Focus on VSO Malawi: their humanitarian projects

Our partnership with VSO Malawi (Voluntary Service Overseas) is becoming more concrete as they are carrying on a comparative study using the xRapid-Malaria app. The purpose of this study is to assess the accuracy of the xRapid-Malaria diagnostic test in comparison to the traditional microscopy diagnostic. Three main parties are working alongside on this project: VSO Malawi, xRapid and medical institutions such as CHAM (Christian Health Association of Malawi) and the College of Medicine. By now, 23 lab technicians have been recruited by VSO Malawi to enable the accomplishment of the study and ultimately to fight malaria. We will communicate on the results by the end of April.

As a major charity, VSO Malawi is currently leading other projects in three main fields: Education, Health and Secure Livelihoods. For each field, the NGO is investing a lot of efforts to make Malawi a better place to live in.

VSO’s Education program is made of many projects but one main goal remains: making sure children can read and enumerate. 68 teachers have been taught how to use digital education technology (using iPads app). It resulted in improving learners’ global skills, increasing enrollment, assessing them in a better way and enhancing individual help. They also trained key players at the district level on budget management to help them register a visible impact on the education they provide.

VSO’s Health program comprises different projects which all aim to improve Malawians’ health practices, especially women’s and prisoners’. Aside from the comparative study with xRapid-Malaria, VSO Malawi has a major role in local prisons. The NGO is mainly active in four prisons in the country (prisons for women, youth and mixed ones). They are working to improve the prisoners’ nutrition and provide them with HIV tests and treatments. Furthermore, they chose to anticipate the prisoners’ release by training warders to conduct psychological sessions.

VSO’s Secure Livelihoods program directed most of its effort towards making communities resilient to climate change and improving communities’ economic status. They organised focus group discussions that involved several stakeholders in the organic coffee value chain (including the Government of Malawi as well as 98 farmers and other main stakeholders). Their goal is to improve market access for the poorest.

“As Malawians cut many trees for charcoal production purposes, we are trying to improve environmental awareness in local communities”

VSO seeks to have a strong impact on environment in Malawi. “As Malawians cut many trees for charcoal production purposes, we are trying to improve environmental awareness in local communities” said Anock Kapira, Head of Program at VSO Malawi. Simultaneously, they started a tree plantation program to replace trees that had been cut down.

Even if the country is politically and socially stable, VSO Malawi is redoubling its efforts to improve significantly the standards of living for local communities in the south-east African country. At xRapid, we are very proud to contribute to their Health Program by providing them with a way to prevent and eradicate malaria, and thus, save lives. We would like to thank Anock Kapira, from VSO Malawi, for his contribution to this article.

xRapid installs its R&D Centre in the south of France

xRapid has chosen to install its R&D Centre within the business incubator of the prestigious french engineer school “École des Mines de Saint-Étienne” in Gardanne, near Marseille.

“It’s a dynamic economic environment that relies on a strong industrial base and school talents, just one hour away from London” explained Jean Viry-Babel, xRapid’s CEO.

Installing xRapid’s labs on a school campus is an excellent overall strategy for the internationally based startup. Indeed, it allows them to have access to a wide range of scientific equipment, along with fully motivated and highly qualified students.

The offices opened in October 2016 and the team now consists of two full-time researchers, one assistant and five engineer students actively working on xRapid’s applications. The R&D team is currently developing a new product. We will let you know more about this project in due time…

 

Malaria & Poverty : a vicious cycle

Malaria is one of the most important challenges to global public health and is often referred as the epidemic of the poor. Whilst the disease is in large part determined by climate and ecology, and not to poverty per se, the impact of malaria takes its toll on the poorest. Recent studies estimate that the disease costs Africa $US 12 billion in lost Gross Domestic Product. Countries with high malaria transmission have historically had lower economic growth than in countries without malaria.  Their economy growth slows by 1.3% per year as a result of lost life and low productivity.

