Malaria ‘epidemic’ looms as mosquitoes defy insecticides

MOSQUITOES DEFY INSECTICIDE TREATED BEDNETS… There are growing concerns that emerging resistance to insecticides among Anopheles mosquitoes and to antimalarial medicines among Plasmodium parasites, if left unchecked, could lead to a substantial increase in malaria incidence and mortality.

In recent times there have been many researches towards the elimination of Malaria and it's vector in Nigeria. There have also been huge investments to increase the quantity of insecticides used for malaria control, scale up of the distribution of long-lasting insecticidal nets (LLIN) and use of indoor residual spraying (IRS).

Despite all these efforts, researchers have found that mosquitoes are now becoming resistant to insecticides, which is now a serious concern and threat to malaria control.

There are growing concerns that emerging resistance to insecticides among Anopheles mosquitoes and to antimalarial medicines among Plasmodium parasites, if left unchecked, could lead to a substantial increase in malaria incidence and mortality.

According to the World Health Organisation (WHO), resistance is known to affect all major malaria vector species and all four recommended classes of insecticides. Since 2010, a total of 60 countries have reported resistance to at least one class of insecticide, with a total of 49 of those countries reporting resistance to two or more classes.

According to a study led by Charles Wondji of the Liverpool School of Tropical Medicine, with Kayla Barnes, Gareth Weedall and colleagues in journal PLOS Genetics, genetic analysis of mosquito populations in Africa shows that recent successes in controlling malaria through treated bednets has led to widespread insecticide resistance in mosquitoes.

However, according to the WHO, the understanding of the extent of the problem is incomplete, because: many countries do not carry out adequate routine monitoring for insecticide resistance in local vectors; and monitoring data are often not reported in a timely manner.

Previous researches indicate there are four classes of insecticides- pyrethroid, organochlorine, organophosphate and carbamate) recommended for malaria control of which only pyrethroid was approved for use on LLIN. It has been shown that the loss of this insecticide’s effectiveness will lead to increase in preventable deaths, particularly in most vulnerable groups, hence the need to maintain the effectiveness of LLIN in era of growing resistance.

A recent study carried out by scientists at the Nigeria Institute of Medical Research (NIMR), Yaba, Lagos, revealed that mosquitoes in 18 states in Nigeria have developed resistance to the LLIN insecticide nets, with Lagos, Ogun and Niger state having the highest incidence of cases.

Other states where the resistance were also detected include Jigawa, Katsina, Kebbi, Sokoto, Zamfara, Benue, Kwara, Nasarawa, Plateau, Anambra, Enugu, Rivers, Ondo, Osun and Oyo state, with the outcome of the study identified as a major threat to the eradication of malaria in Nigeria by 2030.

The Nigerian National statistics showed that malaria accounts for 60 per cent of hospital outpatients visits, 25 per cent infant deaths, 30 per cent of under-five deaths and 11 per cent of maternal mortality annually, although, currently, the prevalence of malaria in Nigeria is 27 per cent.

The lead researcher and the Deputy Director & Head, Public Health Department, NIMR, Dr. Sam Awolola, in his paper titled: “Need to Mitigate the Effect of Insecticide Resistance in Malaria Control in Nigeria” said, the result of the study meant that Nigeria would record a shocking increase in malaria deaths in the states where mosquitoes had developed resistance to these insecticide nets without swift intervention, adding that over 182 million long-lasting insecticide-treated nets have been distributed since 2003 till date recording 16 per cent reduction rate in 2008 to 2011 which have not been sustained.

Awolola who stressed that one of the consequences of the development would be more deaths from malaria, which are imminent in the affected areas, blamed the new trend of resistance to use of some reagents on agricultural products, saying “basically, one of the major factors that contributed to insecticide resistance is the use of some reagents for agriculture globally. Most of the insecticides used in public health are also used in agriculture, which is a major source of resistance.”

He noted that there should be strategic plans and policies to curb the widespread of these insecticide resistances, in which if no pre-emptive action is taken in Nigeria, it will likely, have significant operational impact.

