop Med Hyg. (2020 Sep 3. doi: 10.4269/ajtmh.20-0889). Online ahead of print. The Peruvian Ministry of Health reports a near absence of malaria cases in the Amazon region during the COVID-19 pandemic.

However, the rapid increase in SARS-CoV-2 infections has overwhelmed the Peruvian health system, leading to national panic and closure of public medical facilities, casting doubt on how accurately malaria cases’ numbers reflect reality. In the Amazon region of Loreto, where malaria cases are concentrated, COVID-19 has led to near-complete closure of the primary healthcare system, and diagnosis and treatment of acute febrile illnesses, including malaria, has plummeted. Here, we describe the potential association of COVID-19 with a markedly reduced number of reported malaria cases due to the reduced control activities carried out by the Peruvian Malaria Zero Program, which could lead to malaria resurgence and an excess of morbidity and mortality.

Dengue, malaria a new threat for Covid patients

Doctors in at least two Delhi hospitals have reported patients with twin infections of Covid-19 and dengue or malaria, a trend that could become worrying since the double disease may be deadlier, and the region is entering its most critical season for mosquito-transmitted diseases. The anecdotal reports tie in with latest findings that suggest a high prevalence of co-infections of diseases such as malaria, dengue and leptospirosis, which together have several symptoms that overlap with a symptomatic Covid-19 illness. Andhra villages see big drop in dengue, malaria, typhoid cases after pilot sanitation drive. Andhra govt data shows cases of seasonal diseases like dengue, typhoid, acute diarrhoea & malaria fell 97.4%, 96%, 81.7% and 50.4%, respectively, after the sanitation drive.

Now, months after the launch of the drive called ‘Manam Mana Parishubhratha’ (Our Cleanliness and Us), these villages have recorded a massive drop in the numbers of patients reporting with seasonal diseases like dengue, typhoid, malaria and acute diarrhoea. a 50.4% decrease in malaria cases (601), said the data.

AIIMS study finds zoonotic malarial parasite in acute febrile illnesses patients.

A zoonotic disease is a disease that can be spread/jump from animals to humans and vice versa. AIIMS researchers have sounded a note of caution after finding the presence of monkey malarial parasite ‘Plasmodium knowlesi’ in the north Indian population while doing a study on patients with acute febrile illnesses (AFI) and pathogens causing them.

The presence of the zoonotically transmitted malaria parasite was found during the study of acute febrile illnesses and causative pathogens in certain patients admitted in AIIMS from July 2017 to September 2018. The All Indian Institute of Medical Sciences (AIIMS) researchers from the Department of Biochemistry, along with clinicians from the Department of Medicine, were involved in the study on the pathogens causing severe fever.



World TB Day: considering malaria coinfection

Typical of our big disease mindset, most donor agencies think of HIV-Tuberculosis coinfection when addressing a connection among the three Global Fund diseases. Take as an example a recent News Flash from the Global Fund: “In a major step toward addressing the growing number of people affected by co-infection with tuberculosis and HIV, the Global Fund is improving the way it approaches treatment programs in countries with high rates of each disease. Millions of people infected with both TB and HIV could benefit from better services.”

World TB DayThe possible neglect of TB and malaria interactions might be understood by the fact that HIV and TB have much wider areas of endemicity than malaria. On the other hand both HIV and TB are disproportionately represented in malaria endemic Africa. At present the main connection between malaria and TB is the fact that they must share out of the same ‘envelope’ when new Global Fund support is distributed through the new funding mechanism to countries, a process that some see as moving more toward donor control and AID effectiveness and away from human rights.

Today the Stop-TB Partnership and related organizations are observing World TB day by noting that at least one-third of newly infected people will not get appropriate treatment. Poor access to or inadequate and inappropriate treatment plagues all three diseases, especially where health systems are weak.  We need an integrated approach to strengthen systems and improve care.

In the meantime, researchers have maintained interest in possible interactions between TB and malaria. For example Ann-Kristin Mueller and colleagues have published a study entitled, “An Experimental Model to Study Tuberculosis-Malaria Coinfection upon Natural Transmission of Mycobacterium tuberculosis and Plasmodium berghei,” using a mouse model. A slide presentation on their work is also seen at the website. As Mueller notes, “Concurrent infections most likely modulate the respective immune response to each single pathogen and may thereby affect pathogenesis and disease outcome. Coinfected patients may also respond differentially to anti-infective interventions.”

Mueller puts is mildly when she says that TB-malaria coinfection “has not been studied in detail.” We might need to step back in time over 2900 years where according to Lalremruata and colleagues, “the notion that the agricultural boom and dense crowding occurred in this region (southwest of modern Cairo), especially under the Ptolemies, highly increased the probability for the manifestation and spread of tuberculosis. Here we extend back-wards to ca. 800 BC new evidence for malaria tropica and human tuberculosis co-occurrence in ancient Lower Egypt.”

In a 2013 review on “Co-infection of tuberculosis and parasitic diseases in humans,” Xin-Xu Li and Xiao-Nong Zhou found only two direct reports of malaria and TB co-infection, one a case report from 1945 and the other on host response in malaria and depression of defense against tuberculosis from 1999.

Finally a review of hospital records from 2007 in Luanda, Angola found that Malaria was diagnosed during admission and hospital stay in 37.5% of TB patients. Clearly the time has come to take coinfection seriously as both a research and service delivery topic.