geoffrey modest medical blogs

Overall, the results are pretty miserable for medication adherence to malaria prophylaxis in long-term travelers to malaria-infested areas. A recent article found that twice-a-week prophylaxis with atovaquone – proguanil (Malarone) was very effective (see   malaria prophylaxis malarone biw jtravelmed2016  in dropbox, or doi: 10.1093/jtm/taw064) ​. Details: -- an observational study was conducted in two sites in West Africa: the jungle in Angola and a medical station in Equatorial Guinea. -- Angola: 14 male expatriates, median age 24, working in the jungles of Angola for 16 months. During the first six months, all refused malaria prophylaxis, and eight developed malaria, 2 with severe cases. They then accepted twice weekly AP (atovaquone-proguanil), given through directly-observed therapy. -- Equatorial Guinea: 108 medical staff and families (50% male, age range 1.5 to 71 with 28 < 12 years old, mean stay 19.5 months. 49 declined malaria prophylaxis, 40 receive...

There was a recent systematic review and meta-analysis of the relationship between the risk of malaria in kids <16 yo and socioeconomic status  (see  malaria and SES lancet 2013  in dropbox, or  http://dx.doi.org/10.1016/S0140-6736(13)60851-X) .  15 studies are included in the meta-analysis. --Baseline data:     --2.57 million people were at risk for falciparum malaria in 2010, a huge global public health issue.     --Both national income and rates of economic growth are lower in malaria endemic countries than in countries where it is not endemic     --an intervention which decreases malaria 10% is associated with a 0.3% increased economic growth (ie bad cycle: poor areas have more malaria which decreases economic growth).     --Using a medical/pharmacologic approach to decrease malaria inevitably leads to resistant strains of mosquitoes and malaria paras...