“The LLIN Universal Coverage gap for Nigeria will remain unmet when generic LLINs are deployed in areas with high levels of metabolic-based insecticide resistance, as consequently, the level of efficacy intended might not be met.” He added: “Resistance data needed for evidence-based planning are limited in a number of state Ministries of Health because of the lack of capacity to carry out resistance tests, and if nothing is done in the country, insecticide resistance could eventually lead to widespread operational failure and much of the gains made in malaria prevention and control could be lost.”

Meanwhile, the WHO has recommended an immediate and pre-emptive action to delay resistance, which requires the use of tools with proven optimal efficacy to be deployed rationally as part of an evidence-based Insecticide Resistance Management Strategy,

The search for an alternative measures for the insecticide resistance has gained momentum with NIMR identifying a new generation combination LLIN (PBO-LLIN) and IRS Insecticides (pirimiphos-methyl (acetylic CS) and Ficam to have improved efficacy against the pyrethroid resistant mosquitoes in Nigeria, which was also revealed at the institute.

The Director General, NIMR, Prof. Babatunde Saloko warned that the progress made in combating malaria in the country was under threat due to the discovery.“There is now clear evidence that insecticide resistance has been confirmed in at least 20 states across Nigeria. There is also a gap of in the availability of resistant data in 14 states which requires urgent attention,” he said.

He explained that such resistance could lead to public health crisis, as insecticide resistance could quickly over power the current portfolio of vector control tools being used in the country.

Salako explained that it was high time the country did away with ‘one-size-fits-all’ approach, and embrace multiple vector control interventions.“There is need to explore alternative non-chemical base control measures,’’ he said.

He, however, called on the Ministry of Health and the government to support the institute in the area of funding to enable them make more advancement in operational research on the new tools on mosquitoes’ resistance to eliminate malaria for good in Nigeria, also urging the government to empower the institute to explore the use of alternative mosquito control.

“The government as a matter of urgency must designate NIMR as a hub for vector surveillance and insecticide resistance mapping in Nigeria. It must empower scientists to explore the use of alternative mosquito control measures such as the “sterile insect techniques” and “genetically modified mosquitoes” for malaria control,” he added.

Evidence of a multiple insecticide resistance in the malaria vector Anopheles funestus in South West Nigeria published in Malaria Journal noted: “This study reports the presence of multiple insecticide resistance in Anopheles funestus population from Akaka-Remo in the southwestern Nigeria. Molecular analysis conducted in the course of this research have revealed that this Anopheles funestus population have developed multiple resistance mechanisms to withstand lethal doses of insecticides used in public health.

“The consistent implication of Anopheles funestus in malaria transmission at Akaka-Remo was also established in this study. Nevertheless, further studies are needed to determine the spread of insecticide resistance and to conduct more investigations on underlying mechanisms of insecticides resistance for improved malaria control strategies in Nigeria.”

The WHO insists that the global malaria community needs to take urgent action to prevent an increase in insecticide resistance, and to maintain the effectiveness of existing vector-control interventions.

The WHO Global plan for insecticide resistance management in malaria vectors (GPIRM), issued in May 2012, is a global plan of action for all stakeholders engaged in the fight against malaria. The document provides comprehensive technical recommendations to manage insecticide resistance in different situations.

The GPIRM calls for the following key actions to be undertaken:
*plan and implement insecticide-resistance management strategies in malaria-endemic countries;
*ensure proper, timely monitoring of entomological and resistance monitoring and effective management of data;
*develop new, innovative vector-control tools;
*fill gaps in knowledge on mechanisms of insecticide resistance, and the impact of current approaches to management of insecticide resistance; and
*ensure that enabling mechanisms (advocacy, and human and financial resources) are in place.

Insecticide-treated bed nets and indoor spraying have been incredibly successful at preventing the spread of malaria, but their widespread use has driven mosquitoes to evolve resistance to these insecticides. By identifying genetic patterns that predict when and where resistance will evolve, scientists hope to mitigate the effects of resistance.

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Oxfam's Byanyima 'Not Happy' With International Response to Nigerian Food Crisis

Winnie Byanyima

Over 4.7 million people in northeast Nigeria are in dire need of basic amenities like food, water and shelter, says Oxfam. A delegation has been on a fact-finding visit to the region.

