New drug for recurring malaria | Hacker News Reader

New drug for recurring malaria

bbc.com

48 pointsDoreenMichele15 comments

Important reminder:

- The atovaquone/proguanil (e.g: Malarone) combo still works well. It's affordable and widely available.

- It's also __curative__, meaning it DOES destroy the plasmodium in the liver (not just in the blood). The fact we are using it preventively often leads people to think we still can't cure malaria. If you have malaria, go see a tropical disease specialist to get rid of those nasty recurring episodes.

- Any anti malaria drugs have very serious side effects, even if Malarone is the nicest of all. If you end up living in a infected country for good, you should really ponder how long it's acceptable to take it. In the end, both the parasite and Malarone will attack your liver. Yeah, it sucks.

That being said, it's always good to have new options, if just to reduce the chance of resistance. Chloroquine based drugs (e.g: Nivaquine) are pretty much useless now because of it, and I don't know anybody who tried Mefloquine (e.g: Lariam) that will ever go back to it.

I've had Lariam once or twice as Malarone used to be really expensive in the UK (10$ vs 150$ ish) and I don't think I had any of the famous side effects. It can be hard to tell when you're in a radically different country, very hot, with strange food and drinking a lot...

I took Larium (Mefloquine) for about 7 months while in the US Peace Corps. I had incredibly vivid dreams, all of which I would remember and I also developed depression that went away as soon as I switched off the drug. No good.

I ended up working for a company in another country that didn't have any requirements regarding malaria prophylaxis so I didn't take any drugs. I got malaria and it was god awful for a couple days but got over it quickly. Compared to the side effects of Larium or taking heavy doses of Doxycycline or getting the more spendy Malarone, it was worth rolling the dice.

Do not drink at all while taking Lariam, at least in my experience. I would never take that crap again. I woke up on the side of a road where the police had dropped me off right outside town after some moderate drinking, and I am a heavy "partier."

Not only that but it brought out weird parts of my personality that aren't normally more than background chatter I ignore in my daily life, like grandiosity and melodramatic emotionality including severe melancholy.

Last time I took Larium was near the White Nile in Uganda for 3 weeks. The beer there is pretty strong and people stay up late! During the trip I did feel pretty lethargic, but it was very hot and I was very active so I didn't blame the larium. No other symptoms. On other trips I've taken Chloroquinine/Proaganol (this is what it's called in the UK anyway) and it was fine, I think that is only useful in a few regions now though?

I've been living in malarial regions for 2 years now. I stopped taking my daily malarone pills after 6 months. Now I only take it when I've been bit quite heavily or if I start to feel sick.

The new drug is designed to kill plasmodium vivax which is relatevely rare in Africa. IMHO Malarone is not effective against this "softer" form of malaria which would usually not kill you if untreated.

Plasmodium falciparum is responsible for the most dangerous form of malaria and is common in large parts of sub-saharan Africa. Like OP stated correctly, it is (still) curable, but the new drug discussed in the article is probably not an option here.

By the way the plasmodium vivax kind of malaria was still present in northern Germany (and probably parts of the Netherlands) in the 20th century, with Anopheles atroparvus being the vector. It's unclear why it disappeared in the 1960s but sleeping away from cattle and proper water management is always a good idea.

I've had malaria twice [1] [2] in the last 18 months while driving around Africa, so this is great news for me. I wouldn't say I've had a full blown recurrence, though I have never felt 100% since that first episode more than 18 months ago. I kind of just feel a bit crap all the time, once a month or so a little worse than the rest of the time.

[1] http://theroadchoseme.com/malaria

[2] http://theroadchoseme.com/malaria-round-two

How much would it cost to build this?

* An electrified mosquito net.

* With guard rubber net large enough to let mosquitoes through to the execution chamber but small enough to prevent accidental self electrocution.

* battery/inverter source to allow all night protection.

SHAPE

1. Box the bed completely

2. Or a single board large enough to increase the likelihood of mosquitoes running into it themselves.)

>How much would it cost to build this?

It's not just cost, but also logistics, education, and adoption.

In the region where bed-nets are important, you don't usually have electricity, easy access, or deep understanding of anti-malarial techniques. Just getting bed-nets shipped there and getting people to use them consistently is a struggle. These regions are hot, and bed-nets are stifling. Sometimes a good nights sleep is preferable. The cheapest and easiest solution is usually education. Stuff like "don't sleep in the same room as your livestock" can change the risks for getting malaria.

In general, it is unfair to approach this problem with a high-tech first world solution because those at risk do not have access to the all the things needed to maintain that solution indefinitely. Yes we can alway provide medical aid, but eradication starts by reducing the overall burden of malaria through educating how to reduce risk of bites in the first place.

Should first world countries stop using electric cars because poorer countries don't have stable electricity?

Those who can have stable electricity and can afford this solution are currently left with subpar solutions.

Mosquitoes are increasingly becoming resistant to insecticide - let's not forget some insecticides' ingredients can be carcinogenic. Their effect don't last through the night. And require leaving the room for a few hours after spray.

Electric swatters or mosquito bats are a joke. You can't swat a bug in your sleep. If new mosquitoes can enter the room after the sweep, it's a futile exercise.

Let's not even talk about those repellents - chemical and electric. In my experience, they don't work.

BTW, an electrified mosquito net is not a high tech solution. Just a marsh of two existing solutions - mosquito nets and electric swatters.

The bait is the human in the cage. So it's guaranteed to work.

I hope there's some else can answer my original question.

It amazes me how rare window/door screens are across latin/south america, and I’m sure other parts of the world that need them the most.

I live in Mexico where people will have a mosquito racket in every room, holding one in their hand while they watch TV, yet keep their windows and doors open for air (and mosquito) circulation.

Even in Guadalajara. The first thing I do when I move somewhere is buy some cheap screen-window kits.

Personally I'd be more interested in a mosquito laser:

* infrared high resolution camera with image recognition for mosquito as well as human eyes to avoid

* microphone that can detect the characteristic mosquito flying sound

* laser powerful enough to damage mosquito wings using microphone to detect general direction and camera to aim exactly at wings

* bonus: add something to attract mosquitoes towards it to bring them to closer range

Install in bedroom for a peaceful night. Or an outdoor version to protect an entire village.

There are people working on this:

https://en.wikipedia.org/wiki/Mosquito_laser

Although nothing much seems to have happened in reality:

https://www.fastcompany.com/3059127/what-happened-to-the-mos...

I reckon this electrified net should be cheaper than a laser solution. It shouldn't be difficult to come up with a portable / modular design that allows for camping or outdoor work.

Reply on news.ycombinator.com