TropIKA Blog Portal http://blog.tropika.net Tropical Diseases Research to Foster Innovation & Knowledge Application Thu, 08 Jul 2010 13:29:37 +0000 http://backend.userland.com/rss092 en <![CDATA[Partnership deal will support development of potential new antimalarial]]> Anacor press release. ]]> http://blog.tropika.net/tropika/2011/03/31/partnership-deal-will-support-development-of-potential-new-antimalarial/ <![CDATA[Tsetse fly success reported from Guinea's Loos Islands]]> Glossina palpalis gambiensis), which transmits the disease is common in the three inhabited islands. (It is not found in the two Loos Islands that are uninhabited.) While the flies remain, there is still the possibility that HAT may return to the islands. The flies are also a considerable nuisance to the local fishing communities, hamper the development of tourism and affect pig-breeding, which is an important activity on one of the islands. An area-wide programme designed to eradicate the flies from the islands was therefore begun in 2006. It is intended to serve as a test-bed for tsetse eradication in other parts of Africa. The programme uses several control methods including: impregnated traps and targets (ITTs), selective groundspraying, epicutaneous insecticide treatment of pigs, and impregnated fences around pig pens. Three sentinel sites were used to monitor fly density. Before the control programme began, density levels were 10, 3 and 1 tsetse/trap/day but by July 2010 the figure had dropped to zero in all three sites. The rate of reduction was faster where the control methods were implemented as a combination. The published paper gives details of the control methods and discusses the lessons learned. The latter include the importance of involving local teams and local communities. The authors point out that tsetse flies may still be present on the Loos Islands at very low, undetectable, densities. More detailed research, involving intensified trapping activities, will therefore be required before tsetse eradication on the islands can be declared. Eradicating diseases (or disease vectors) is more readily achievable on small islands than it is on continental mainlands. However, projects like these have much to teach us and demonstrate what is possible. Reference 1. Kagbadouno MS, Camara M, Bouyer J, Courtin F, Onikoyamou MF, Schofield CJ, Solano P (2011). Progress towards the eradication of Tsetse from the Loos islands, Guinea. Parasit Vectors; 4(1):18. Available online: http://www.parasitesandvectors.com/content/4/1/18 ]]> http://blog.tropika.net/tropika/2011/02/21/tsetse-fly-success-reported-from-guineas-loos-islands/ <![CDATA[A time to be bold]]> 1] that after two years work, with the participation of over 250 scientists, the agenda for research has been published in the form of a series of 12 rigorously peer-reviewed articles, available as a collection within the open-access journal PLoS Medicine. The UK’s Department for International Development has been drawing up its own malaria agenda [2], focusing on the part it will play in international efforts to achieve the Millennium Development Goals relating to the disease. DFID has opted for an evidence-based approach and the publication of its malaria “framework for results” is accompanied by the release of a comprehensive “evidence overview” document that could be of considerable value to other malaria policy makers. One new tool that now seems set to play a useful part in improving malaria control is the RTS,S vaccine, which has been shown in a trial [3] to provide protection that extends at least 15 months post-vaccination. It is quite clear, however, that the level of protection is only around 50%. This could potentially save many lives but, if eradication is the goal, then better vaccines will be needed. But in addition to effective tools to control or eradicate malaria we need to know where this disease is going. Will it be more widespread and will case numbers increase as a result of global warming? Helping to inform the debate on this important question is a new study [4] in which meteorological data demonstrated that temperatures have risen in a part of the Kenyan highlands where malaria cases are known to have increased. While malaria has accounted for much of the new content appearing in TropIKA.net since the start of the year, our coverage of other infectious diseases of poverty has been far ranging. Early-stage research conducted in Denmark [5] has achieved encouraging results with a tuberculosis vaccine intended to protect against both new infection and the emergence of the latent form of the disease. New data has confirmed that TB threatens the poor wherever they live [6] and shown that the high prevalence of the disease found in many prisons spills over to impact the wider population [7]. An issue we have previously highlighted on TropIKA.net is the danger posed by inaccurate serological tests for TB; WHO has now issued a negative policy recommendation (the first of its kind for the organization) that the tests should not be used [8]. Meanwhile, an outspoken article from Bangladesh [9] claims that TB control efforts are wrongly focused, and that the level of progress towards the targets that have been set has been exaggerated. New research on other infectious diseases of poverty has produced both encouraging and disappointing findings. In Brazil three-quarters of the patients given the drug miltefosine were cured of cutaneous leishmaniasis [10], compared with only half of those on the standard treatment. But bednets failed to protect against leishmaniasis in trial in India and Nepal [11]. Meanwhile, Sierra Leone has increased the coverage rate of in its lymphatic filariasis drug administration programme [12]. Other diseases recently featuring on TropIKA.net have included sleeping sickness [13], schistosomiasis [14] and rabies [15]. With the right level of commitment, the control of all these diseases could be improved but global eradication seems an unrealistic proposition. Or do we lack the vision and the courage to make the paradigm shift required in our thinking? ]]> http://blog.tropika.net/editorschoice/2011/02/04/a-time-to-be-bold/ <![CDATA[Fighting sleeping sickness: bring on the transgenic cows?]]> Human African trypanosomiasis (HAT or sleeping sickness) remains an important infectious disease of poverty. It is mostly transmitted through the bite of an infected tsetse fly. Currently there are an estimated 30,000 cases of the disease in 36 African countries. While progress has been made in controlling HAT, the treatments available leave much to be desired. Diagnosis and surveillance are also problematic. A news article in Nature Medicine [1] describes the work of Jayne Raper, a biochemist at New York University School of Medicine, who over the last 20 years has expanded understanding of how HAT parasites evade the human immune system, and the genetic mutations involved in resistance to the disease. Two parasite species can cause HAT: Trypanosoma brucei gambiense (T.b.g.) is found in west and central Africa and accounts for over 95% of cases; and the remainder are caused by Trypanosoma brucei rhodesiense (T.b.r.), found in eastern and southern Africa. Wild animals and agricultural livestock are an important reservoir of T.b.r. (Animals can also be infected with T.b. g but their importance as a reservoir is not clear.) Jayne Raper's many important contributions have included research on the trypanosome lytic factor (TLF ) but have not so far led to new interventions to combat HAT. The article discusses her desire to develop a genetically modified cow that would be resistant to Trypanosoma parasites. Not only could this be a potential means of reducing the reservoir of infection for the minority (T.b.r) form of HAT but also, by reducing the deaths of cattle in endemic areas, it would be of considerable benefit to poor communities. As the article notes, this is a controversial idea. Many others in the field believe that the focus should remain on using the knowledge now available on HAT to develop new treatments. Hostility towards the use of genetic engineering technology could also make it very difficult to introduce the transgenic cow across Africa. Nevertheless Raper, who has already created a trypanosome-resistant mouse, remains undaunted