Mosquitoes cling to the inside of a jar loaded with repellent during a test as part of a tour of the Center for Disease Control laboratory, Thursday, April 4, 2024, in Fort Collins, Colo.
| Photo Credit: AP

The spread of the mosquito species Anopheles stephensi across Africa poses a significant problem to a continent already heavily burdened by malaria. Most – 90% – of the world’s malaria deaths are on the continent.

Researchers from Djibouti reported the presence of An. stephensi in the Horn of Africa in 2012. Until then it had not been found in Africa although it was known to be widespread in Southeast Asia and parts of the Arabian Peninsula. By 2017 it had spread through the Horn of Africa, reaching Ethiopia, Somalia and Sudan.

The spread of An. stephensi is particularly concerning because the mosquito has a number of characteristics that make it difficult to control. This species can thrive in urban areas and likes being near humans. They lay their eggs in any available water source – such as water containers, abandoned tyres and flowerpots – and their eggs can survive being dry for a long period of time. In addition, An. stephensi feeds on its vertebrate host both indoors and outdoors. This reduces the impact of commonly used vector control methods such as insecticide-treated nets and indoor residual spraying.

The invasion of this urban mosquito into Africa threatens the malaria elimination aspirations of the continent, particularly as 42.5% of Africa’s population now live in urban areas.

As a result, national malaria control programmes have increased surveillance efforts in urban areas to enable early detection and control. Countries have also run awareness campaigns to encourage communities to reduce potential breeding sites.

The species has not yet been detected in southern Africa. Nevertheless the South African national malaria control programme, with the support of the National Institute for Communicable Diseases, is increasing surveillance activities in areas where this species may occur.

Invasive species

Many epidemics and pandemics have been driven by pathogens, hosts and vectors invading new areas. These include the Black Death in 14th century Europe, caused by the invasion of rats carrying fleas infected with the plague.

The Asian tiger mosquito (Aedes albopictus) and the yellow fever mosquito (Aedes aegypti) both carry dangerous diseases such as dengue, yellow fever and Zika. The spread of these mosquito species into North America and Europe during the 1970s and 1980s was associated with large increases in these diseases.

While Aedes mosquitoes transmit viral diseases, Anopheles mosquitoes transmit malaria. Of the 500 Anopheles species, only 30-40 can spread malaria. Common species that transmit malaria in Africa are Anopheles gambiae, An. arabiensis and An. funestus.

Anopheles gambiae is one of the most effective malaria vectors in the world. It invaded South America in the 1930s. This species rapidly established itself in Brazil, causing a malaria epidemic with an estimated fatality rate of 13%. Anopheles gambiae was eventually eliminated from Brazil in the 1940s after a highly co-ordinated and resource-intensive effort.

Anopheles stephensi is a malaria vector native to South Asia. It transmits both Plasmodium falciparum and P. vivax. It rapidly adapts to changes in the environment and is found in both rural and urban areas. This is different from African malaria vectors, which are typically found in rural areas.

Controlling this invasive mosquito is very challenging. It is difficult to find, particularly in urban areas, and is resistant to a number of insecticides. Although there are no specific programmes to eliminate this species from Africa, the affected countries are implementing a range of control measures.

Urgent action

The presence of An. stephensi in Africa is a call to action to all interested in controlling and eliminating malaria.

It is imperative that entomological surveillance (the search for and biological investigation of insects, including malaria vectors) is strengthened across the continent. New information about the species must be shared promptly to ensure malaria control programmes use the correct methods to prevent it from spreading further into the continent.

And an integrated approach to vector control is urgently required. Vector control measures, adapted to local conditions, are key to preventing the spread of An. stephensi. National malaria control programmes cannot rely solely on insecticides to control this mosquito. They must invest in novel vector control methods that target outdoor-biting mosquitoes.

Governments must also invest in educating communities on the appropriate methods for storing water as well as eliminating potential breeding sources. South America has implemented strong policies to reduce breeding areas for Aedes mosquitoes. Similar approaches in Africa would reduce the presence of An. stephensi, as well as of Aedes mosquitoes, which carry many dreaded diseases including dengue, yellow fever, chikungunya and Zika.

