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    Mosquitoes around the home can be reduced significantly by minimizing the amount of standing water available for mosquito breeding. Residents are urged to reduce standing water around the home in a variety of ways.


    The best way is to avoid being bitten by mosquitoes.This can be accomplished using personal protecting  while outdoors when mosquitoes are present. Treated bed nets should be used sleeping. Mosquito repellent should be used when outdoor.


    Nearly half of the world’s population is at risk of getting malaria. Pregnant women are particularly at risk of malaria. Children under 5 years are at high risk of malaria.


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  • Volume 1

3T: Test, treat and track

Once upon a time, there emerged an American Pop group known simply as the 3T. The trio featured the three sons of Tito Jackson (of Jackson 5 fame). The group was called 3T because the members had their first names starting with the letter ‘T’.

Today the global malaria community is reminded of a different kind of ‘three Ts’ to maintain the focus on the great killer disease. 

The World Health Organization’s (WHO’s) new initiative T3: Test, Treat and Track, urges malaria-endemic countries and donors to move towards universal access to diagnostic testing and antimalarial treatment to build robust control and surveillance systems.


RDT kit
“Until countries are able to test, treat, and report every malaria case, we will never defeat this disease,” says Dr Margaret Chan, WHO Director-General, who was in Namibia for World Malaria Day this year.

"We need strong and sustained political commitment from all countries where malaria is endemic, and from the global health community, to see this fight through to the end.”

This requires more commitment in many malaria-endemic countries in Africa where over 80% of cases are still being treated without diagnostic testing.

INESS and T3
INDEPTH Network Effectiveness and Safety Studies (INESS), a large scale study, is equally concerned about the testing, treatment and tracking of malaria.

It provides governments a platform for the universal roll out of T3. It entails the understanding of constraints, appreciation of key success factors and gives the opportunity for long term follow up to ensure success through synergies.

“WHO’s T3 strategy is a laudable approach for all countries” says Prof Alex Dodoo, the Director of the WHO Collaborative Centre for Advocacy and Training in Pharmacovigilance, University of Ghana Medical School.

He noted that INESS, which provides a platform to examine the real life safety and effectiveness of anti-malarials in several African countries, has a stable and reliable platform for understanding and expanding the roll out of T3.

Prof Dodoo said most ACTs on the market are efficacious, but estimated to be only 30 percent effective because of certain relevant issues including cost, adherence, provider behavior, acceptability, availability, quality and safety.

He said there is the need to examine why this happens within the context of the existing health system. A large scale real-life study holds the key but these are rarely done in Africa.

The launch of INESS fills this gap and will provide objective country-specific effectiveness and safety data to inform global and national policy and practice.

The Study focuses on systems and effectiveness, efficacy, access, targeting accuracy, provider compliance, adherence, acceptability, cost and cost effectiveness.

It also estimates the incidence of adverse drug reactions and provides safety information on high risk group from health facility and demographic surveillance systems (DSS) data linkage and to identify unexpected adverse events.

Among the benefits of INESS is a reduction of the time between the moment the new anti-malarial drugs are registered and introduced for use and this is done by generating large scale district-level effectiveness data for different antimalarial drugs.

It also aims at enhancing the capacity in Africa to monitor local health systems in order to track costs and effective coverage

INESS has met most of its key objectives. Studies involving amodiaquine+artesunate and artemether+lumefantrine are completed in Ghana and Tanzania.

There is no doubt that the universal diagnostic testing will ensure that patients with fever receive the most appropriate treatment, and that antimalarial medicines are used rationally and correctly.

But millions of people still lack ready access to appropriate treatment. The effort must be scaled up to ensure that every confirmed malaria case gets treated.

Artemisinin-based combination therapy (ACT)
Many countries have made significant progress in improving access to antimalarials. Governments are providing artemisinin-based combination therapies (ACTs) free of charge to all age groups.

The gains from these are self-evident in countries like Senegal where a scale-up of diagnostic testing is saving lives every year.

Improved surveillance for malaria cases and deaths will help countries determine which areas or population groups are most affected. It will also help ministries of health to identify resurgences and map new trends - thus maximising the efficiency of prevention and control programmes. Better surveillance will also allow for a more effective delivery of international aid programmes.

“T3: Test, Treat, Track aims to galvanize endemic countries and their partners to build on the success of malaria prevention efforts over the past decade,” says Dr Robert Newman, Director of WHO’s Global Malaria Programme.

“In recent years, there has been major progress in the development of new diagnostic tools and highly effective antimalarial medicines. The challenge now is to ensure these tools get used, and that countries accurately measure their public health impact.”

Malaria progress 2000-2010
During the past decade, global malaria prevention and control efforts have been scaled up, with notable progress in sub-Saharan Africa, where the vast majority of malaria cases occur.

The number of long-lasting insecticidal nets delivered to malaria-endemic countries in sub-Saharan Africa increased from 5.6 million in 2004 to 145 million in 2010.

Programmes to spray the interiors of buildings with insecticides were also expanded, with the number of people protected in sub-Saharan Africa rising from 10 million in 2005 to 81 million in 2010.

The availability of rapid diagnostic tests has made it possible to improve and expand diagnostic testing for malaria. The rate of testing - in the public sector in Africa - rose from less than 5% in 2000 to 45% in 2010.

Meanwhile, the number of ACTs procured worldwide by government health departments also increased exponentially: from 11 million in 2005 to 181 million in 2010.

However, malaria transmission still occurs in 99 countries around the world, and the malaria burden continues to cripple health systems in many African countries. In 2010, this entirely preventable and treatable disease caused an estimated 655 000 deaths worldwide. About 560 000 of the victims were children under five years of age, which means malaria killed one child every minute.

“Sustaining recent gains in Africa will require continued political commitment and funding,” said Dr Thomas Teuscher, Executive Director, Roll Back Malaria Partnership.

 "An estimated 3 million lives can be saved between now and 2015, if we continue to work in partnership and if governments in endemic countries redouble their efforts to provide people with essential health services.”

Despite significant progress in the last decade, malaria continues to exert a significant health and cost burden in Africa and still contributes to under-development

It stands to reason therefore that governments increase support for malaria eradication efforts bearing in mind that WHO’s T3 strategy is a laudable approach for all countries to test, treat and track malaria.

- By Becky Kwei – Ghana



Iness Edition