by the challenge. Reference 1. Willyard C (2011). Putting sleeping sickness to bed: Nature Medicine; 17;14-17. Available online: http://www.nature.com/nm/journal/v17/n1/full/nm0111-14.html ]]> http://blog.tropika.net/tropika/2011/01/24/fighting-sleeping-sickness-bring-on-the-transgenic-cow/ <![CDATA[Researcher profiled]]> Raymond Hui, a principal investigator with the University of Toronto’s Structural Genomics Consortium. Hui started out as a robotics engineer but moved on to genomics, where his research includes diseases such as malaria, tuberculosis and sleeping sickness (human African trypanosomiasis). He explains in the article that he hopes his work on the three-dimensional structure of proteins in disease-causing organisms will lead on to the development of new treatments. ]]> http://blog.tropika.net/tropika/2010/10/13/researcher-profiled/ <![CDATA[Rethinking priorities]]> most of the really poor people in the world live in Africa; most fevers in Africa are caused by malaria; persistent brain damage is an inevitable consequence of cerebral malaria; we know (roughly) the prevalence of TB in countries like South Africa; childhood TB is not a priority area; pneumonia and diarrhoea are not neglected diseases; and innovations in medical research always happen in the North, not in disease-endemic countries themselves… Whether these recent developments represent good news or bad, they call into question the ordering of many of the current priorities for research, policy and public health practice. Researchers at Oxford University have applied a new “multidimensional poverty index”, to conclude that there are more poor people in eight of India’s states than in the 26 countries of sub-Saharan Africa combined [1]. Not everyone will agree with this analysis, but the infectious disease burden of India’s poor surely deserves to be accorded a higher priority. It has for some years been believed that an African child with fever is most likely to have malaria. As confirmatory diagnostic tests are usually unavailable on the frontline of care, the practice of “presumptive” diagnosis and treatment is therefore recommended. However, a mathematical modelling study [2] has concluded that most fevers are not malaria. In some parts of Africa, 80% of children attending public clinics with fever are probably suffering from some other infection. The findings provide strong support for the new rapid diagnostic tests to be made available at all health facilities in Africa. One of the most serious consequences of malaria is the lasting cognitive damage suffered by children who develop cerebral malaria. A very “early” study [3] with laboratory mice suggests that adding antioxidants to standard malaria treatment may help prevent this. (By coincidence, this research has been published within a few days of an analysis [4] appearing to show that a high prevalence of parasitic infections holds back rises in the average IQ in disease-endemic countries.) A post-mortem study [5] in a South African hospital produced findings that are truly shocking; half of the young adults who died in this hospital were culture-positive for TB and one case in six involved a drug-resistant strain of M. tuberculosis. The country is known to have a high prevalence of tuberculosis and of drug resistance but the situation may be worse than previously believed. TB programmes usually focus on adults. However, in a recent article [6] Indian and Indonesian specialists argue convincingly that this has led to a neglect of paediatric TB. Once again the priority list has been challenged. The establishment of the Millennium Development Goals has had a major influence on policies and priorities. The latest annual report [7] on progress made towards the MDGs makes interesting reading; there have been both encouraging achievements and some disappointments. However, the report is unequivocal on one matter: “The need to refocus attention on pneumonia and diarrhoea – two of the three leading killers of children – is urgent”. Acute respiratory infections and diarrhoeal disease were at one time high on the priority list and it is unclear why they have steadily slid downwards. Now is the time to reverse that trend. The latest of our popular ‘Profiles’ series of articles on TropIKA.net [8] highlights the achievements of BIOTEC, a research centre created by the Thai government to generate biotechnology innovations. The innovatory research programme conducted at BIOTEC, which has included the development of a new malaria drug that will soon be entering clinical trials, challenges the notion that, while innovations may be evaluated in the South, the original breakthroughs will always take place in the better-resourced research environments of the North. Also on TropIKA.net... Other examples of progress towards new treatments have been reported on TropIKA.net lately. Merck & Co is investigating the potential use of one its existing drugs as a treatment for Chagas disease [9] and an agreement [10] between two non-profit groups will see potential new TB drugs tested also for their possible use against neglected conditions including Chagas, African trypanosomiasis and leishmaniasis. There has been good news on lymphatic filariasis (LF). It has been calculated that, in its first eight years, the Global Programme to Eliminate Lymphatic Filariasis has brought benefits worth $21.8 billion to individuals, and savings of $2.2 billion to the health systems of endemic countries [11]. Many national LF efforts have experienced difficulties, including the reluctance of many people at risk of infection to comply with mass drug administration programmes. A study from India [12] has shown that community education can improve compliance rates, particularly if this education includes advice on self-care of afflicted limbs for those already suffering from the distressing symptoms of this condition. The study has neatly illustrated the importance of considering not only long-term public health considerations but also the needs of individuals. Paul Chinnock Editor, TropIKA.net]]> http://blog.tropika.net/editorschoice/2010/07/20/rethinking-priorities/ <![CDATA[Most paediatric fevers not caused by malaria]]> study by Oxford University and other research groups, whose authors caution against the "continued indiscriminate use of anti-malarials for all fevers across Africa."   Of the 183 million children with malaria symptoms treated by public health clinics in 2007, only 43 percent were diagnosed with malaria, but many more most likely received anti-malarial medication. "Malaria is still routinely made as the diagnosis of convenience in response to paediatric fever," the study's lead researcher, Peter Gething, told IRIN. "This in part stems fromofficial guidelines that have only recently been updated, and in part because often the only treatments available in front-line clinics are anti-malarials." In 2006 the World Health Organization (WHO) recommended that health workers in countries with a high number of suspected cases of malaria treat children with fevers - the main clinical symptom of malaria - for the disease, even without a diagnosis. There was little else to do at the time, said WHO expert Peter Olumese. "The probability was high that the fevers were from malaria, the disease could turn fatal quickly and there was no time to lose, and there were no proven diagnostic tools," he told IRIN. Since then, rapid diagnostic testing for malaria has become available, making it possible to confirm diagnoses without health workers, a microscope or a laboratory. In 2008, 11.5 million of these tests were distributed in Africa; in 2009, the Global Fund to Fight AIDS, Tuberculosis and Malaria financed 74 million tests, and another 105 million in 2010, according to the Roll Back Malaria Partnership. People in communities have been trained to test one another for malaria. In Senegal, people of all ages are treated for malaria in government-funded health centres only once there is a positive result from a laboratory or rapid test. In sub-Saharan Africa 31 countries have a policy of "universal diagnostic testing", while another 15 countries in the region have set a goal of testing before treatment in children aged five and older, judging it too risky to delay treatment in younger patients.