Crucially, a healthy population without circulating parasites is key to a malaria-free future. Integrating clinical care, vector control and community awareness of the disease is the best way to ensure a malaria-free future for the continent.

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Twelve breast cancer genes identified in women of African ancestry in a large study published on Monday may one day help better predict their risk for the disease and highlights potential risk differences from women of European descent.
| Photo Credit: Getty Images/iStockphoto

Twelve breast cancer genes identified in women of African ancestry in a large study published on Monday may one day help better predict their risk for the disease and highlights potential risk differences from women of European descent.

Studies to identify genetic mutations linked with breast cancer have previously mainly focused on women of European ancestry.

The new findings are drawn from more than 40,000 women of African ancestry in the United States, Africa and Barbados, including 18,034 with breast cancer.

Some of the mutations identified had not previously been linked with the disease, or were not as strongly linked as in this new analysis, indicating that genetic risk factors “may differ between females of African and European ancestry,” the researchers wrote in Nature Genetics.

One newly identified mutation in particular was linked with the disease with a strength “rarely observed” in the field of cancer genetics, the researchers said.

Certain other genes known to increase breast cancer risk in white women were not associated with the disease in this study, the report also noted.

Black women in the United States have higher rates of breast cancer before age 50, a higher incidence of harder-to-treat breast cancers, and a 42% higher breast cancer death rate than white women, according to the American Cancer Society.

Adding the newly identified genes to previously recognized breast cancer genes such as BRCA1 and BRCA2 that are linked with the disease in all populations, the researchers developed a breast cancer risk score for women of African ancestry that was significantly more accurate than currently available tools, they said.

Six of the abnormal genes were associated with an elevated risk for so-called triple-negative breast cancer, the most aggressive form of the disease. Black women have nearly a three-fold increased risk for this type of breast cancer compared to white women, previous research has shown.

Women in the study carrying all six genes were 4.2 times more likely to be diagnosed with triple-negative breast cancer than those with none or only one of the variants, the study found.

The usefulness of the new variants needs to be further evaluated before testing for them becomes routinely available, said study leader Dr. Wei Zheng of Vanderbilt University Medical Center in Nashville.

The American Cancer Society says many genetic mutations previously identified as breast cancer risk factors in white women are also strongly linked with disease risk in Black women, and advises genetic testing for all patients regardless of race.

But U.S. Black women are less likely than white women to undergo breast cancer genetic testing, largely owing to differences in physician recommendations or access to care, the society notes.

This 2014 photo made available by the U.S. Centers for Disease Control and Prevention shows a feeding female Anopheles gambiae mosquito.
| Photo Credit: AP

Malaria incidents are on the rise. There were 249 million cases of this parasitic disease in 2022, five million more than in 2021. Africa suffers more than any other region from malaria, with 94% of cases and 95% of deaths worldwide.

This year two revolutionary malaria vaccines are being rolled out across the continent. Nadine Dreyer asks Jaishree Raman if 2024 will be the year the continent takes a significant leap towards beating the disease.

The RTS,S malaria vaccine

The RTS,S vaccine was the first to target a parasite. It was developed by the Walter Reed Army Research Institute after 30 years of intense research and approved by the World Health Organization in 2021.

R21/Matrix M

After decades of vaccine research, a second malaria vaccine was approved just two years after the RTS,S vaccine. The R21/Matrix is a second-generation RTS,S vaccine. It was developed by Oxford University’s Jenner Institute and approved by the WHO in October 2023.

No silver bullet

While the fight against malaria has been significantly bolstered by the availability of these vaccines, they are not the silver bullets that are going to get us to an Africa free of malaria.

They are, nonetheless, a welcome addition to the malaria elimination toolbox and ideally should be used together with other control strategies like long-lasting insecticide-treated bed nets, rapid diagnosis, and treatment with an effective antimalarial.

This will be the year that many vulnerable young African children will have access to not one, but two malaria vaccines.

