Malaria Competence: Where are we now?

Today, there are 109 malarious countries in 4 regions. There are at least 300 million acute cases of malaria each year globally, resulting in more than a million deaths. Malaria is Africa's leading cause of under-five mortality (20%) and constitutes 10% of the continent's overall disease burden. Nevertheless, dying of malaria is not a fatality. Around the world communities mobilize their own resources to roll back malaria. *

Kokoko Gapoti, a great and respected sorcerer in a village in Togo explains: “In the past, many people were sick because of malaria. Women did not go to antenatal visits. There were many miscarriages and also many deaths among young children. Since we started to discuss this together, there have been no more miscarriages.”

How can all of us strive to eradicate malaria and to become malaria competent? We invite you to do your malaria competence self-assessment with your family, your colleagues, your village or community on World Malaria Day, 25 April 2009. This simple tool will help you to discuss how competent you are as a community towards malaria and to plan together for action.

Download the self-assessment framework
Read more about how to do your self-assessment

In Sohm (the Gambia), an average of five young children died from malaria every year. “Since we have been helped by the self-assessment, no child has died,” stated Mrs Sera Badjie.

Aziawo Kokou, district coach of Zio South (Togo), can’t stop singing the praises of the Club for Mothers in Bolougan. “At the beginning the mothers didn’t have the money to buy bednets, so they started to cultivate maize and manioc in a community field, and eventually they bought bednets with the income for the sales of these products.

If you live in a country where there is no malaria, you can still do the self-assessment, because:
- Members of your community might travel to a country where there is malaria
- There might be dengue infected mosquitoes

We encourage you to share your experience in this forum. Please tell us if you plan to participate in this initiative and how. Use the forum also to ask for facilitation tips from other friends - and to share yours! Then, share how your self assessment went and which actions you will take to improve your Malaria competence.

Read more on malaria competence in Togo and the Gambia.

* Malaria in Africa, Roll Back Malaria,

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Hi friends,

The Core Facilitation Team in Chiang Mai and 3 Thai coaches will do their malaria competence self-assessment tomorrow! We'll up-load the results and proposed actions. I hope that you will have time to do yours!

Dear friends,

This afternoon, the Core Facilitation Team of the Constellation (Gaston, Marlou, Lek and Laurence) and two coaches, Usa and I, came together to do our malaria competence self-assessment. After a fruitful discussion, we agreed on a common level on each of the practices. (See attached)

There is no malaria in Chiang Mai but we all sometimes travel to malarious countries. Also there is dengue in Chiang Mai. We decided to do our self-assessment on malaria only but using our experience on dengue as a good practice to learn on malaria as well.

Actually, almost all of us take action when we go to malarious countries: we take prevention treatment, we use mosquito repellent, I use a plug against mosquitoes at night in my hotel room, we know what to do and where to go if we have malaria, etc. In Chiang Mai, community teams spray outside the houses against dengue. We eliminate all the stagnant water in our gardens.

We decided to improve on the following practices with these actions:

- Acknowledgment: We will inform the coaches whenever they travel for the Constellation to malarious countries about the risk of malaria (and other diseases) by sending them a link to a specialized website (ex: Tropical Institute Belgium ). We will add the link to this kind of website database in their coaching agreement and add a link on our website.

- Prevention ITN, IRS, IPT: Gaston will find more information about ITN, IRS and IPT because we didn't know much about it.

- Way of deploying our own strengths: we want to adapt the self-assessment, to make it easier to use in any context. In the group on malaria competence , we will launch a discussion to update the self-assessment.

I'm sure we can still learn a lot from all of you. So please share how you did your self-assessment and what you plan to do to improve your competence.

Best regards,

Dear Friends,

This is a day to dedicate ourselves to the important cause of fighting and winning against malaria on all the days to come .

Would like to convey my best wishes for re-invigouration of our efforts to fight malaria in the most effective manner.

The endeavours have to be strengthened in accordance with the needs of the specific geographical areas and the incontrovertible evidence necessitating appropriate responses.