The direct cost includes high public expenditure to attempt to maintain health facilities and infrastructures, manage effective malaria control campaigns and provide public education. Malaria costs are also widely felt as workers productivity lowers with increased sick leave, absenteeism and premature mortality of the workforce. The disease is as much burdensome for families and households. According to the European Alliance Against Malaria “The permanent neurological and physical damages caused by severe episodes of the disease hamper children’s schooling and their general well-being. They can directly affect their education and ability to learn in later life.”

Malaria and poverty constitute a vicious cycle. These two plagues need to be tackled together. Social and economic conditions need to be addressed while malaria control should be seen as a poverty reduction strategy.

A look back at one year of xRapid in Papua, Indonesia

In a recent interview, Digicape Managing Director Robin Olivier stated that his company, xRapid’s distributor in South Africa, “is proud to be supporting the innovative work that xRapid has put into developing the solution that is so simple to use but also empowering to the health care and aid workers, patients, families, and communities”. In order to develop a product that is tuned to its user, xRapid works indeed in close partnership with early adopters.

In a previous post, xRapid introduced you to a health practitioner who work in Papua, the easternmost province of Indonesia. Despite the unfavourable environment:  unstable internet, short medical supplies, no infrastructures, the nurse is still providing health care services to the local communities. One year ago, she decided to fight malaria on a deeper level by incorporating xRapid-Malaria into her daily nurse routine.

The automated diagnostic test is particularly helpful in times of emergency or epidemic, as it is right now in the era. Malaria cases have been increasing due to the strike of a strep infection which weakens the immune system. The nurse declared that while she was diagnosing one of her patient with the automated diagnostic test: “In one of the fields (out of 10) the malaria parasite total was 900. Yes, the patient was very ill. Most of my patients of last week came up positive for P. falciparum”.

xRapid in Papua

As usual, she was the first to test the new version of xRapid-Malaria. She thought that the thick smear option was more fitted to her work. “Well, I was never an expert at doing a thin blood slide, so it’s great to have the option of a thick smear. It works way better for me as I run a clinic, where people are not just sick with malaria. It allows me to process the slides later one; as opposed to being a lab technician who can process the slides immediately.”.

We look forward to collaborating with her on the future versions of xRapid-Malaria app.

To be continued…

Malaria control initiatives: a focus on Tanzania

Malaria is a major public health problem in Tanzania, all residents are at a risk of infection. WHO estimates that 60 000 to 80 000 malaria deaths occur annually, among all ages.

Tanzania has long been committed to the fight against this dreadful disease, especially in the semi-autonomous region of Zanzibar. Since 2006, the prevalence of malaria dropped from 25 to less than 1 percent in the archipelago thanks to malaria control projects such as those initiated by the US President Malaria Initiative (PMI). Programs initiated in Tanzania focused mainly on Diagnosis and treatment, 30% of the malaria control allocation (2000-2010), as well as the delivery of Insecticide-Treated Nets (ITNs), 48%.

Through collaboration with the private sector and nongovernmental organisations (NGOs), the Ministry of Health and Social Welfare created a system of producing and distributing mosquito nets to reach the whole country, whose efficiency has been recognised by its peers.

Nets showed great results in preventing malaria but International Organisations such as WHO stress the importance of implementing accurate, cheap and easy-to-use drugs as well as diagnostic tools to end malaria for good. Tanzania took action on this issue since the second objectives of the National Malaria Strategic Plan (2014-2020) is to “Prevent the occurrence of severe morbidity and mortality related to malaria infection through the promotion of universal access to appropriate early diagnosis, prompt treatment, and provision of preventing therapies and vaccines to vulnerable groups.” To achieve this goal, the government, NGOs, researchers as well as the private sector have to work closely so that Tanzania can enforce the best solutions. With its automated malaria diagnostic test, xRapid can be part of the answer.