Many tiny organisms including bacteria, fungi and viruses normally live on our bodies, and even inside us. These are called the microbiome. The large number of these organisms living in the gastrointestinal tract are collectively known as the gut microbiome.

Increasingly the gut microbiome is recognised as playing a large part in health and disease, particularly relating to human physiology, metabolism and immune function.

There are now more than 700 published papers looking at the interaction between COVID and the gut microbiome. Many of these studies demonstrate the possible contribution of gut bacteria to COVID infection and severity, as well as the effect COVID (and its treatment) potentially has on our gut bacteria.

Now, a new study has found severe COVID may be related to fungal bugs in our gut microbiome. This could be through a variety of changes to the immune system in response to specific fungal species.

Also Read | Humans evolved with their microbiomes – like genes, your gut microbes pass from one generation to the next

What the study did

Fungal organisms in the microbiome are referred to as the fungal microbiota, or mycobiota. While it’s normal to have a range of fungal organisms in the gut, changes in the types or amount can be linked to disease, just like with variations in gut bacteria.

In the study published in Nature Immunology, the researchers investigated the possible relationship between mycobiota and COVID in a few different ways.

First, they compared patients with and without COVID, looking at the levels of certain fungal organisms in samples from their gastrointestinal tracts. This included 66 people with severe COVID, 25 with moderate COVID and 36 without COVID.

The researchers also measured antibodies in the participants’ blood against these same organisms, which lets us know that they triggered an immune response.

Explained | How does the gut microbiome link to autism spectrum disorders?

To investigate further, the researchers conducted experiments in mice. They gave the mice some of the fungal organisms taken from COVID patients and measured some of the same outcomes, including antibodies in the blood. They also looked to see if certain treatments, such as antifungals, would make a difference.

While this isn’t the first study looking at gut mycobiota and COVID, it’s very comprehensive and reports some interesting findings.

What the study found

The researchers detected a greater amount of fungal organisms in patients who had COVID compared with controls who did not.

Antibodies to certain fungi were also heightened in the blood of COVID patients. In other words, the presence of these fungal organisms and an associated immune response seems to be linked to a more severe COVID infection. In particular, two Candida species and S. cerevisiae were linked to disease severity.

When the researchers isolated live fungi from fecal samples of COVID patients, Candida albicans was common in the gut of patients with COVID, and its growth correlated with more severe disease.

Also Read | COVID and your gut: How a healthy microbiome can reduce the severity of infection – and vice versa

To look at the impact of these fungal species on immune responses, mice were colonised with Candida strains isolated from the COVID patients.

The researchers found older mice who were colonised with C. albicans and then infected with COVID showed a very different immune response compared to mice that weren’t given the Candida fungus. This included having more immune cells called neutrophils in the blood and increases in other markers of inflammation including in the lungs.

Some of these changes were partially resolved with anti-fungal treatment or other specific anti-inflammatory medications that have shown benefit in COVID patients.

Some limitations

All of this suggests variations in the mycobiota may contribute to the excessive inflammatory immune response seen in severe cases of COVID. A link between the fungal microbiome and inflammation isn’t completely new – other studies have shown an impact on inflammatory conditions linked to similar changes in the mycobiota.

As with all studies, there are some limitations to consider here. First, the number of human participants was relatively low, with only 91 patients with COVID included, and 36 in the control group. Many parts of the study analysed even smaller groups of patients or patient samples.

Also Read | Are you sure you contain 10x as many microbes as human cells? 

Second, the study was conducted in 2020 during the first wave of COVID infections. A lot has changed since then including the virus itself. And most people have now not only been vaccinated but also previously exposed to the virus.

Nonetheless, this study raises many possibilities including perhaps being able to look at who might be a greater risk of more severe COVID based on their mycobiota. There may even be a possibility of trying to change the mycobiota to reduce the risks from COVID infection. But to get to these points we need a lot more research.

There are multiple factors that determine the make-up of our microbiome, including mycobiota. These are likely to include diet and lifestyle factors alongside other factors like medical conditions and treatments, such as antibiotics.