According to international aid agency Oxfam, at least 4.7 million people in northeastern Nigeria are currently in dire need of basic amenities like food, water and shelter. On a visit to the region, Oxfam's executive director Winnie Byanyima called on the international community to match its words with action and address the ongoing humanitarian crisis.

Winnie Byanyima at the PeoplesClimate march in New York

Winnie Byanyima and Amina J Mohammed

Winnie Byanyima, Speaking at the World Economic Forum

The situation in northeastern Nigeria, which is a stronghold of Boko Haram jihadists, has been described by the United Nations as "the largest crisis on the African continent."

Thousands of people, mostly children, are believed to have died of hunger and malnutrition.

Speaking to DW, Byanyima said the region was on the brink of famine. "If action is not taken now, we could see millions of people move into the famine category. So I'm here to push decision-makers to avert a catastrophic loss of life," she said.

Byanyima said that more could and should have been done earlier.

"I have to admit that we have come in late, we could have come in earlier, this was a slow onset crisis," she said, adding that she was disappointed that resources pledged had still not arrived. "I'm not happy about the United Nations and the coordinating role it should play for all of us. We can do better than this. These people deserve better," she said.

Human rights abuses also on increase

As the situation worsens, cases of human rights abuses in the camps for internally displaced persons (IDPs) are also on the increase. During their visit, members of the Oxfam delegation were in Kushari, Gwoza and Jakana where they met girls and young women who are part of a training program for monitoring threats and human rights abuses in their community.

Maryam Muhammad Ali has been conducting research and reporting rights abuses to humanitarian organizations in Maiduguri. She told DW that she and others were "like ambassadors to women in our community. There are a lot of cases of human rights abuses like rape, denying women their rights, and child labor, and the victims are afraid to speak out. We are conducting research, talking to the victims and reporting what we find to agencies to take action."

Oxfam has called on the international community to support the efforts of a number of non-governmental organizations in northeastern Nigeria to get suffiicient food and other relief materials into the region to meet the needs of the people.

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Shocking: Less Than 1% of Women in Nigeria Use Condoms

 

Shocking: Less Than 1% of Women in Nigeria Use Condoms

Meningitis outbreak death estimate rises to 489 in Nigeria – official

Children undergoing vaccination against meningitis in Nigeria.

A Nigerian health official said Wednesday that a suspected 489 people have died during the latest meningitis outbreak to hit Nigeria. At least five northern states — Sokoto, Zamfara, Katsina, Kebbi, Niger — and the Federal Capital Territory have been affected by the epidemic over the past five months.


Nigeria has started a large-scale vaccination programme in response to the mass outbreak that has affected mostly children.

 “As of now, there have been a total of 4,637 suspected cases out of which we have had 489 fatalities. Of these, 207 have been confirmed in laboratory tests,” junior health minister Osagie Ehanire told reporters after cabinet meeting in Nigeria’s capital of Abuja. 

Ehanire said that an ongoing vaccination campaign is yielding positive results. “I can tell you now that we are beginning to see the plateau, that is to say the epidemic is no more rising. It’s beginning to flatten out,” Ehanire said. 
“We cannot tell immediately how many doses of vaccines we will need. But we have placed an order for an additional two million doses,” Ehanire said. 

Meningitis is caused by different types of bacteria, six of which can cause epidemics. It is transmitted between people through coughs and sneezes, and facilitated by cramped living conditions and close contact. 
The illness causes acute inflammation of the outer layers of the brain and spinal cord, with the most common symptoms being fever, headache and neck stiffness. Nigeria lies in the so-called “meningitis belt” of sub-Saharan Africa, stretching from Senegal in the west to Ethiopia in the east, where outbreaks of the disease are a regular occurrence.

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Your past alcoholism can harm your child’s future health

Alcohol 

Men and women who drink alcohol need to read this. New research suggests that binge drinking earlier in life could compromise the health of your future children. The finding adds to  current research on how parents’  lifestyles can influence the health of their future children.

