Malaria Control & Elimination

The World Health Organization Global Malaria Programme, in keeping with its mandate to set evidence-informed policies for malaria control, has convened the Malaria Policy Advisory Committee as a mechanism to increase the timeliness, transparency, independence and relevance of its recommendations to World Health Organization member states in relation to malaria control and elimination.As a result, there is a growing need for the malaria policy setting process to rapidly review increasing amounts of evidence.

During the last decade, substantial progress has been made in controlling malaria worldwide through the large-scale implementation of effective malaria interventions. The magnitude of this progress has led some malaria-endemic countries, even those with historically high burdens of malaria, to consider the possibility of malaria elimination. Malaria elimination is defined as the reduction to zero of the incidence of infection caused by a specified malaria parasite in a defined geographical area as a result of deliberate efforts. Significant progress has been achieved in malaria control worldwide over the past decade. Increased financial support for malaria programs has enabled impressive reductions in transmission in many endemic regions. These successes have stimulated renewed discussion of how, when, and where malaria can be eliminated.

Malaria is one of the leading causes of death worldwide. According to the World Health Organization’s (WHO’s) world malaria report for 2018, there were 228 million cases and 405,000 deaths worldwide.Background The efficient allocation of financial resources for malaria control using appropriate combinations of interventions requires accurate information on the geographic distribution of malaria risk. An evidence-based description of the global range of Plasmodium falciparum malaria and its endemicity has not been assembled in almost 40 y. This paper aims to define the global geographic distribution of P. falciparum malaria in 2007 and to provide a preliminary description of its transmission intensity within this range. Methods and Findings The global spatial distribution of P. falciparum malaria was generated using nationally reported case-incidence data, medical intelligence, and biological rules of transmission exclusion, using temperature and aridity limits informed by the bionomics of dominant Anopheles vector species.

The objectives of this study are to describe the malaria situation in Ghana and give a brief account of how mathematical modelling techniques could support a more informed malaria control effort in the Ghanaian context. A review is carried out of some mathematical models investigating the dynamics of malaria transmission in subSaharan African countries, including Ghana. Collaboration between malaria control experts and modellers will allow for more appropriate mathematical models to be developed. A core set of intervention and treatment options are recommended by the World Health Organization for use against falciparum malaria.

Control, elimination, and eradication of malaria are one of the world’s greatest public health challenges, especially in Sub-Saharan Africa.The expectation of producing an effectivevaccine has been on for 40 years, but the recent breakthrough announcement of a malaria vaccine showing some level of protection among infants and children 3-4 years post vaccination seems like an excellent starting point. The globally accepted strategy for the control of malaria rely on chemotherapy, but unfortunately the overreliance on chemotherapy without proper control of drug usage and diagnosis has encouraged the selection of drug-resistant parasites, significantly contributing to the problem. Therefore, the prospects of malaria eradication rest heavily on integrated approaches that would include chemotherapy, vector control, and manipulation of environmental and ecological characteristics, and vaccination.

Bio-surfactants are amphiphilic biological compounds made extracellular or cell membrane part bacteria, yeast and filamentous fungi. Bio-surfactants are made up of a hydrophilic moiety, may be acid, peptide, action, anion, mono, di or polysaccharides and a hydrophobic moiety, which may be unsaturated or saturated hydrocarbon chains or fatty acids. Many advantages for bio-surfactants comprise biodegradability, low toxicity, biocompatibility and digestivity, presence of raw materials and specificity. The bio-surfactant production was known by many methods includes, hemolytic activity, oil displacement test emulsification index, surface tension reduction, blue agar plate or CTAB agar plate method, hydrocarbon overlay agar method. There are many medial applications for bio-surfactant which includes antimicrobial activity. Biosurfactants having capacity to be toxic on cell membrane permeability in similar method to detergent effect, anti-cancer activity, the neuronal differentiation in PC 12 cells induced by MEL and get ready the ground work for the use of microbial extracellular glycolipids as novel reagents for cancer cell treatment, antiviral activity, the sophorolipids surfactants produce by C. bombicola having structural analogues such as the sophorolipiddiacetate ethyl ester which is powerful spermicidal and virucidal agent and its virucidal activity similar to nonoxynol-9 against the human semen. Anti-adhesive agents, bio-surfactants having capability for adhesion residing for pathogenic organisms to solid surfaces or infection site, anti-fungal activity, flocculosin is a glycolipid produced by yeast like fungus P. flocculosa having antifungal activity against pathogenic yeasts and human mycoses. Immunological adjuvants, bacterial lipo-peptides when mix with classic antigens having active nontoxic, nonpyrogenic immunological adjuvants. Gene delivery, the liposomes based on bio-surfactants having increasing efficiency for gene transfection than cationic liposomes trading use.