At this stage there are fewer proposed interventions for influencing mycobiota than for gut bacteria. But studies such as this one demonstrating the importance of the fungal bugs in our gut will hopefully lead to more research in the area.

Laura Jackson became seriously concerned about her daughter and math when the girl was in third grade. While many of her classmates flew through multiplication tests, Jackson’s daughter relied on her fingers to count, had difficulty reading clocks and burst into tears when asked at home to practice math flashcards.

At school, the 9-year-old had been receiving help from a math specialist for two years, with little improvement.

“We hit a point where she was asking me, ‘Mom, am I stupid?’” Jackson recalled.

One day, when having lunch with a friend, Jackson heard about a disorder known as dyscalculia. She later looked up a description of the learning disability that impacts a child’s ability to process numbers and retain math knowledge. “I was like, ‘Oh my gosh, this is my kid,’” Jackson said.

Nationwide, hundreds of thousands of students face challenges learning math due to disabilities like dyscalculia, a neurodevelopmental learning disorder caused by differences in parts of the brain that are involved with numbers and calculations. There are often obstacles to getting help.

America’s schools have long struggled to identify and support students with learning disabilities of all kinds. Kids often languish while waiting to receive a diagnosis; families frequently have to turn to private providers to get one; and even with a diagnosis, some schools are unable to provide children the help they need.

That’s slowly changing — for some disabilities. Most states have passed laws that mandate screening early elementary students for the most common reading disability, dyslexia, and countless districts train teachers to recognize struggling readers. Meanwhile, parents and experts say schools neglect students with math disabilities like dyscalculia, which affects up to 7% of the population and often coexists with dyslexia.

“There’s not as much research on math disorders or dyscalculia,” as there is on reading disabilities, said Karen Wilson, a clinical neuropsychologist who specializes in the assessment of children with learning differences. “That also trickles down into schools.”

Also Read | Gene responsible for neurodevelopmental disorders identified

Math scores in the U.S. have remained dismal for years and only worsened during the COVID-19 pandemic. Learning struggles for some may be due to dyscalculia or other math learning disabilities, yet few teachers report their students have been screened for dyscalculia.

Experts say learning the most effective methods for teaching students with math disabilities could strengthen math instruction for all students.

“If it works for the students with the most severe disconnections and slower processing speeds, it’s still going to work for the kids that are in the ‘middle’ with math difficulties,” said Sandra Elliott, a former special education teacher and current chief academic officer at TouchMath, a multisensory math program.

Some signs of dyscalculia are obvious at an early age, if parents and educators know what to look for. Young children might have difficulty recognizing numbers or patterns. In elementary school, students may have trouble with math functions like addition and subtraction, word problems, counting money or remembering directions.

Explained | How can you know if your child has autism?

Even after Jackson learned about dyscalculia on her own, her daughter’s Seattle-area public school was doubtful the third grader had a learning disability because she was performing well in other areas. Teachers suggested Jackson spend extra time on math at home.

“For so many parents, they assume the school would let them know there’s an issue, but that’s just not how it works,” said Jackson, who ultimately wrote a book, Discovering Dyscalculia, about her family’s journey.

Students with dyscalculia often need a more structured approach to learning math that involves “systematic and explicit” instruction, said Lynn Fuchs, a research professor in special education and human development at Vanderbilt University.

Part of the problem is that teachers don’t receive the training needed to work with children with math disabilities. At least one state, Virginia, requires dyslexia awareness training for teacher licensure renewal, but has no similar requirement for math disability training.

Also Read | How Immersive Technology can help students with learning disabilities 

“It’s pretty rare for undergraduate degrees or even master’s degrees to focus on math learning disabilities with any level of breadth, depth, quality or rigor,” said Amelia Malone, director of research and innovation at the National Center for Learning Disabilities.

Without more widespread knowledge of and support for dyscalculia, many parents have had to look for specialists and tutors on their own, which they say can be particularly challenging for math, and costly. In 2019, Jackson started pulling her daughter out of school for part of each day to teach her math at home.

“I am not a math teacher, but I was so desperate,” Jackson said. “There’s no one who knows anything, and we have to figure this out.”