When it comes to the health of children, mother and father play an equal role. Although we may put a lot of emphasis on how a mother’s lifestyle choices can affect the health of her future children, a father’s age and lifestyle is just as important. A man or woman’s lifestyle can have significant effect on the health of their future offspring. For instance, researchers say lifestyle can cause epigenetic changes in a man’s sperm’s DNA that could eventually affect his offspring’s genome. Mothers should note that drinking while pregnant can harm an unborn child, but new research suggests that  alcohol abuse before pregnancy can also hurt a child’s health. 

This risk remains even if she abstains throughout the entire period of conception and pregnancy. In a study, presented at the Endocrine Society’s 99th annual meeting in Orlando, Florida, researchers from Rutgers University revealed that mice who were subjected to binge drinking habits similar to  those practiced by humans  gave birth to offspring with high blood sugar and other changes in glucose function. 
The researchers suggested that, if the same holds  true for  humans, binge drinking before pregnancy may increase a child’s risk of developing diabetes as an adult. According to Dipak Sarkar the lead investigator, the effects of alcohol use during pregnancy on an unborn child are well known, including possible birth defects and learning and behavior problems. 

However, it is not known whether a mother’s alcohol use before conception also could have negative effects on her child’s health and disease susceptibility during adulthood. For the study, the team had rats binge drink for four weeks by giving them a diet that was 6.7 percent alcohol. This was enough to raise their blood alcohol levels to those of binge drinking humans. The rats were then taken off this diet for several weeks before they were bred. According to the study, several weeks of alcohol abstinence for the rats was equivalent to several months of abstinence in humans. Results showed that adult offspring born to female mice that binge drank displayed a number of signs of abnormal glucose function, such as increased blood glucose levels and decreased insulin levels in the blood and pancreatic tissue. While it’s not clear yet if the same results are found in human children born of mothers who binge drank prior to conception, these findings suggest that a mother’s alcohol misuse before conception may be passed on to her offspring, possibly increasing their chances of developing certain diseases, such as diabetes.
It’s not just a mother’s lifestyle choices that could have long-term consequences on offspring;  past research has suggested that a father’s lifestyle could also play a role. Recent study found that alcohol use in fathers was linked to decreased birth weight, reduction in overall brain size, and impaired cognitive function. This was because an alcoholic lifestyle lead to epigenetic changes in sperm’s DNA that could be passed on for several generations. 

In addition to this, the research  also suggested that alcohol abuse in fathers could  influence gene expression for organ structure in their offspring, a factor that would contribute to a number of health problems such as fetal alcohol spectrum disorder. So if you are an alcoholic, you could unknowingly influence the organ structure and gene expression in your children, causing significant health problems such as fetal alcohol spectrum disorder  (FASD). 
This is a serious health condition that causes significant birth defects and learning difficulties in children, and according to the study, can still be diagnosed in children whose mothers never consumed alcohol during their pregnancy. Dr. Joanna Kitlinska stated that “Up to 75 percent of children with FASD have biological fathers who are alcoholics, suggesting that preconceptual paternal alcohol consumption negatively impacts their offspring.” 

The research was based on epigenetics, a relatively new field of science that explores how lifestyle and environment can change how certain genes in human DNA are expressed. Although our DNA is set in stone, recently researchers have noted that by altering the physical structure of DNA, certain factors can have an effect not only on your health, but also the health of future generations. For example, a study from 2014 found that endurance training can physically change the way our DNA creates skeletal muscle.
In addition to FASD, alcohol use in fathers was linked to decreased birth weight, marked reduction in overall brain size, and impaired cognitive function. The study also revealed that factors such as a father’s age, diet, and stress level could all have effects on the eventual health of his children.

For example, paternal obesity was linked to enlarged fat cells in the offspring, changes in metabolic regulation, diabetes, obesity, and even the development of brain cancer. In addition, past research has shown that traumatic events can alter gene expression as well and experiencing famine can “scar” the DNA of not only the individual but also their future offspring. The team hopes their findings could help better understanding of what influences the genetics and health of future offspring, and perhaps even be used to help recommend lifestyle alterations for people who wish to be parents. Thankfully, studies have shown that just as poor lifestyle choices can change DNA for the worse, correcting these habits can also reverse the effect.

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