More on malaria from IRIN

 BURKINA FASO: When is malaria not malaria?

 GLOBAL: Spoonfuls of sugar could save malaria patients

 MALI: Combating malaria misdiagnosis

 TIMOR-LESTE: Rebuilding infrastructure poses challenge to tackling malaria

Yet it can be equally risky to treat someone for malaria based only on the assumption that they have the disease, the director of WHO's global malaria programme, Robert Newman, told IRIN. "You might be wasting ACT [anti-malarial artemisinin-based Combination Therapy], while increasing the risk for drug resistance; also, you are not treating the underlying febrile disease and the drug delay can be fatal. If you treat bacterial pneumonia with anti-malarials, you still have a problem." On Kinaserom, one of the islands in Lake Chad, health workers recently started using rapid tests to check patients suspected of having malaria. Mahamat Boukar Moussa, the head nurse at a clinic on the island, told IRIN he gave patients malaria medication even when test results were negative. "The tests are not accurate and we cannot risk inaction." Raoul Ngarhounoum, the regional health director overseeing the rollout of malaria rapid testing, told IRIN he agreed with the health workers' scepticism. "These are malaria-endemic areas, and just because a test says it is not malaria does not mean it is not." Gething said that besides quality control, "Simply supplying RDT [rapid diagnostic testing] universally is likely to be less effective if it is not accompanied by sufficient training for front-line health workers." The Foundation for Innovative New Diagnostics, which works with WHO to create quality control standards for rapid tests, recommends spot checking in each batch of tests ordered to ensure the tests were not poorly manufactured, or had been damaged in transit or storage. Malaria treatment would not change overnight, said Gething. "In an ideal world, all fevers reaching clinics in Africa would be tested for malaria, using a reliable diagnostic test ... As always, the reality on the ground is more complex. For years the advice has been to treat all fevers as malaria, and changing that dogma is likely to take time." 

Source: IRIN

]]> http://blog.tropika.net/tropika/2010/07/07/most-paediatric-fevers-not-caused-by-malaria/ <![CDATA[Angola suspends sleeping sickness research efforts]]> Angolan News Agency, the Institute had been hoping to screen more people for the disease this year. However, after screening just 3.7% of the population at risk, activities were halted due to a lack of funds. In 2008, 12% of the population were screened and the goal was set to raise this figure to 80% by 2012.]]> http://blog.tropika.net/tropika/2010/06/15/angola-suspends-sleeping-sickness-research-efforts/ <![CDATA[Charting the bottom ten]]> By Margaret Harris This is a first attempt to chart the distribution of these neglected diseases and is based on published epidemiological data. Let the maps cycle, or click on each disease name at the top to see where in the world that disease can be found. We welcome feedback, updates and suggestions on ways to improve the information provided. The interactive map on the TropIKA.net home page shows 10 diseases - some with names few can pronounce- that have been identified by the Unicef/UNDP/World Bank/WHO Special Programme for Research & Training (TDR) as the most neglected of infectious diseases, hampering the health and development of the world's poorest people. The diseases: Chagas, dengue fever, human African trypanosomiasis (HAT) onchocerciasis, leishmaniasis, leprosy, lymphatic filariasis, malaria, tuberculosis and schistosomiasis are still endemic in much of the world, particularly tropical regions. Their distribution and effects differ from disease to disease but their burden remains heavy. Africa, South America and Asia all contain countries affected by at least one of these neglected diseases of poverty. Not only do these diseases disproportionately affect impoverished populations, they reduce economic activity. The annual economic loss in Africa due to malaria has been estimated as $12 billion, representing a crippling 1.3 percent annual loss in GDP growth in endemic countries. Schistosomiasis and malaria lower child survival, while onchocerciasis and schistosomiasis hamper children's school performance. Lymphatic filariasis interferes with agricultural productivity as does onchocerciasis and schistosomiasis [1]. Leishmaniasis, human African trypanosomiasis and lymphatic filariasis are associated with an economic burden of a different kind as infected people pay excessive amounts for treatment and seek inappropriate of ineffective care [1]. Leprosy leads to social isolation and stigmatization, particularly among women who may not present for diagnosis due to fear of loss of marriage opportunities. TDR is working to identify the needs, gaps and potential for action in research for infectious diseases of poverty, including the ten that appear on this map. A think tank made of 125 experts from around the world is examining the research, debating the issues and developing options for action. Their findings will feed into the Global Report for research on infectious diseases of poverty, due to be published in 2011. Reference 1. Hotez PJ, Fenwick A, Savioli L, Molyneux DH (2009). Rescuing the bottom billion through control of neglected tropical diseases. Lancet; 373:1570-1575]]> http://blog.tropika.net/tropika/2010/06/14/charting-the-bottom-ten/ <![CDATA[A "manifesto" for combatting NTDs]]> "Manifesto for Advancing the Control and Elimination of Neglected Tropical Diseases", published this week. Writing in PLoS Neglected Tropical Diseases, Peter Hotez, President of the Sabin Vaccine Institute and Distinguished Research Professor of The George Washington University Medical Center, and Bernard Pecoul, Executive Director of Drugs for Neglected Diseases initiative (DNDi), outline in eight points why the global community should increase financial support for NTD control and elimination efforts and research and development. The manifesto states that:

·      All NTDs are "tool ready" with cost-efficient and effective interventions that could be implemented now, even if for some diseases such tools are far from being perfect or complete.

·      At the same time that NTDs are tool ready they are also tool deficient, signifying that the tools are incomplete, or inadequate, to sustain elimination efforts.

·      NTDs have received little attention from the international community during the past ten years despite their large disease burden.

·      Increasing evidence indicates an association between NTD prevalence and conflict and violation of human rights.

·      NTDs can be particularly destabilizing and disrupt agricultural productivity and food security. Many poor societies with high NTD burdens have been recently engaged in a civil or international conflict or are currently at war.

·      Sustained involvement by the WHO and other international health agencies is crucial for current and future NTD control and elimination efforts.

·      Nothing is more important to the success of global NTD control than the involvement of communities themselves and disease-endemic countries' health ministries.

·      Achievement of Millennium Development Goal 8 ("develop a global partnership for development") will rest with stakeholders — health ministries, affected communities, public–private partnerships, large and small non-governmental organizations, etc. — establishing a well-functioning international strategy for NTD control.

While acknowledging that policymakers are “slowly beginning to appreciate the importance of NTDs” — evidenced by the creation of a new department of Neglected Tropical Diseases at the World Health Organization; TDR’s 10-year strategic plan; and the identification, by NIH’s Francis Collins, of neglected diseases as a research priority, among other developments — Hotez and Pecoul argue that the challenge of NTDs calls for a manifesto — “a public declaration of motives by a government or by a person or group regarded as having some public importance.”

Moreover, they add, by doing more to tackle NTDs, the global health community can make progress toward Millennium Development Goals.

"[NTD control] activities have facilitated the delivery of additional interventions such as insecticide-treated bed nets, antimalarial drugs, micronutrients, and childhood immunizations," they write.

The authors urge scientists working on NTDs to increase collaboration and identify funding opportunities and cost-efficient interventions.