At the tutoring organization Made for Math, specialists have found children with dyscalculia need repetition, especially to understand math facts. Some students attend tutoring up to four days a week, at a cost of up to $1,000 a month.

“It’s hard because it’s not something schools are offering, and kids deserve it,” said Heather Brand, a math specialist and operations manager for the organization.

Also Read | The book ‘Take Time’ attempts to be a guide to different kinds of learning disabilities

There are pockets of progress around the country in screening more children for math disabilities, but movement at the federal level — and in most states — is “nonexistent,” said Malone, of the National Center for Learning Disabilities.

New York City is one district that has prioritized math disability screening and math instruction in the early years. In 2015 and 2016, the city spent $6 million to roll out a math curriculum featuring games, building blocks, art projects and songs. The district has also introduced universal math and reading screeners to try to identify students who may be behind.

There are ways that all schools can make math instruction more accessible, experts say. In elementary schools, activities that involve more senses should be used more widely, including whole-body motions and songs for teaching numbers and hands-on materials for math operations.

Jackson said her daughter could have benefited from a wider variety of methods at school. When the teen returned to school-based math classes in high school, after several years of learning math at home, she achieved an A in algebra.

“When you really understand what it is to be dyscalculic, then you can look around and decide what this person needs to succeed,” Jackson said. “It’s not just that you’re ‘bad at math’ and need to buckle down and try harder.”

This image from video, provided by UPMC/Pitt Health Sciences, taken Oct. 26, 2015, shows University of Pittsburgh researcher Robert Gaunt preparing Nathan Copeland for research testing if brain implants could help the paralyzed man feel sensation in his own hand while using a mind-controlled robotic arm. Recently, a paralysed Swiss man became the first person to test a new technology that reads his thoughts using AI and then transmits signals through his own nervous system to his arms, hands and fingers.
| Photo Credit: AP

A paralysed Swiss man has become the first person to test a new technology that reads his thoughts using AI and then transmits signals through his own nervous system to his arms, hands and fingers in order to restore movement.

The treatment, a combination of a brain-computer interface and a spinal implant, had previously allowed a paraplegic patient to walk again, a breakthrough that was published in the scientific journal Nature in May.

But this is the first time it’s being used for “upper extremity function,” Onward, the Dutch company behind it, said Wednesday.

“The mobility of the arm is more complex,” surgeon Jocelyne Bloch, who carried out the implantation procedures, told AFP.

Though walking comes with its own challenges — notably balance — “the musculature of the hand is quite fine, with many different small muscles activated at the same time for certain movements,” she said.

The patient, who wishes to remain anonymous, is a 46-year-old who lost the use of his arms after a fall. Two operations were carried out last month at the Lausanne University Hospital in Switzerland.

Also Read | Elon Musk’s Neuralink to start human trial of brain implant for paralysis patients

The first involved removing a small piece of cranial bone and inserting in its place the brain implant, which was developed by the French group CEA-Clinatec and measures a few centimeters in diameter.

In the second, surgeons placed a stimulator roughly the size of a credit card developed by Onward inside the patient’s abdomen, and connected it through electrodes to the top of his spinal column.

The brain-computer interface (BCI) records brain signals and decodes them using artificial intelligence to make sense of the patient’s intentions, acting as a “digital bridge” to send these instructions on to the spinal cord stimulator.

“It’s going well so far,” said Bloch, who co-founded Onward and is a consultant for the company. “We are able to record brain activity, and we know that the stimulation works,” she said.

“But it is too early to talk about what progress he has made. “

Still in training

The patient is still in the training phase, teaching his brain implant to recognise the different desired movements.

Also Read | The race to link our brains to computers is heating up

The movements will then have to be practiced many times before they can become natural. The process will take a few months, according to Dr. Bloch.

Two more patients are scheduled to participate in this clinical trial, and the full results will be published later.

Spinal cord stimulation has already been used in the past to successfully move paralysed patients’ arms, but without reading their thoughts by pairing it with a brain implant.

