Professor Leanne Robinson at work in Papua New Guinea (Image credit: Mayeta Clark)
The emergence of new diagnostic tools and treatment strategies are positive developments in the challenge to control Plasmodium vivax, the dominant malaria parasite throughout the Asia-Pacific and South American regions.
Burnet Institute scientists are playing an important role in helping to generate evidence on the operational feasibility of these new tools and assess their public health benefits and cost-effectiveness.
Almost 40 percent of the world’s population is at risk from P.vivax, which is more difficult to control than P.falciparum malaria due to its ability to hide undetected in the human liver before reactivating weeks or months after the initial infection.
Treatment for P.vivax is complicated by the fact that the available medications, primaquine and tafenoquine, can induce potentially fatal haemolysis in patients who are deficient in the enzyme glucose-6-phosphate dehydrogenase (G6PD).
G6PD deficiency is the most common human enzyme deficiency in the world and most prevalent in malaria endemic areas where treatment for P.vivax is most needed.
“The need for accurate and easy-to-use G6PD diagnostics is extremely high,” , Burnet Institute Program Director Health Security and Group Leader, Vector Borne Diseases and Tropical Health, said.
“We are involved in a in Papua New Guinea to assess the feasibility of using newly developed G6PD point of care tests to determine who can safely be administered higher, more effective doses of primaquine.”
Professor Robinson noted, however, a challenge to accessibility.
“The currently available tests are going to be able to implement in provincial hospitals or large health facilities because they are instrument-based and require training and ongoing support, but this is not always where they’re most needed,” Professor Robinson said.
“In many countries in the region and in particular in Papua New Guinea, the populations that suffer the largest burden of vivax are remote communities who only have access to an aid post or small community health centre.
“So, there’s a real need to establish the feasibility of testing while continuing to develop and evaluate easier-to-use field-deployable rapid tests to ensure that populations that suffer the burden of vivax can safely receive effective treatment.”
To achieve this will require key stakeholders globally – from governments and funding bodies, to community organisations, industry and civil society organisations – to work in partnership for the elimination of malaria.
“On , my message is that we need to work together, work harder and smarter to implement the malaria control tools that we already have, while looking to integrate new tools and strategies for diagnosis, treatment, and surveillance of malaria to have an even bigger impact,” Professor Robinson said.
“We need to not only sustain malaria control, but also accelerate to elimination and the only way to achieve that is by working in partnership and supporting country-led approaches to strengthening control, and ensuring that communities drive the implementation and uptake of effective interventions.”
The estimates malaria caused 627,000 deaths in 2020 from an estimated 241 million cases worldwide.
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