Anti-malarial drug resistance on the Thai-Myanmar border

Malaria is a treatable disease, but in a certain part of South East Asia anti-malarial drugs are becoming less effective as time passes by.

Wellcome, a British biomedical research charity conducted a study on the Thailand-Myanmar border in partnership with Shakolo Malaria Research Unit thai staff working at SMRU on drug resistance(SMRU) clinics. After 10 years and 1.005 patients with uncomplicated Plasmodium Falciparum, the researchers have found that genetic mutations in the kelch gene of the malaria parasite have made the parasite resistant to the anti-malarial drug mefloquine and the drug artesunate. These drugs are typically used in the Artemisinin-based Combination Therapy also known as ACT. It “means that the first-line ACT introduced here in 1994 has finally fallen to resistance.” said Professor Francois Nosten, Director of SMRU. This resistance poses a serious threat to the control and eradication of malaria in the area.

Malaria has been eliminated in most part of the Mekong region but remains a threat along the borders of Myanmar and Thailand. In addition to being heavily forested, the area sees a lot of migration and the few health workers can’t always reach everyone. This lack of human resources, as well as the shortage of reliable microscopic facilities, is one of the main cause of drug resistance. To counterbalance this insufficiency, the study conducted by Nyunt MH* reveals that health providers are mostly using Rapid Diagnostic Tests (RDTs). “However, challenges, including problems of distribution for widespread adoption of diagnostics by RDTs have been reported in many other countries, as has variability in the quality of performance of RDTs, including sensitivity, specificity, heat stability and longevity.” (Ibid.). Inaccuracy in diagnosis leads to overtreatment and treating cases without malaria. This use of ACT contributes to the emergence and the spread of drug-resistant strains.

Easy, accurate and fast diagnosis is the gateway for effective malaria treatment as well as a measure to limit unnecessary drug administration. On top of staff education and drug research, the diffusion of diagnostic tools such as xRapid-Malaria could be the solution for drug resistance. According to xRapid’s early user in Papua Indonesia, being able to use the automated diagnostic app “to know if malaria is involved helps relieve some of my stress when trying to treat patients with limited diagnostic resources, plus appropriate treatment can be given.”

*Nyunt MH and al., 2016, “Challenges Encountered by Local Health Volunteers in Early Diagnosis and Prompt Treatment of Malaria in Myanmar Artemisinin Resistance Containment Zones”, Malaria Journal

Malaria is expected to be eliminated by 2040

World health experts consider that a malaria free world is possible within a generation. According to the World Health Organisation (WHO) report “Global Technical Strategy for Malaria 2016-2030”, by 2020, six countries in Africa are already expected to be malaria-free: Algeria, Botswana, Cape Verde, Comoros, South Africa and Swaziland.

Since 2000 great progress has been made around the globe, driven by the technological progress made by eliminating countries, donors, partners and the private sector. The WHO report states that the use of insecticide-treated bed nets, regular bug spraying inside houses and rapid diagnostic testing, such as RDT and xRapid-Malaria, have led to a rapid decline of the infection rates.

Winnie Mpanju-Shumbusho, the retired assistant director-general for malaria at WHO said it was crucial that the African continent took advantage of the technological opportunities now present to fight and eradicate the disease. Doctor Pedro Alonso, director of Global Malaria Programme at WHO added: “New technologies must go hand with strong political and financial commitment”.

Malaria is a preventable disease. Technological tools such as the automated diagnostic app helps people find it, track it and eliminate it.

Malaria free world by 2040

Source: http://www.shrinkingthemalariamap.org/

Click on the picture to see the evolution over time, from 1900 to 2040.

A look back at 9 months of xRapid in Papua Indonesia

For the past nine months, xRapid has been assisting two health workers in their daily work life in Papua, the easternmost province of Indonesia. Due to the hot humid climate, the island is endemic to malaria. The whole population has been affected by the Plasmodiumparasite, mainly vivax and few falciparum.