And brain implants have already been used so that a patient can control an exoskeleton. The Battelle research organisation used a brain implant to restore movement in a patient’s arm — through a sleeve of electrodes placed on the forearm, stimulating the muscles required from above.

“Onward is unique in our focus on restoring movement in people who have paralysis by stimulating the spinal cord,” the company’s CEO Dave Marver told AFP, adding the technology could be commercialised by the end of the decade.

Brain implants were long trapped in the realm of science fiction, but the field is now rapidly growing thanks to firms like Synchron and Elon Musk’s Neuralink.

They are working on having paralysed patients to control computers through thought, restoring for example the ability to write.

For approximately 80% of the world’s population, the first stop after catching a cold or breaking a bone isn’t the hospital — maybe because there isn’t one nearby, or they can’t afford it. Instead, the first step is consulting traditional medicine, which cultures around the world have been using for thousands of years.

Traditional medicine encompasses the healing knowledge, skills and practices used by a variety of cultures and groups.

Examples of traditional medicine include herbal medicine; acupuncture; Tui Na – which is a type of massage originating in China; Ayurveda – which is an ancient system of promoting health through diet, exercise and lifestyle from India; and Unani – which is another ancient system of health from South Asia, balancing key aspects of the mind, body and spirit.

In recognizing that traditional medicine and other alternative forms of healing are critical sources of health care for many people worldwide, the World Health Organization and the government of India co-hosted their first-ever Traditional Medicine Summit. The summit took place in August 2023 in Gandhinagar, Gujarat, India.

The summit brought together health care policymakers, traditional medicine workers and users, international organizations, academics and private sector stakeholders from 88 WHO member states. Leaders at the summit aimed to share best practices and scientific evidence and data around traditional medicine.

Also Read | India’s traditional medicine discourse: less about medicine, more about India 

As researchers interested in how to provide patients both in the U.S. and around the globe with the best possible medical care, we were interested in the summit’s findings. Understanding traditional medicine can help health care professionals create sustainable, personalized and culturally respectful practices.

Critical health care for many

In many countries, traditional medicine costs less and is more accessible than conventional health care. And many conventional medicines come from the same source as compounds used in traditional medicine – up to 50% of drugs have a natural product root, like aspirin.

Many factors may influence whether someone chooses traditional medicine, such as age and gender, religion, education and income level, and distance to travel for treatment. Cultural factors may also influence people’s use of traditional medicine.

In China, for example, as more people have embraced Western culture, fewer have chosen traditional medicine. In contrast, many African migrants to Australia continue to use traditional medicine to express their cultural identity and maintain a cohesive ethnic community. A patient’s preference for traditional medicine often has significant personal, environmental and cultural relevance.

A framework for traditional medicine

Countries have been pushing the WHO to study and track data on traditional medicine for years. In the past, WHO has developed a “traditional medicine strategy” to help member states research, integrate and regulate traditional medicine in their national health systems.

The WHO also created international terminology standards for practicing various forms of traditional medicine.

The practice of traditional medicine varies greatly between countries, depending on how accessible it is and how culturally important it is in each country. To make traditional medicine safer and more accessible on a broader scale, it’s important for policymakers and public health experts to develop standards and share best practices. The WHO summit was one step toward that goal.

Also Read | WHO asks countries to work towards unlocking the power of traditional medicine

The WHO also aims to collect data that could inform these standards and best practices. It is conducting the Global Survey on Traditional Medicine in 2023. As of August, approximately 55 member states out of the total 194 have completed and submitted their data.

Acupuncture – a case study in safety and efficacy

Some traditional medicine practices such as acupuncture have shown consistent and credible benefits, and have even started to make it into mainstream medicine in the U.S. But leaders at the summit emphasized a need for more research on the efficacy and safety of traditional medicine.

Although traditional medicine can have a range of benefits, some treatments come with health risks.

For example, acupuncture is a traditional healing practice that entails inserting needles at specific points on the body to relieve pain. But acupuncture can cause infections and injuries if the practitioner doesn’t use sterile needles or if needles are inserted incorrectly.

Still, acupuncture is the most commonly used traditional medicine practice across countries, with 113 WHO member states acknowledging their citizens practiced acupuncture in 2019.