"By highlighting important challenges in the fight against NTDs, this 'manifesto' calls on the global community for urgent, renewed, and innovative efforts."]]> http://blog.tropika.net/tropika/2010/05/26/a-manifesto-for-combatting-ntds/ <![CDATA[Neglected tropical diseases: debating the best way forward]]> PLoS Medicine's Debate series examines the different approaches that can be taken to tackle neglected tropical diseases (NTDs). Some commentators, such as Jerry Spiegel and colleagues from the University of British Columbia, feel there has been too much focus on the biomedical mechanisms and drug development for NTDs, at the expense of attention to the social determinants of disease. Burton Singer argues that this represents another example of the inappropriate “overmedicalization” of contemporary tropical disease control. Peter Hotez and colleagues, in contrast, argue that the best return on investment will continue to be mass drug administration for NTDs. Reference 1. Spiegel JM, Dharamsi S, Wasan KM, Yassi A, Singer B, et al. (2010) Which New Approaches to Tackling Neglected Tropical Diseases Show Promise? PLoS Med 7(5): e1000255. Available from: http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1000255]]> http://blog.tropika.net/tropika/2010/05/24/neglected-tropical-diseases-debating-the-best-way-forward/ <![CDATA[Neglected protozoan diseases to be the subject of Paris conference]]> Further details of the event are available on the Insitut Pasteur website. The deadline for registration is 30th June. ]]> http://blog.tropika.net/tropika/2010/05/14/neglected-protozoan-diseases-to-be-the-subject-of-paris-conference/ <![CDATA[A wider view]]> Profiles”, in which we feature in-depth interviews with influential figures in research and policy whose work concerns the infectious diseases of poverty. Our latest interviewee is one of the most charismatic individuals in this field – Peter Hotez of the Sabin Vaccine Initiative and the Global Network for Neglected Tropical Diseases (NTDs). No one has done more than Professor Hotez to raise the profile of the NTDs. Speaking to TropIKA.net’s Tatum Anderson, he describes the career path that led him to specialize in this area. Peter Hotez also explains the justification for the Global Network’s current focus on just seven neglected infections: three soil-transmitted helminths (ascariasis, trichuriasis and hookworm), lymphatic filariasis, onchocerciasis, schistosomiasis and trachoma. All of these diseases could already be brought under control, if sufficient support were to be provided for mass drug administration programmes. Different strategies, Hotez says, will be needed to address other diseases of poverty. The Global Network will broaden its focus later. TropIKA.net already takes a wider view in our coverage of the infectious diseases of poverty. Our content also features new developments in such areas as malaria, tuberculosis, dengue and the kinetoplastid diseases (Chagas disease, leishmaniasis and human African trypanosomiasis [sleeping sickness]). Recent developments we have lately highlighted include research that, according to some interpretations, suggests that vivax malaria may be getting more common in Africa. We have also examined some of the new advances being made in leishmaniasis research. It is not often that molecular targets are identified for potential new treatments against the infectious diseases of poverty, so it is gratifying to be able to report that such a target has been found by researchers seeking new drugs for sleeping sickness. Other significant advances recently announced include genomic research on Mycobacterium tuberculosis, the organism that causes TB. The M. tb genome was first sequenced in 1998 but less than 40% of its genes had been “annotated”, meaning that their functions and pathways had yet to be understood and described. Important new insights have now been gained through the work of scientists at the Open Source Drug Discovery (OSDD) initiative in India. (A TropIKA.net article published in March provides more information about OSDD and the concept of open-source drug discovery.) Another area where progress is being made is in the search for vaccines to prevent dengue. We take a look at some of the initiatives that are now under way. Scientific advances such as these give us cause for hope, but there is also a need for political commitment from governments in disease-endemic countries and the global community as a whole. It has therefore been disappointing to read the findings of new research that suggests many African governments have reduced the proportion of their budgets that they are devoting to health. Finally, don't forget to visit the TropIKA.net blog where there have been some interesting postings by guest bloggers from Farmabrasilis and the Asia Pacific Malaria Elimination Network. Paul Chinnock Editor, TropIKA.net]]> http://blog.tropika.net/editorschoice/2010/04/28/a-wider-view/ <![CDATA[Tuberculosis: facing up to the issues]]> World TB Day (24th March) will soon be with us. There are many issues that must be urgently addressed if further progress is to be made in controlling this disease, which kills over one and a half million people every year. There are particular concerns over the growing numbers of cases of drug-resistant forms of TB and new understanding [1] of the mechanism of action of two drugs active against multiple-drug resistant TB may help inform the search for the new drugs that are so desperately needed. A neglected area of TB research has been diagnosis. Sputum microscopy – sometimes referred to as the “gold standard” for diagnosing TB – is time consuming, can only be conducted in the lab and often gives incorrect results. A rapid test that can be used on the front line is required. News of new funding [2] provided by the Gates Foundation to a non-profit group that focuses on this issue is much to be welcomed. Interestingly, a manufacturer of breath tests for disease diagnostics says it has developed a simple test that can diagnose active pulmonary TB within minutes – see TropIKA.net News in brief [3]. The importance of partnership is always stressed in TB control efforts. Important partners in the delivery of care include the private health care sector and it is disappointing that in India [4] many private practitioners do not apparently provide the recommended TB treatment DOTS (directly-observed therapy short course.) Good news Several recent TropIKA.net articles report good news concerning other infectious diseases of poverty. For example, a trial in India [5] found that a single transfusion of the drug amphotericin B, for which patients stayed in hospital for just 24 hours, was as effective in the treatment of visceral leishmaniasis (VL) as a course of treatment requiring a one-month hospital stay. This finding could have major implications; it would be possible to significantly increase the number of VL patients who receive treatment. When new drugs are introduced they are not always popular with patients and this is bound to affect their compliance with the treatments they are prescribed – something that is not always taken into consideration when implementing new programmes. Much depends on the switch to artemisinin-combination therapy (ACT) as the standard treatment for uncomplicated malaria and it is reassuring to learn [6] that the introduction of the ACT Coartem in Dar es Salaam, Tanzania has met with a positive reception from the local community, including mothers whose children have been treated for malaria. A TropIKA “Research in brief” article [7] includes further welcome news: a new insecticide could be in prospect for mosquito control, research at the “basic” level could lead on to the development of treatments for cholera and for the kinetoplastid diseases, and a drug already in use in veterinary medicine could be developed as a new treatment for onchocerciasis. Looking to the future, research into sleeping sickness (human African trypanosomiasis) will be boosted by new Gates funding, and the Australian government has made new grants to researchers working on malaria [8]. In both these cases the research will be based in institutions located in developed countries, but there is a pressing need for more research to be done in disease-endemic countries themselves and for it to be conducted by nationals of those countries. This was the theme of the African Expert Meeting on Pharmaceutical Innovation in Africa, held in Pretoria, South Africa [9], where a call was made for support to enable the development and production of medicines, “in Africa, by Africans”. The registration in African