Malaria may become treatable with the approval of tafenoquine

Health Care, Heart Care Foundation of India, Medicine Comments Off

Treatment is the second step; the first is prevention from the disease and stopping transmission

New Delhi, 24th July 2018: The USFDA has given its approval for a new drug called Krintafel (tafenoquine) to treat P. vivax malaria relapse, which accounts for 34% of the estimated 13 million cases in India.

The drug has been developed by a not-for-profit research and industry partnership and is the first new treatment for the disease in more than 60 years. It is most likely to get fast-tracked approvals for use globally. It is a single-dose, ‘radical cure’ treatment (when given with chloroquine) for ages 16 years and older that kills dormant infection in the liver to prevent relapse.

India had an estimated 1.31 million malaria cases and 23,990 deaths in India, where more than half of the population (698 million) is at risk of infection, according to the World Malaria Report 2017 by WHO. India accounted for 6% of all malaria cases in the world, 6% of the deaths, and 51% of the global P. vivax cases.

Speaking about this, Padma Shri Awardee Dr KK Aggarwal, President, HCFI, said, “Availability of this drug in India has the possibility to make a huge difference to the treatment of malaria as P. vivax is sensitive to treatment. For India to achieve the target of eliminating malaria by 2030, it is mandatory that the transmission of P. vivax is curbed. India still has an extremely weak malaria surveillance system. Each case of malaria has been shown to cost households at least US $2.67 (range US $0.34–7.66) in direct out-of-pocket expenses. In adults, this leads to an average of 3.4 days (range 2–6 days) of lost productivity, at a minimum additional indirect cost of US $10.85. Despite efforts at various levels, this disease still remains an acute public health challenge.”

The ‘T3’ initiative of the WHO Global Malaria Program supports malaria-endemic countries in their efforts to achieve universal coverage with diagnostic testing and anti malarial treatment, as well as in strengthening their malaria surveillance systems T3 stands for Test, Treat, and Track.

Adding further, Dr Aggarwal, who is also the Vice President of CMAAO, said, “Malaria is entirely a preventable disease. It is also a treatable disease provided it is diagnosed and treated in time. The symptoms of malaria are non-specific and can be variable. Thus, it may be mistaken for other diseases such as viral infections, typhoid and the diagnosis of malaria may be missed as a result.”

Tafenoquine is a long-acting 8-aminoquinoline that, like primaquine, targets P. vivax hypnozoites. A phase IIb trial of adults in Asia and South America found that a single dose of tafenoquine in conjunction with chloroquine may be more effective at preventing P. vivax relapse than a 14-day course of primaquine with chloroquine. As with primaquine, tafenoquine can induce hemolytic anemia in patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency.

Some tips from HCFI.

  • Do not let water stagnate in your house and the surrounding areas. If any utensil or container that stores water is cleaned properly once in a week, there are no chances of mosquito breeding.
  • Using mosquito nets/repellents in the night may not prevent malaria because these mosquitoes bite during the day time.
  • Mosquitoes that do not produce a sound do not cause diseases.
  • Wearing full sleeves shirt and trousers can prevent mosquito bites. Mosquito repellent can be helpful during the day.

Woman dies during surgery, family alleges negligence: No surgery is risk free

Health Care Comments Off

A 50-year-old woman died during a kidney operation at a private hospital in Patiala here on Sunday morning. Members of the deceased’s family have alleged negligence. However, doctors said the patient had died due to the cardiac arrest. The deceased, Shanti Devi, was admitted to Janak Surgicare and Ankur Advanced Urology Centre for bilateral kidney ailment on July 12. Shanti Devi, a resident of Ulaana village near Ghanaur in Patiala, was earlier operated for kidney stone on July 13 and July 14. However, she died during another operation on Sunday morning, said the police. Doctor Ankur Bansal from the hospital said: “The patient was suffering from bilateral kidney ailment. She was operated on July 13 and July 14. However, when we were operating for the third time on Sunday morning, the patient died during operation due to a cardiac arrest after anaesthesia. (TOI, Tribune)

Overall anesthesia-related mortality rates vary from two deaths per 10,000 anesthetics administered to one death per 200,000 anesthetics. Standard American Society of Anesthesiologists (ASA) monitors include pulse oximetry, electrocardiography (ECG), a noninvasive blood pressure device, and temperature, as well as integrated monitors on all anesthesia machines that generate alarms for common and/or serious potential problems

Patients whose estimated risk of death is less than 1% are labeled as being low risk and require no additional cardiovascular testing. Higher-risk patients are those whose risk of death is 1% or higher and these are the patients who may require additional cardiovascular evaluation.

No surgery is risk free.

While anesthesia has certainly become safer now, other factors such as the surgery itself, age of the patient, general condition of the patient, preexisting medical conditions, experience of the surgeon increase the risk associated with a surgical procedure.

The risks of anesthesia increase with high-risk patients.

Dr KK Aggarwal

Padma Shri Awardee

Vice President CMAAO

Group Editor-in-Chief IJCP Publications

President Heart Care Foundation of India

Immediate Past National President IMA