Interestingly, battlefield acupuncture has successfully treated many U.S. military members, for example, for pain reduction. It is simple to use, transportable and has no risk of addiction.

There’s also some evidence supporting the use of traditional medicine, including acupuncture, meditation and yoga to treat post-traumatic stress disorder.

However, acupuncture practitioners aren’t trained in a uniform way across countries. To provide guidelines for best practice, the WHO developed standardized benchmarks for practicing acupuncture in 2021. The WHO aims to develop similar standards for other forms of traditional medicine as well.

Interest in traditional medicine is growing among those who have mainly used conventional medicine in the past. More research and collaborative efforts to develop safety standards can make traditional medicine accessible to all who seek it.

Indonesian researchers have tested a cheaper way of monitoring antimicrobial resistance that could be a key tool for developing countries. Image for Representation.
| Photo Credit: Getty Images/iStockphoto

Indonesian researchers have tested a cheaper way of monitoring antimicrobial resistance that could be a key tool for developing countries.

Indonesian researchers have tested a cost-effective, relatively quick method of measuring changes in antimicrobial resistance that could help developing countries fight a problem seen as a global threat.

Instead of sticking to an approach that emphasises the need for intensive laboratory testing that might not be practical in many countries, they assessed lot quality assurance sampling — a system where a population’s antimicrobial resistance can be assessed using smaller sample sizes.

That’s good news for the G20 after health ministers committed to tackling the threat comprehensively at their meeting last month. Antimicrobial resistance is the ability of microbes to block the effect of drugs that are meant to kill them. This makes infections harder to treat and can lead to longer hospital stays, more expensive care and increased risk of death.

The high level of antimicrobial resistance in Indonesia is now becoming a silent pandemic.

Explained | Is air pollution driving the rise of antibiotic resistance? 

The United Nations has warned the rise of ‘superbugs’ could kill 10 million people a year globally by 2050 and be a drain on the world economy. Like in many other countries, the improper use of antimicrobial drugs and other factors that trigger resistance, such as poor sanitation and air pollution, are prevalent in Indonesia. In 2015, the 68th World Health Assembly adopted the Global Action Plan on antimicrobial resistance.

It emphasises the importance of enhanced global surveillance, particularly in low- and middle-income countries where it is a major concern. One of the key pillars of the Global Action Plan is the support for national strategies through improved global surveillance.

The proposed global surveillance system aims to estimate the prevalence of resistance by using laboratory testing of clinical samples. However, this approach is not always practical in developing countries because of their limited access to quality microbiology diagnostics.

Population-based surveillance is a preferred strategy, but it is also time-consuming, labour-intensive and costly. That means many regions need a rapid, feasible and affordable surveillance strategy.

Explained | The challenge of antimicrobial resistance

Indonesian researchers found an alternative approach: they tried lot quality assurance sampling. This method, which was originally developed in the manufacturing industry to assess batch quality, involves classifying a population as having a high or low prevalence of antimicrobial resistance based on a small sample size.

It has proved to be more practical and cost-effective than conventional population-based surveillance. The Indonesian research applied the lot-based approach to assess the prevalence of antimicrobial resistance in patients with suspected urinary tract infections.

The researchers wanted to estimate the test characteristics for identifying populations with a high prevalence of resistance in urinary tract pathogens, provide lot-sampling classifications for 15 antibiotics in 11 different settings and estimate the cost of implementing lot sampling in a single health facility.

The testing was done in the Indonesian cities of Medan and Bandung, and the exercise was repeated 1,000 times for each of the 13 lots.

Also Read | Putting minds and funds together to find ways of tackling drug resistance 

They found lot testing was 98 percent effective in correctly identifying populations with a high prevalence of antimicrobial resistance.

Overall, the researchers were able to show that lot quality assurance sampling is a promising approach to efficiently estimate antimicrobial resistance prevalence and guide treatment decisions, especially in resource-limited settings.

