Posts or Comments 26 October 2021

Archive for "poverty"



Economics &poverty Bill Brieger | 16 Aug 2021

With all its recent troubles, Haiti is still challenged by malaria

In the past month Haiti has experienced a political assignation, a magnitude 7.2 earthquake and a flood-threatening tropical storm. Add to these are endemic health problems like malaria. The Pan American Health Organization reported that in 2019 Haiti suffered more than 4,600 cases of the disease.

The difficulties responding to the above mentioned challenges is deep seated in efforts to suppress the country since it won its independence in 1804. The rest of the world, particularly Europe and the United States have been responsible for destabilization over the past two centuries.

As part of the online roundtable on Brandon R. Byrd’s book, The Black Republic, Leslie M. Alexander noted that, “We Have Not Yet Forgiven Haiti For Being Black”. He explains that, ” few are willing to ask the hard questions about how and why Haiti perpetually appears to teeter on the brink of economic and political disaster,” and might we add health disasters to the list.

Alexander points out that, “The painful truth is that Haiti’s decision to declare its independence from France and to establish itself as a sovereign Black nation caused most Western nations to declare Haiti as public enemy number one. From the birth of Haitian independence in 1804 until the present day, the United States and other western European nations have used their economic and diplomatic strength in an effort to isolate and impoverish Haiti. ”

Malaria persists where there is poverty and conflict. The solution to malaria in Haiti must account for political and economic interventions that address the injustices of the past.

Equity &Gender &Health Systems &Migration &Nomadic People &poverty Bill Brieger | 05 Mar 2021

Nomads in Mali Face Barriers to Health Care

We are sharing the abstract of a just published article by Moussa Sangare and colleagues entitled, “Factors hindering health care delivery in nomadic communities: a cross-sectional study in Timbuktu, Mali,” that appears in BMC Public Health. As COVID-19 has been disrupting health services generally, we need greater awareness of the serious barriers faced by more vulnerable populations even in better times.

Background: In Mali, nomadic populations are spread over one third of the territory. Their lifestyle, characterized by constant mobility, excludes them from, or at best places them at the edge of, health delivery services. This study aimed to describe nomadic populations’ characteristics, determine their perception on the current health services, and identify issues associated with community-based health interventions.

Methods: To develop a better health policy and strategic approaches adapted to nomadic populations, we conducted a cross-sectional study in the region of Timbuktu to describe the difficulties in accessing health services. The study consisted in administering questionnaires to community members in the communes of Ber and Gossi, in the Timbuktu region, to understand their perceptions of health services delivery in their settings.

Results: We interviewed 520 individuals, all members of the nomadic communities of the two study communes. Their median age was 38?years old with extremes ranging from 18 to 86?years old. Their main activities were livestock breeding (27%), housekeeping (26.4%), local trading (11%), farming (6%) and artisans (5.5%). The average distance to the local health center was 40.94?km and 23.19?km respectively in Gossi and Ber. In terms of barriers to access to health care, participants complained mainly about the transportation options (79.4%), the quality of provided services (39.2%) and the high cost of available health services (35.7%). Additionally, more than a quarter of our participants stated that they would not allow themselves to be examined by a health care worker of the opposite gender.

Conclusion: This study shows that nomadic populations do not have access to community-based health interventions. A number of factors were revealed to be important barriers per these communities’ perception including the quality of services, poverty, lifestyle, gender and current health policy strategies in the region. To be successful, future interventions should take these factors into account by adapting policies and methods.

Advocacy &COVID-19 &Insecticide &Mosquitoes &poverty &Resistance &Severe Malaria Bill Brieger | 22 Oct 2020

Malaria News Today 2020-10-22

The search for adjunctive therapy to aid in recovery from cerebral malaria is explored in Malaria Journal. A faster acting crystalline form of an insecticide is studied. In Nigeria the National Malaria Elimination Program advocates for equal footing with COVID-19 action. Links to full stories and abstracts are found below.

Dimethyl fumarate reduces TNF and Plasmodium falciparum induced brain endothelium activation in vitro

Neida K. Mita-Mendoza, and colleagues studied Cerebral malaria (CM) which is associated with morbidity and mortality despite the use of potent anti-malarial agents. Brain endothelial cell activation and dysfunction from oxidative and inflammatory host responses and products released by Plasmodium falciparum-infected erythrocytes (IE), are likely the major contributors to the encephalopathy, seizures, and brain swelling that are associated with CM. The development of adjunctive therapy to reduce the pathological consequences of host response pathways could improve outcomes.

To accurately reflect clinically relevant parasite biology a unique panel of parasite isolates derived from patients with stringently defined CM was developed. The effect of TNF and these parasite lines on primary human brain microvascular endothelial cell (HBMVEC) activation in an in vitro co-culture model was tested. HBMVEC activation was measured by cellular release of IL6 and nuclear translocation of NF?B. The transcriptional and functional effects of dimethyl fumarate (DMF), an FDA approved drug which induces the NRF2 pathway, on host and parasite induced HBMVEC activation was characterized. In addition, the effect of DMF on parasite binding to TNF stimulated HBMVEC in a semi-static binding assay was examined.

The findings provide evidence that targeting the nuclear factor E2-related factor 2 ( NRF2) pathway in tumour necrosis factor (TNF) and parasite activated human brain microvascular endothelial cell (HBMVEC) mediates multiple protective pathways and may represent a novel adjunctive therapy to improve infection outcomes in CM.

Fast-acting insecticide polymorph could boost malaria-control efforts

Chemistry World reports on a faster-acting version of a common insecticide could boost malaria control efforts. The new crystalline form of deltamethrin is absorbed by mosquitoes 12 times faster than commercial forms and could help to limit malaria transmission despite growing rates of insecticide resistance.

Microcystals of contact insecticides like deltamethrin are crucial ingredients in indoor sprays and treated bed nets used to combat malaria-spreading mosquitoes. But many mosquito populations are developing resistance to these compounds, which is harming efforts to control the disease.

Treat Malaria as National Health Emergency, NEMP tells Federal Government

The Coordinator of National Malaria Elimination Programme (NEMP), has asked the federal government to tackle malaria as a national health emergency in the same manner COVID-19 pandemic is being handled. Against the background of increasing poverty in the country, Civil Society in Malaria Control, Immunisation and Nutrition (ACOMIN) has said there is a direct linkage between malaria scourge and the level of poverty in communities.

Speaking at a meeting with the civil society group involved in anti malaria advocacy, Coordinator of NEMP, said the current level of funding of the health sector by government is unacceptably low.