countries of new drugs shown to be effective against the infectious diseases of poverty was also discussed at this meeting [10]. Robust registration procedures are of course necessary but they must not lead to unnecessary delays in bringing the fruits of scientific research to those who most need them. Paul Chinnock Editor, TropIKA.net]]> http://blog.tropika.net/editorschoice/2010/03/03/tuberculosis-facing-up-to-the-issues/ <![CDATA[Neglected tropical diseases in the Lancet]]> Lancet. The series continues and the following articles are now freely available (registration required). Programmes, partnerships, and governance for elimination and control of neglected tropical diseases Bernhard Liese, Mark Rosenberg, Alexander Schratz Integration of control of neglected tropical diseases into health-care systems: challenges and opportunities John O Gyapong, Margaret Gyapong, Nathaniel Yellu, Kwadwo Anakwah, George Amofah, Moses Bockarie, Sam Adjei Mapping, monitoring, and surveillance of neglected tropical diseases: towards a policy framework MC Baker, E Mathieu, FM Fleming, M Deming, JD King, A Garba, JB Koroma, M Bockarie, A Kabore, DP Sankara, DH Molyneux Socioeconomic aspects of neglected tropical diseases Lesong Conteh, Thomas Engels, David H Molyneux Also recently published in the journal's Seminar section is an update on human African trypanosomiasis (sleeping sickness).]]> http://blog.tropika.net/tropika/2010/01/25/573/ <![CDATA[Uganda takes action against trypanosomiasis]]> BBC news story that focuses on the barriers a Ugandan mother had to surmount in order to get treatment for her young daughter. The story also describes a veterinary project in Uganda which seeks to reduce levels of infection with the trypanosome parasite in cattle. (In this part of Africa, cattle are the main reservoir of the parasite responsible for sleeping sickness in humans.) The innovative project involves private, community-based vets.]]> http://blog.tropika.net/tropika/2009/12/16/uganda-takes-against-trypanosomiasis/ <![CDATA[Sleeping sickness survey in Ghana finds no active cases]]> Web Ghana says the search was conducted under the auspices of the Pan African Tsetse and Trypanosomiasis Eradication Campaign (PATTEC). Over 10,000 blood samples were taken in Western and Upper West regions but the Trypanosoma brucei parasite was found to be present in only 24 samples. Thomas Azurago, Ghana's HAT Programme Officer, said 57 tsetse flies were trapped during the survey in four communities in the Western Region and eight of them tested positive for the parasite. He also cautioned that there was a low awareness of the disease amongst health personnel, which could hold back efforts to complete the elimination of the disease from Ghana. ]]> http://blog.tropika.net/tropika/2009/09/07/sleeping-sickness-survey-in-ghana-finds-no-active-cases/ <![CDATA[Overcoming neglect: profiling the people]]> Profiles section in which Tatum Anderson interviews key figures working against the infectious diseases of poverty. We are delighted that our latest interviewee is Dr Awa-Marie Coll-Seck executive director of the Rollback Malaria Partnership (RBM). She plays a crucial role in coordinating the activities of the myriad of organizations now involved in international efforts to improve malaria control. One of the many new malaria initiatives is the Affordable Medicines Facility for malaria (AMFm). There is currently much debate, for example in a recent PLoS Medicine article, as to the merits of this scheme and how it might best be implemented. Another recent Profile interviewee, Brian Greenwood, is probably best known for his work against malaria but in his long career in tropical medicine he has also focused on other diseases, among them is meningitis. We report on the launch of the African Meningococcal Carriage Consortium (MenAfriCar), to be headed by Professor Greenwood, which will make a concerted effort to understand the spread of meningococcal meningitis in Africa. We also report good news on another disease that is predominantly an African problem – onchocerciasis (river blindness). Mass administration of the drug ivermectin kills the larvae of the parasite responsible but not the adult; repeat treatments (once or twice a year) are therefore given. It has been widely believed that communities living in areas endemic for the disease would need to be given these treatments indefinitely. However, a study in Mali and Senegal found that, after 15-17 years of mass drug administration with ivermectin, only a few people were still infected and treatment could safely be stopped. Ivermectin is not, however, an ideal drug. Many patients find it extremely unpleasant to take and parasite resistance to the drug has been reported. Research to find new ways to control river blindness that do not depend on ivermectin therefore remains important – see TropIKA.net news story on the latest meeting of the SCOOTT Consortium (Sustainable Control of Onchocerciasis today and Tomorrow). Amongst the other good news has been the announcement by the International Trachoma Initiative that three more countries (Ghana, Mexico and Saudi Arabia) have now met the criteria for elimination of trachoma as a public health problem. It is unusual to see a low-, a medium- and a high-income country mentioned together for the same achievement! Tropical diseases can indeed afflict both rich and poor but it those who live in poverty who are the most vulnerable. Many of the countries where dengue fever is a problem are emerging economies in Latin America and Southeast Asia. The economic impact of the disease is therefore considerable. Probably the most comprehensive study to date seeking to quantify this impact has just been published. Infectious diseases that affect poor people are by and large neglected, but with increasing wealth in dengue-afflicted nations, perhaps the economic imperative will lead to an expansion of efforts to develop a vaccine and a treatment for this increasingly common disease. The diagnosis of the infectious diseases of poverty is itself a neglected issue. When advances are made in the treatment of a disease, rapid and reliable diagnosis becomes even more important, as was discussed in the case of malaria in a recent BMJ article. Two initiatives to address the neglect of diagnosis have made an appearance in TropIKA.net during the last few days. The African Network for Drugs and Diagnostics Innovation (ANDi) has announced that it will present its strategy and business plan in October, and the TropIKA.net blog links to an interview with Joseph Ndung’u of the Foundation for Innovative New Diagnostics (FIND) about the search for a new diagnostic test for trypanosomiasis (sleeping sickness). - For more on new developments in diagnosis, see also a recent article in TDR News. Paul Chinnock Editor-in-Chief, TropIKA.net ]]> http://blog.tropika.net/editorschoice/2009/07/31/overcoming-neglect-profiling-the-people/ <![CDATA[Sleeping sickness: facing up to the challenge of improving diagnosis]]> FIND) is, however, making progress. It is evaluating a low-cost microscope suitable for field use and attempting to develop a molecular detection kit hat does not require a sophisticated lab or specialized personnel. More details are provided by IRIN, in an interview with Joseph Ndung'u, head of trypanosomiasis at FIND.]]> http://blog.tropika.net/tropika/2009/07/16/sleeping-sickness-facing-up-to-the-challenging-of-improving-diagnosis/ <![CDATA[Evidence into policy – policy into practice]]> research capacity in Africa, a gene map has been constructed for the parasite that causes schistosomiasis, opening up new avenues for research, and a potential new rabies vaccine has given promising results in mice. A trial has begun of a new drug for river blindness, and a trial of an improved treatment for sleeping sickness has been completed with encouraging results. Meanwhile the US government has made it clear that, following the broadening of its policies on global health, it will provide new support for the control of neglected tropical diseases (NTDs). Unfortunately, only seven infections from the long list of NTDs have been targeted by the US at this stage. (Leishmaniasis, Chagas disease and dengue fever are examples of the NTDs not yet included.) Nevertheless, this is still an exciting initiative and other countries in the North might now be expected to follow the US lead. These examples of positive developments contrast with the news from Kenya that over 70% of malaria patients there are given the wrong malaria treatment; they receive older ineffective antimalarials and not artemisinin combination therapy (ACT), the internationally recommended treatment. This finding (from the 2007 Kenya Malaria Indicator Survey, the full report of which is not yet freely available) supports observations in many African countries that ACTs are only getting through to a minority of those who need them. Coincidentally, within the same month that the Kenyan report was published, the 250 millionth dose of the most widely available ACT, Coartem, was delivered. (TropIKA.net marked the event with an interview with the head of marketing and access for the malaria initiative at Coartem’s manufacturer, Novartis.) Progress is therefore being made but there is a long way to go. An example of what a malaria control programme can achieve comes from a study conducted in the tiny island of Bioko, Equatorial Guinea where, within four years of the introduction of a multi-intervention strategy, prevalence in children dropped from 42% to 18% and all-cause child mortality fell by two-thirds. Such research demonstrates what is possible, but the challenge remains of bringing the potential benefits of research evidence to entire populations in disease-endemic countries. “Evidence into policy” is the first part of this challenge. A recent article in Lancet Infectious Diseases noted that, while national guidelines in most Africa countries now list ACTs as the recommended first-line treatment for malaria, the majority of these guidelines have not changed as regards second-line treatment, for which they still recommend oral quinine monotherapy. This is despite the fact that the World Health Organization has stated that ACTs should also be the mainstay of second-line treatment. But “policy into practice” is the next part of the challenge. In the case of ACTs, practitioners cannot give them to patients, as either first- or second-line treatment, if the drugs are not actually available. I am reminded of the British civil servant who said, after a new directive from his political masters, “If the policy is that pigs will fly, whose fault is it when they don’t?” (Sometimes those who write policy documents and guidelines need to distinguish between aspirational and operational targets.) Two other research articles highlighted on TropIKA.net have implications for policy making in child health. A systematic review concludes that WHO is wrong in its recommendation that iron supplements should not be given to children under two years, if they live in malarious regions. In contrast, a South African study provides evidence to support the WHO position that children known to be HIV-infected shown not be given BCG, even in countries where the risk of TB infection is high. The interpretation of the evidence in such studies is, however, always likely to be controversial. Putting evidence into policy and policy into practice both present formidable obstacles. Paul Chinnock Editor-in-Chief, TropIKA.net ]]> http://blog.tropika.net/editorschoice/2009/07/15/evidence-into-policy-%e2%80%93-policy-into-practice/ <![CDATA["Neglected diseases, neglected people"]]> TropIKA.net reported earlier on the second stakeholder conference of the Drugs for Neglected Diseases initiative (DNDi) held in Nairobi. Now, an article from the IPS news service includes an interview with Marcel Tanner, chairman of DNDi's board of directors, given during the event. He discusses the problems resulting from the lack of adequate treatments for diseases such as leishmaniasis and human African trypanosomiasis (sleeping sickness). Using the phrase "neglected diseases, neglected people". Marcel Tanner describes the attitude of the pharmaceutical industry towards tropical diseases that primarily affect the marginalised poor. ]]> http://blog.tropika.net/tropika/2009/07/07/neglected-diseases-neglected-people/ <![CDATA[The poverty fly: article on trypanosomiasis]]> IRIN News includes an interview with Joseph Ndung'u, head of the human African trypanosomiasis (“sleeping sickness”) programme at the Geneva-based Foundation for Innovative New Diagnostics (FIND). Dr Ndung'u says: “Whereas the impact [of our work] on humans may not be so obvious, the link to Africa’s agriculture is what makes tsetse flies so important. With oxen to pull ploughs, you can produce 10 times more, feed yourself and your children and have enough to sell at the market.” However, he believes that the apparent drop in the number of humans affected by trypanosomiasis – from an estimated half-million a decade ago to 75,000 in 2007 according to WHO – has reduced funding for tsetse fly research, surveillance and disease control. IRIN also spoke to Jorge Hendrichs, the head of a joint FAO and International Atomic Energy Agency (IAEA) project which seeks to control tsetse flies by releasing males sterilised by irradiation. He describes tsetse as "the poverty fly". "Why," asks Jorge Hendrichs, "are there lush green areas with very hungry poor people? Look closer and you will notice women working the land with their bare hands. There are simply no animals in the poorest rural areas of Africa. Tsetse have killed the cattle that would have pulled plough sin the fields or transported food to the market.” ]]> http://blog.tropika.net/tropika/2009/05/22/the-poverty-fly-article-on-trypanosomiasis/ <![CDATA[Protein family influences development of sleeping sickness parasite]]> Nature. The authors argue that the protein family will prove a useful biomarker and may aid in the development of new treatments. Keith Matthews and colleagues at the University of Edinburgh, UK show that the PAD (proteins associated with differentiation) family of proteins helps the parasite, Trypanosoma brucei, respond to specific environmental cues that influence its form — the parasites have a complex life cycle, and exist in different forms in mammalian and insect hosts. The proteins are expressed on the surface of the transmission-competent ‘stumpy-form’ parasites in the bloodstream. When PAD expression is abolished, the ability to change shape in response to key environmentalcues is diminished. A commentary (2) on the study has been published in the same issue of Nature. References 1. Dean S, Marchetti R, Kirk K, Matthews KR (2009). A surface transporter family conveys the trypanosome differentiation signal. Nature; 459(7244):213-217. 2. Shadan S (2009). Microbiology: Signals for change. Nature; 459(7244):175.]]> http://blog.tropika.net/tropika/2009/05/19/protein-family-influences-development-of-sleeping-sickness-parasite/ <![CDATA[JAMA on negleted tropical diseases]]> JAMA) is one of the world's most highly rated general medical journals but is not noted for the level of attention it gives to the infectious diseases of poverty, compared for example to PLoS Medicine or the Lancet. However, a recent article in JAMA's Medical News & Perspectives section, "Attention Sought for Neglected Diseases", makes an interesting read. The article uses human African trypanosomiasis (HAT; sleeping sickness) as an example of a disease where, “Doctors and nurses in the field are forced to care for patients with treatments that are largely archaic, toxic, ineffective; some are unaffordable and some are nonexistent.” The words are those of Sophie Delaunay, executive director of the US section of Médecins Sans Frontières. The article goes on to refer to the work of the Drugs for Neglected Diseases Initiative (DNDI) and of the Neglected Tropical Disease Control Program of RTI International. Mary Linehan of RTI notes the particular difficulties of finding treatments for the three kinetoplastid diseases (HAT, Chagas disease and leishmaniasis). She says that available treatments have not been adapted to conditions in affected countries: “They require heavy management of the patient, which is very difficult to ensure in remote settings". Examples are briefly given of the public-private partnerships which are now seeking to develop new treatments. JAMA is not an open-access journal but for those with access to a library with a JAMA subscription, the article may be read here. ]]> http://blog.tropika.net/tropika/2009/05/14/jama-on-negleted-tropical-diseases/ <![CDATA[Angola has a new medical research institute]]> report from allAfrica.com says the centre will conduct research on a number of conditions including: malaria, TB, HIV/AIDS, filariasis, schistosomiasis, trypanosomiasis and viral haemorrhagic fevers. The centre, known as CISA, is sponsored by Angolan government, Portugal and the Calouste Gulbenkian Foundation. Portugal's Health Ministry and the Agostinho Neto University Medicine Faculty are partners in the project. ]]> http://blog.tropika.net/tropika/2009/04/28/angola-has-a-new-medical-research-institute/ <![CDATA[Uganda responds to sleeping sickness cases]]> review of new research on human African trypanosomiasis (HAT, sleeping sickness), it was noted that the great majority of cases of this disease, which is fatal if not treated, are never reported. HAT is also a disease that is of little interest to the media. It is therefore encouraging to see a report in Uganda's New Vision of a briefing given to journalists by Director of Health Services, Dr Samuel Ojok, concerning the HAT situation in Dokolo District. It seems that the health services, with WHO support, are acting appropriately to contain the spread of the disease in the area. The interest of the media is also commendable as it will increase awareness and aid control efforts. However, the situation which Dr Ojok describes is very worrying. There have been 120 cases and 18 deaths recently. Dr Ojok said the disease spread to the district in 2004, following the arrival of infected animals from the Busoga region for sale by businessmen. Many cases had presented in a confusing form and as people were generally unaware of the symptoms they often delayed seeking health care. The experience of Dokolo District is yet another demonstration that more needs to be done to control this disease, and of the need for increased research efforts.]]> http://blog.tropika.net/tropika/2009/03/31/uganda-responds-to-sleeping-sickness-cases/ <![CDATA[Neglected diseases: too upsetting to think about?]]> World Tuberculosis Day and to the publication of the latest WHO annual report on the disease. While it is easy to be cynical about the increasing number of annual days focussing on particular health or social issues, World TB Day does succeed in getting TB into the media, which can often be difficult, even for charities paying for fund-raising advertisements. In the TropIKA.net blog, we reported on the charity which was told by a TV company that its film about Buruli ulcer was too shocking to show during the daytime. This was despite the very restrained and tasteful nature of the film, in which the ulcers themselves were carefully blurred. Perhaps this is one reason why most infectious diseases of poverty are so severely neglected – they are too upsetting for us even to think about. The Second International Conference on Buruli Ulcer is incidentally now taking place in Benin. Sleeping sickness (human African trypanosomiasis) is another much neglected disease. TropIKA.net has taken a look at research articles published on the disease within the last few months and we have attempted to sum up the key developments in a review article. A non-government organization specialising in the leading infectious cause of blindness, trachoma, has announced that it is merging with a larger NGO. Should there be organizations that focus on just one disease or does this promote a ‘vertical’ approach to health care? And does it help when such bodies merge; does it make bureaucracy worse or reduce it? It would be interesting to have the opinions of TropIKA.net readers on these questions. Each of our articles and blogs has a facility for comment, so please do get in touch. We have had some good feedback on a number of our articles lately - see the following examples: 1, 2, 3. But I shall finish this latest Editor’s choice by returning to World TB Day. The Stop TB Partnership has this year stressed the economic benefits of TB control. Dr Marcos Espinal, Executive Secretary of the Partnership said, “Most highly affected countries could gain nine times or more their investments in TB control”. In the current economic climate it is indeed important to emphasise such points to policy makers, with regard not just to TB but all the infectious diseases that blight the lives and reduce the productivity of the world’s poorest people. However, we must keep in mind the humanitarian as well as the economic imperative. It is unfair and unjust that millions of people continue to suffer from diseases like trachoma, Buruli ulcer and trypanosomiasis. Regardless of the financial costs and benefits, action against all these diseases must now be stepped up. Paul Chinnock Editor-in-Chief, TropIKA.net ]]> http://blog.tropika.net/editorschoice/2009/03/30/neglected-diseases-too-upsetting-to-think-about/ <![CDATA[A time for maps: sleeping sickness]]> TropIKA.net the latest progress made in the Malaria Atlas Project. Now a research article in the International Journal of Health Geographics describes the HAT Atlas initiative. HAT is human African trypanosomiasis or sleeping sickness, a potentially fatal disease of which there are somewhere in the region of 70,000 to 300,000 cases every year. (A TropIKA.net update article recently looked at new developments in HAT research.) Up-to-date as well as historical data collected by national sleeping sickness control programmes, non-governmental organizations and research institutes have been collated over many years by WHO, but it has mainly been unpublished. It is now being screened, harmonized, and analysed by means of database management systems and geographical information systems (GIS). The paper describes the input data, methodology, preliminary results and future prospects for the HAT Atlas initiative, which they authors say will allow major improvements in the understanding of the spatial distribution of the disease. They believe that: "The Atlas of HAT will lay the basis for novel, evidence-based methodologies to estimate the population at risk and the burden of disease, ultimately leading to more efficient targeting of interventions." HAT is one of the most neglected of diseases and even with the creation of a map there will still be a considerable way to go before more effecdtive control of the disease can be achieved. However, it is encouraging to see HAT receiving such attention and it is another demonstration of what can be achieved when GIS is applied to the infectious diseases of poverty. ]]> http://blog.tropika.net/tropika/2009/03/25/a-time-for-maps-sleeping-sickness/ <![CDATA[MSF and DNDi renew their call for funding for neglected disease research]]> Médecins Sans Frontières (MSF) and the Drugs for Neglected Diseases initiative (DNDi) have again called for more sustainable funding for research and development (R&D) to tackle the neglected infectious diseases of poverty, such as sleeping sickness, visceral leishmaniasis, and Chagas' disease. The two organizations argue that: "Although the global R&D landscape has improved for neglected diseases since 2003, the dire needs of the most neglected victims who carry on suffering in the developing world are still largely unmet." MSF has also announced its renewed operational and financial support to DNDi, a non-profit R&D organization co-founded by MSF and five public and private research institutes in 2003. DNDi has developed two fixed-dose combination treatments (ASAQ and ASMQ) for malaria without patent protection, resulting in medicines that are adapted to patient needs and can be sourced from several manufacturers. A sleeping sickness treatment has also provided promising results in a clinical trial. DNDi has in addition developed the largest-ever R&D portfolio for potential new treatments for sleeping sickness, visceral leishmaniasis and Chagas' disease. Further details are available in a press release. In a speech to The United Nations Economic and Social Council (UN ECOSOC), Sophie Delaunay Executive Director of MSF, USA, also spoke of the need for more funding, saying: "History has proven that when health threats are acknowledged and confronted, innovative and improved treatments usually follow despite tremendous scientific challenges. There is no choice but to massively scale up R&D for neglected diseases to save the countless lives being wasted by these ancient diseases." ]]> http://blog.tropika.net/tropika/2009/03/03/msf-and-dndi-renew-their-call-for-funding-for-neglected-disease-research/ <![CDATA[Innovations and lessons from history]]> Mobile phone technology helps contain disease outbreak. Of the diseases on the TropIKA.net priority list, it is tuberculosis that has been most in the headlines over the last few weeks. We have summed up some of the most important developments in our article, Tuberculosis profile rising. Malaria also receives more attention from the international media than was previously the case. The World Malaria Report for 2008 was reported by many newspapers worldwide and (as I write this latest Editor’s Choice column) news is coming in of agreement at the UN for major new funding for malaria control. However, the excitement over new developments and innovations should not mean that the lessons of