Microbial compounds that possess pronounced surface and emulsifying activities are categorized as biosurfactants. Biosurfactants include a wide range of chemical structures, such as glycolipids, lipopeptides, polysaccharide–protein complexes, phospholipids, fatty acids and neutral lipids. For instance, Cooper and Goldenberg described different bio emulsifiers produced by two Bacillus species in water-soluble substrates with different emulsifying and surface activities. It is, therefore, reasonable to expect different properties and physiological functions for unique groups of biosurfactants. Moreover, these molecules can be tailor-made to suit different applications by modifying the growth substrate or growth conditions. Although most biosurfactants are regarded to be secondary metabolites, some may play crucial roles for the survival of biosurfactants-producing microorganisms through facilitating nutrient transport or microbe–host interactions or by acting as biocide agents. Biosurfactant roles include increasing the surface area and bioavailability of hydrophobic water-insoluble substrates, heavy metal binding, bacterial pathogenesis, and quorum sensing and biofilm formation. Biosurfactants are amphipathic molecules with both hydrophilic and hydrophobic moieties that partition preferentially at the interface between fluid phases that have different polarity and hydrogen bonding, such as oil and water or air and water interfaces. This property elaborates their wide use in environmental applications. Most work on biosurfactant applications has been focused on their use in environmental applications owing to their diversity, environmentally friendly nature, suitability for large-scale production and selectivity. Despite their potential and biological origin only a few studies have been carried out on applications related to the biomedical field. Some biosurfactants are suitable alternatives to synthetic medicines and antimicrobial agents and may be used as safe and effective therapeutic agents

Synthetic surfactants are becoming increasingly unpopular in many areas and applications due to previously disregarded effects on biological systems and this has led to a new focus on replacing such products with biosurfactants that are biodegradable and created from renewal resources. Microbially derived biosurfactants have been investigated in numerous studies in areas including: increasing feed digestibility in an agricultural context, improving seed protection and fertility, plant pathogen control, antimicrobial activity, ant biofilm activity, wound healing and dermatological care, improved oral cavity care, drug delivery systems and anticancer treatments. The development of the potential of biosurfactants has been stopped somewhat by the myriad of steps taken in their investigations, the focus on pathogens as source species and the costs associated with large�scale production. Here, we focus on various microbial sources of biosurfactants and the current trends in terms of agricultural and biomedical applications.

Prevention of Healthcare related Infections has been the focus of Infection Prevention and Quality Initiatives for more than two decades, and multidrug resistant organisms are responsible for many of these infections, further messing up their diagnosis. In addition to strengthening antimicrobial stewardship practices, and improving adherence to standard precautions (including hand hygiene), contact precautions for patients colonized or infected with multidrug resistant organisms have been advised and broadly adopted to prohibit horizontal transmission in the acute care healthcare setting. However, the data firming these recommendations derives predominantly from epidemic rather than endemic settings, where the burden of transmission as well as the transmission rate is by definition high. Guidelines underscore the cruciality of a basic multiprong step that includes education around epidemiologically important organisms, hand hygiene, contact precautions, environmental cleaning and antimicrobial stewardship. Additional measures recommended in the outbreak setting, such as active screening for MDR GNR, MRSA and VRE, alerts for previous positives with pre-emptive CP, and cohorting of patients and staff, etc have also been presented on occasion. The presenter will discuss the strengths and weaknesses of these steps when used alone or in conjunction, and will argue that the focus on the primacy of contact precautions in acute care settings is misplaced for most MDR organisms. Alternative focus and practices will be presented.

The occurrence and undesirable complications from health care–associated infections (HAIs) have been well recognized in the literature for the last several decades. The occurrence of HAIs continues to rise at a dramatic rate. HAIs originally referred to those infections related with admission in an acute-care hospital (formerly called a nosocomial infection), but the term now applies to infections acquired in the continuum of settings where persons get health care (e.g., long-term care, home care, ambulatory care). These unanticipated infections happen during the course of health care treatment and result in significant patient illnesses and deaths (morbidity and mortality); prolong the duration of hospital stays; and necessitate additional diagnostic and therapeutic interventions, which generate added costs to those already incurred by the patient’s underlying disease. HAIs are considered an undesirable outcome, and as some are preventable, they are considered an indicator of the quality of patient care, an adverse event, and a patient’s safety issue.

the most frequent types of adverse events affecting hospitalized patients are bad drug events, nosocomial infections, and surgical complexities.1, 2 From these and other studies, the Institute of Medicine reported that adverse events affect approximately 2 million patients each year in the United States, resulting in 90,000 deaths and an estimated $4.5–5.7 billion per year in additional costs for patient care.3 Recent modification in medical management settings have shifted more medical diagnosis and services to outpatient settings; fewer patients are accepted into hospitals. The disappointing fact is that the average duration of inpatient admissions has declined while the frequency of HAIs has increased.4, 5 The true incidence of HAIs is likely to be underestimated as hospital stays may be shorter than the incubation period of the infecting microorganism (a developing infection), and symptoms may not come up until days after patient gets discharged. For example, between 12 percent and 84 percent of surgical site infections are detected after patients are released from the hospital, and most become evident within 21 days after the surgical operation.6, 7 Patients receiving follow up care or routine care after a hospitalization may seek care in a non acute care facility. The reporting systems are not as well networked as those in acute care facilities, and reporting mechanisms are not directly connected back to the acute care setting to document the suspected origin of some infections.

HAI surveillance has monitored continous trends of infection in health care facilities.8 With the application of published evidence-based infection control strategies, a decreasing trend in certain intensive care unit (ICU) health care-associated infections has been reported through national infection control surveillance9 over the last 10 years, although there has also been an alarming increase of microorganism isolates with antimicrobial resistance. These modifying trends can be affected by factors such as increasing inpatient acuity of illness, inadequate nurse-patient staffing ratios, unavailability of system resources, and other demands that have challenged health care providers to continuosly apply evidence-based recommendations to maximize prevention efforts. Despite these demands on health care workers and resources, reducing preventable HAIs remains an imperative mission and is a contagious opportunity to improve and broaden patient safety.