Would like to emphasise the need to act on all aspects of prevention,care, support and treatment for all diseases in general (keeping all the socio-economic determinants in mind when chalking out/implementing all interventions) and AIDS,Tuberculosis and Malaria in particular.

Would like to share a message from NIH and a report on tracing resistance to the antimalarial drug sulfadoxine which is of immense importance to many countries in Africa and Asia.

Regards and best wishes,

Dr.Rajesh Gopal.

APRIL 25, 2009

U.S. Department of Health and Human Services
National Institute of Allergy and Infectious Diseases (NIAID)

For Immediate Release: Friday, April 24, 2009

CONTACT: NIAID Office of Communications, 301-402-1663, niaidnews@niaid.>

APRIL 25, 2009
Statement of B.F. (Lee) Hall, M.D., Ph.D., and Anthony S. Fauci, M.D.
National Institute of Allergy and Infectious Diseases
National Institutes of Health

On April 25, we commemorate the second World Malaria Day with a renewed
commitment to work with our global partners to accelerate the fight
against malaria throughout the world. We embrace the theme of this
year's World Malaria Day, "Counting Malaria Out," by recognizing that
the ultimate goal of ridding malaria from every region of the globe will
require three phases: control, elimination and, finally, eradication.

Approximately half of the world's population lives in regions at some
risk for malaria. In 2006, an estimated 250 million people were infected
by malaria parasites, according to the World Health Organization (WHO).
Nearly 1 million people -- mostly young children and pregnant women in
Africa -- died that year.

The National Institute of Allergy and Infectious Diseases (NIAID), part
of the National Institutes of Health, supports recent calls to work
toward the goal of malaria eradication, while recognizing that such an
enormous undertaking must be tackled in stages. First, we must control
malaria by stopping the spread of the malaria parasite and reducing the
burden of disease region by region. Then we must eliminate the parasite
from malaria-endemic countries. Ultimately, we must eradicate malaria
from every country throughout the world. Such a venture will require a
multi-pronged strategy involving diverse interventions and numerous
communities, organizations, companies and governments working together
in a coordinated effort.

Today, the Roll Back Malaria (RBM) Partnership launches a campaign to
engage the international community in an intensified effort to halve the
global malaria burden by 2010, an important milestone on the road to
achieving the Millennium Development Goal of reducing malaria deaths to
near zero by 2015. Such a bold endeavor will require the help of many
partners in delivering medicines and mosquito control products, such as
insecticide- treated bed nets and indoor spraying with insecticide, to
communities in malaria-endemic regions, scaling up financial
contributions, and developing new interventions to treat malaria and
prevent the spread of the disease. NIAID, a member of the RBM
Partnership, plays an important role in this effort by supporting basic
and clinical research throughout the world aimed at developing new tools
and strategies to prevent, diagnose and treat malaria.

In 2008 NIAID developed a Strategic Plan for Malaria Research as well as
an outline for a comprehensive Research Agenda for Malaria, in which we
describe our commitment to a robust basic research portfolio in malaria
pathogenesis, immunology and epidemiology to better understand the
complex interactions among malaria parasites, mosquito vectors and human
hosts. Such studies are essential to the development of new prevention
and control strategies. In addition to scientific studies, NIAID
supports enhanced research training in the United States and abroad to
develop the organizations and "human capital" vital to moving basic
research discoveries from the laboratory and into the communities
affected by malaria.

Researchers supported by NIAID are making significant progress in
developing new countermeasures to fight malaria. NIAID-supported
scientists are actively engaged in research and development that
supports approximately one-third of the worldwide malaria drug research
portfolio. NIAID also supports research on 20 vaccine candidates, 7 of
which are in clinical trials. Studies on basic mosquito biology have
recently led to the identification of genetic markers involved in
pyrethroid insecticide resistance that are now being evaluated for
utility in the field. Looking to the future, NIAID recently launched a
new initiative, the International Centers of Excellence in Malaria
Research, to support a novel, global, multidisciplinary approach to
understanding malaria in the evolving context of control, elimination
and eradication.