In order to fight this deadly disease, these health workers have reached us through our Indiegogo campaign “End Malaria on Bangka Island, Indonesia” back in 2015. Shortly after, in November, they received a protocol training in Jakarta with xRapid’s CTO Professor David Mendels and started diagnosing patients two months later.

Early diagnosis is the gateway for effective malaria treatment, and thanks to xRapid the nurse was able to save a three days old baby. The newborn wasn’t feeling well, could not eat and had a fever. Even though it is unlikely that babies are born with malaria, the nurse still decided to test her with the automated diagnostic app and the result was positive. Without xRapid, the little girl wouldn’t be alive today.

Being able to use xRapid to know if malaria is involved helps relieve some of my stress when trying to treat patients with limited diagnostic resources, plus appropriate treatment can be given.” – Nurse

As early adopters these health workers helped us adapt our protocol to harsh conditions. “The nurse doesn’t have access to many medical consumables, thanks to her we discovered that we can make the hemolysis with just water instead of the Saponin solution. The slides are less clear of course, but the app can still run and identify the parasites.” – Pr David Mendels, xRapid’s CTO.

We hope that these health workers keep saving many other lives.

xRapid saved a 3 days old baby in Papua

Hopes for a malaria vaccine are still up

New weapons are arriving to aid the fight against malaria, among them a vaccine that could eventually protect millions from infection.

After 30 years of development by GlaxoSmithKline, the Mosquirix vaccine, also known as RTS,S, was endorsed last year by the European drugs regulator and the World Health Organization (WHO). The data from the clinical trial show that malaria cases were reduced by between a third and a half in children aged 5 to 17 months which is lower than other vaccines.

Even if the first generation vaccine did not reach its full potential, WHO stays positive. The organization insures that the vaccine could prevent up to 700 deaths per 100,000 vaccinations amounting to a “significant health impact”. In order to test RTS,S in real life conditions, WHO has ordered 5 pilot programs to take place in Sub-saharan Africa.

xRapid, the mHealth App, has followed with interest the development of this vaccine. Jean Viry-Babel, xRapid’s CEO is “thrilled by the progress of RTS,S. Our fast, accurate and inexpensive diagnostic app is the perfect companion for the deployment of this first parasitic vaccine as we can provide blanket diagnostic at very low cost and very high accuracy virtually everywhere”.

More so because the xRapid malaria diagnostic has geolocation capability, and “we have always seen it as an enabler for targeted vaccination campaigns.Current vaccines have a peak efficiency of 6 months. Combining RTS,S with first hand knowledge of the seasonality and type of malaria could really optimize its effects” – Professor David Mendels, xRapid’s CTO.

Zika outbreak: what you need to know

Zika virus is a rapidly emerging vector-born flavivirus, with potential to spread to new areas where the vector Aedes mosquitos are present.

In May 2015, autothchronous circulation of Zika virus was confirmed in 2 Brazilian states. In October 2015, Brazilian health officials from the state of Pernambuco reported an unusual increase in the number of cases of microcephaly in newborns, and on 11 November 2015, the Ministry of Health declared a public health emergency, establishing an emergency operations centre and deploying surveillance and response teams. Zika virus is now confirmed to be circulating in 21 states, and is estimated to have infected between 440,000 to 1,300,000 people in Brazil in 2015.

As of 23 January 2016, 4,180 cases of microcephaly have been reported from 21 Brazilian states – more than a 20-fold increase compared to the average number of annual cases reported from 2010-2014.

Between 19 November 2015 and 19 January 2016, 23 countries reported autochthonous cases of Zika virus infection: Barbados, Bolivia, Brazil, Cape Verde, Colombia, Ecuador, El Salvador, French Guiana, Guadeloupe, Guatemala, Guyana, Haiti, Honduras, Martinique, Mexico, Panama, Paraguay, Puerto Rico, Saint Martin, Samoa, Suriname, Thailand and Venezuela.