By significantly reducing sample size requirements and increasing efficiency, lot-based surveillance could significantly contribute to public health efforts to combat antimicrobial resistance worldwide. The findings are particularly significant in the context of the growing importance of surveillance as a crucial tool for antimicrobial stewardship.

Previous studies on drug resistance have shown lot-based surveys are effective in identifying local variations in drug-resistant tuberculosis and assessing the prevalence of transmitted drug resistance in HIV.

This style of survey could be implemented at sentinel sites, enabling regular assessments of changing trends, intervention impacts, or early detection of resistance development after introducing new drugs. This utility is particularly beneficial in settings with limited microbiology capacity or where empirical treatment is common, such as primary care settings globally.

The cost of the lot-based surveys, including 15 antibiotics, ranged between US USD 403 and USD 514 in the 11 sites studied — relatively cheaper than conventional testing regimes. Despite some limitations, including the need for careful site selection and ensuring proper laboratory accreditation and quality control, lot quality assurance sampling shows promise in providing valuable information on antimicrobial resistance for both clinicians and policymakers.

IMF delegates participate in a news conference on the IMF release of the World Economic Outlook Update, at IMF headquarters in Washington, DC, on July 25, 2023.
| Photo Credit: AFP

Names of 5 crore MGNREGS workers deleted in 2022-23, Minister informs Lok Sabha

Rural Development Minister Giriraj Singh, in a written reply to the Lok Sabha, on July 25 informed that names of over five crore workers have been deleted under the Mahatma Gandhi National Rural Employment Guarantee Scheme (MGNREGS) in the financial year 2022-23. There has been a hike of 247% in deletions during 2022-23 as compared to 2021-22.

IMF projects Indian economy to grow at 6.1% in 2023

The IMF on July 25 projected a growth rate of 6.1% for India in 2023, which is a 0.2 percentage point upward revision compared with the April projection.

Manipur government partially eases Internet curbs; no access on mobiles

After an 83-day Internet shutdown in Manipur, the State government marginally eased the restrictions on July 25, albeit under strict conditions.

INDIA alliance likely to submit no-confidence motion notice against government in Lok Sabha on Wednesday 

The alliance has already drawn up a draft of the notice and is in the process of getting the necessary 50 signatures of MPs. The group has to submit the notice before 10 am for it to be read out by the speaker in the House on Wednesday.

Gyanvapi mosque management moves Allahabad HC over ASI survey, hearing begins

The Allahabad High Court on Tuesday heard a plea against a district court order directing the Archaeological Survey of India to conduct a survey to determine if the Gyanvapi mosque in Varanasi was built upon a temple. After hearing arguments in the matter, Chief Justice Pritinker Diwaker posted it for further hearing on Wednesday.

President Murmu reaches Odisha on three-day tour

The President will travel to Cuttack on Wednesday, during which she will offer prayers at the Chandi Temple and visit the residence of ‘Utkal Gourab’ Madhusudan Das and pay floral tribute to his statue.

NHRC to host national conference on mental healthcare in Vigyan Bhawan, release a new book

The conference by the National Human Rights Commission on ‘Moving Mental Health Beyond Institutions’ will be held at Vigyan Bhawan, and Union Minister of State for Health Bharati Praveen Pawar will be the chief guest, officials said on Tuesday.

ISRO’s Chandrayaan-3 successfully performs fifth orbit-raising manoeuvre

The Indian Space Research Organisation (ISRO) on Tuesday (July 25) successfully completed the fifth and final orbit-raising manoeuvre (Earth-bound perigee firing) of the Chandrayaan-3 mission. It was performed successfully from ISRO Telemetry, Tracking and Command Network (ISTRAC) in Bengaluru.

Taliban bans beauty salons in Afghanistan despite U.N. concern and rare public protest

The Taliban announced on July 25 that all beauty salons in Afghanistan must now close as a one-month deadline ended, despite rare public opposition to the edict.

Peace-themed torch unveiled for Paris 2024 Olympics

The design of the Paris 2024 Olympic and Paralympic torch was unveiled on Tuesday, imitating the reflection of the Eiffel Tower on the ruffled surface of the Seine river and conveying a peaceful energy, its designer said.