While we celebrate important advances in the fight against malaria, we
also recognize the enormous challenges that lie ahead. For example, we
need faster and more reliable methods for diagnosing malaria to identify
different parasite species and drug-resistant strains that may emerge.
We also need to develop systematic ways to translate the enormous wealth
of basic information concerning the parasite and mosquito vectors into
effective strategies for treating and controlling malaria.

Most importantly, we must work together with all of our partners to
ensure that we do not lose focus as we achieve success in controlling
and eliminating malaria from endemic regions. It is critical that the
global community remain committed -- in the long term -- to sustaining
our efforts until malaria is eradicated from every region of the world.

Lee Hall, M.D., Ph.D., is chief of the Parasitology and International
Programs Branch in the NIAID Division of Microbiology and Infectious
Diseases. Anthony S. Fauci, M.D., is director of the National Institute
of Allergy and Infectious Diseases at the National Institutes of Health
in Bethesda, Maryland.

Media inquiries can be directed to the NIAID News Office at
301-402-1663, .

NIAID is a component of the National Institutes of Health. NIAID
supports basic and applied research to prevent, diagnose and treat
infectious diseases such as HIV/AIDS and other sexually transmitted
infections, influenza, tuberculosis, malaria and illness from potential
agents of bioterrorism. NIAID also supports research on basic
immunology, transplantation and immune-related disorders, including
autoimmune diseases, asthma and allergies.

The National Institutes of Health (NIH) -- The Nation's Medical Research
Agency -- includes 27 Institutes and Centers and is a component of the
U.S. Department of Health and Human Services. It is the primary federal
agency for conducting and supporting basic, clinical and translational
medical research, and it investigates the causes, treatments, and cures
for both common and rare diseases. For more information about NIH and
its programs, visit .

************ ********* ********* *****

Citation: Pearce RJ, Pota H, Evehe M-SB, Baˆ E-H, Mombo-Ngoma G, et al. (2009) Multiple Origins and Regional Dispersal of Resistant dhps in African Plasmodium falciparum Malaria. PLoS Med 6(4): e1000055. doi:10.1371/ journal.pmed. 1000055
FREELY AVAILABLE PAPER from Public Library of Science:
http://medicine. plosjournals. org/perlserv/ ?request= get-document&doi=10.1371/ journal.pmed. 1000055

In research published in PLoS Medicine, Cally Roper of the London School of Hygiene & Tropical Medicine and colleagues use genetic analyses to trace the emergence and dispersal of drug-resistant Plasmodium falciparum malaria in Africa.

They find that resistance to the antimalarial drug sulfadoxine has emerged independently in multiple sites in Africa during the past 10-20 years, and that the molecular basis of resistance differs between east and west Africa. Given the potential for different levels of drug resistance associated with these different parasite strains, the results suggest that coordinated malaria control campaigns across socio-economically linked areas in Africa may reduce the African malaria burden more effectively than campaigns that are confined to national territories.

In a related expert commentary on the new study, Tim Anderson of the Southwest Foundation for Biomedical Research, who was not involved in the study, notes: "this unusually large data set provides an extraordinarily fine-grained view of the spread of resistance alleles across Africa."

READ THE EDITORS'SUMMARY OF THE PAPER: http://www.plos. org/press/ plme-06-04- roper-summary. pdf

Cally Roper
London School of Hygiene and Tropical Medicine
Department of Infectious Tropical Diseases
Keppel Street
London, WC1E 7HT, United Kingdom
+44 207 927 2331
Cally.Roper@ uk

London School of Hygiene and Tropical Medicine Press Office
+44 (0) 207 927 2073/2802
gemma.howe@lshtm. or lindsay.wright@ uk

Related PLoS Medicine Perspective:

Citation: Anderson T (2009) Mapping the Spread of Malaria Drug Resistance. PLoS Med 6(4): e1000054. doi:10.1371/ journal.pmed. 1000054
http://medicine. plosjournals. org/perlserv/ ?request= get-document&doi=10.1371/ journal.pmed. 1000054
this is my self assessment, and i'd try to share with anyone
Dear Armijn Chandra Santosa Besman ,

Please do share at if you want.

You are most welcome.





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