history are forgotten – see Malaria control: ‘faulty intelligence’ led to mistakes. One such lesson is that gains made in infectious disease control so easily can be lost. Having brought rabies under control for several years, China now seems to be facing a resurgence of the disease – see Renewed rabies vigilance needed in China. The increasing number of dengue fever cases is a major problem affecting a much wider area. The situation in the Asia-Pacific region and also Latin America is of increasing concern. One recent research article that has been the subject of a commentary on TropIKA.net is a systematic review examining dengue outbreak prediction and detection tools – see What does dengue disease surveillance contribute to predicting and detecting outbreaks and describing trends? As well as commenting on recently published research article, TropIKA.net highlights review articles of particular importance. Sleeping sickness and Chagas’ disease are often featured on our knowledge platform and a recent review is relevant to both of them – see Trypanosomiasis vector control in Africa and Latin America. An infectious disease that also takes a major toll but which is often forgotten and has not previously appeared on TropIKA.net is bacterial sepsis – see Strategies to Reduce Mortality from Bacterial Sepsis in Adults in Developing Countries. >blog. Responses to what our bloggers are saying are always welcome. Paul Chinnock Editor-in-Chief, TropIKA.net]]> http://blog.tropika.net/editorschoice/2008/09/26/innovations-and-lessons-from-history/ <![CDATA[Infectious diseases of the nervous system: Pathogenesis and worldwide impact]]> Infectious diseases of the nervous system: Pathogenesis and worldwide impact is an international conference that will take place in Paris,10-13th September, 2008. The conference aims to gather a group of experts in a number of infectious diseases that attack our nervous system. The two keynote lectures on the opening day will be [The brain, Africa’s finest and most vulnerable product’ given by Professor Malcolm Molyneux of the Malawi-Liverpool-Wellcome Trust Clinical Research Programme in Blantyre, Malawi and ‘Community-based care for infectious diseases in rural areas of developing world’ given by Professor Paul Farmer, who is a Professor of Medical Anthropology at the Harvard Medical School and Director of Partners in Health Clinics in Haiti and Rwanda. The scientific programme includes the following lectures: ’Trypanosoma Brucei triggers its own multi-step entry into the brain’, by Krister Kristensson at the Karolinska Institute in Stockholm, Sweden; ’Importance of microvesiculation in the immunopathology of cerebral malaria’, by Professor Georges Grau of the Institute for Biomedical Research at University of Sydney, Australia; and ’Signaling mechanisms for survival of leprosy bacteria in the peripheral nervous system’, by Anura Rambukkana at Rockefeller University in New York, USA; among others. More information about the conference, including the complete scientific programme can be found on the conference website.]]> http://blog.tropika.net/tropika/2008/07/09/infectious-diseases-of-the-nervous-system-pathogenesis-and-worldwide-impact/ <![CDATA[Insect repellent makes humans disappear]]> A curious experiment recently published in Science magazine has unveiled the mechanism by which the popular DEET insect repellent works: to begin with, by not working as a repellent at all! A team of molecular neurobiologists at Rockefeller University, in New York City, has found out that, instead of repelling, DEET chemicals interfere with an insect’s olfactory capability, therefore masking the compellingly attractive body odours produced by humans. According to the study, during their target recognition flight – before choosing their victim for a juicy bloody meal – female mosquitoes usually sniff out the lactic acid in human sweat and the carbon dioxide and 1-octen-3-ol alcohol in our breath (present even among the most abstemious). It is somehow similar to when an illusionist like David Copperfield makes that huge airplane simply vanish in front of the eyes of his audience. The difference is that DEET acts through making us disappear from the insect’s ‘noses’, so to speak. Interesting as it may look, it is too early to say if these findings are going to lead to concrete developments that will protect people living in the poor areas of the world, where several insects are vectors for infectious diseases. So far, DEET-based and other repellents have been useful to tourists, explorers, soldiers and researchers, but the expense has put them beyond the reach of indigenous populations. Reference 1. Ditzen M, Pellegrino M, Vosshall LB (2008). Insect Odorant Receptors Are Molecular Targets of the Insect Repellent DEET. Science 319 (5869), 1471. DOI: 10.1126/science.1153121.]]> http://blog.tropika.net/tropika/2008/03/26/insect-repellent-makes-humans-disappear/ <![CDATA[Paul Ehrlich’s Nobel Prize centennial]]> What do the well-known concepts of chemotherapy, the ‘magic bullet’ and side-chain theory have in common? They were all coined by the same person, German scientist Paul Ehrlich (1854–1915), whose 1908 Nobel Prize in Physiology or Medicine centennial is being celebrated this year. His life was a bacteriologist’s dream come true. Recently graduated, Ehrlich was invited to work with Robert Koch on the newly discovered tubercle bacillus. Later he invented a precursor of the Gram staining technique for bacteria. Working together with Emil Adolf von Behring, he developed the diphtheria serum. He discovered the correct structural formula of Atoxil, thereby fostering better treatment for sleeping sickness (human African trypanosomiasis). He produced an effective drug for treating syphilis, illuminated the physiology of the blood-brain barrier, did experimental work on immunity to cancer tumours, and inspired research that led to the development of sulfa drugs, penicillin and other antibiotics. One way to celebrate his Nobel Prize centennial would be to watch the classic Warner Brothers black and white movie Dr Ehrlich’s Magic Bullet from 1940, depicting Ehrlich’s life and achievements, in which the great scientist is played by cult film noir actor Edward G Robinson. This is undoubtedly one of the great Warner screen biographies of famous scientists, along with The Story of Louis Pasteur, which gave Paul Muni the Academy Award for Best Actor in 1936. Films like these, although originally made as entertainment, could be a way to spread the ideas and instigate debate about the life and achievements of some of the great scientific minds of modern times – especially those who have helped in the fight against the infectious diseases of poverty.]]> http://blog.tropika.net/tropika/2008/03/25/paul-ehrlich%e2%80%99s-nobel-prize-centennial/ <![CDATA[TropIKA: an expanding resource]]> News section, where some 20 stories relevant to tropical disease have appeared. We hope soon to be publishing around 10 news stories every week. We have also had two excellent Editorial Opinion articles, which we hope will stimulate some productive controversy. The second of our series of interviews with leading figures in tropical disease research and control is about to go live in our Stakeholders section. There is also a short announcement about our plans to commission specially written articles for the Reviews section, which will play a central role in TropIKA.But TropIKA is not just a place where new articles are published. We seek to provide a portal that will allow anyone with an interest in tropical diseases to link to what is going on in this growing field. Thus, also within the last month, we have added links to recent Reports and Policy & Strategy documents published elsewhere. We are also starting to develop our Funding Opportunities section. Sometimes, one comes across an initiative that is particularly pleasing. A new addition to the websites listed in our Resources section is a case in point. The website http://www.tsetse.org/provides highly practical ‘information to assist in the planning and implementation of tsetse control operations’. It is very encouraging that neglected tropical diseases are not neglected on the World Wide Web but it is not always easy to track down what is out there. Helping link people to resources is a key part of what we do. Paul Chinnock - TropIKA, Editor in Chief]]> http://blog.tropika.net/tropika/2008/03/06/tropika-an-expanding-resource/ <![CDATA[Technology + Scientific knowledge = “Tech-knowledge”?]]> http://blog.tropika.net/tropika/2007/10/29/technology-scientific-knowledge-%e2%80%9ctech-knowledge%e2%80%9d/