Taylor Capizola

In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week. In response to a 2004 meningitis B epidemic in New Zealand, health clinics across the country offered free vaccinations over the course of two years for any individual under the age of 20. The vaccine, MeNZB, is used primarily to protect against meningitis B, but according to ecological data in Cuba, New Zealand, and Norway, the vaccine also appears to be associated with reduced rates of gonorrhea. To study this further, researchers took retrospective data from 11 health clinics across New Zealand, and compared rates of gonorrhea and chlamydia, analyzing the relationship between vaccination and infection rates. The researchers found that vaccinated individuals were significantly less likely to contract gonorrhea than their unvaccinated counterparts—but vaccine effectiveness rates fell for those co-infected with chlamydia. While this vaccine was only on the market from 2004–2006, these results suggest further study of the vaccine’s potential is warranted, especially as gonorrhea becomes increasingly resistant to first-line drugs. The path toward the elimination of measles, mumps, and rubella has been stymied by low vaccination rates in certain areas of the world, including in developed countries like Italy, Romania, Germany, and the United States. The surge in incidence and deaths from these diseases in developed areas of the world suggests there are pockets of low-immunized communities that are leaving thousands of neighboring children in danger of contracting these diseases. The debunked belief that vaccines cause autism has also contributed to this decline in immunization rates. The recent Ebola outbreak in the Democratic Republic of the Congo (DRC) helped the global health community understand the many complex, moving parts to contain an outbreak. While the DRC beat this particular outbreak in a short period of time, the global health community is still worried that this was merely an exception and the international community is still not equipped with the systems needed to deal with a complex, intercontinental pandemic. The outbreak happened in an incredibly remote area of the DRC, which limited the spread of the virus. While the response by the government and the World Health Organization was quick and effective, it is important to consider that outbreaks that occur in or closer to larger towns could pose a much greater threat and complicate the response. Another important factor in managing an outbreak like Ebola is the political health of a nation. Countries like Sierra Leone and Liberia, both heavily impacted by the 2014 outbreak, have been institutionally weakened by recent civil wars, leaving them more susceptible to large-scale and more deadly outbreaks.  

In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week. The University of Southampton studied malaria funding in Sub-Saharan Africa with the intent to map funding amounts in regions where the malaria is endemic. While global deaths due to malaria have fallen by 60 percent over the last 20 years, the parasite still kills over 400,000 individuals every year. Further, the University found that about 25 percent of Sub-Saharan African countries do not receive the funding for malaria research they need to successfully mitigate the impact of the disease. While all countries received funding for non-research purposes—such as for resources like bed nets and anti-malarial drugs—this funding is not sufficient for the regions where mosquitos carrying the parasite are becoming increasingly resistant to current drugs, vector controls, and preventative methods. A number of factors contribute to this gap in funding. Among the most critical is the lack of adequate research infrastructure in many Sub-Saharan African countries. The European Commission, in partnership with the European Union (EU), have devised and launched a new-age action plan to combat antimicrobial resistance (AMR). The foundation of the plan posits that AMR impacts not only human health, but also in environmental and animal health. The goal of these efforts is to make the EU a “best practice” region for combatting AMR; to boost research, development, and innovation; and to shape the global agenda. The new plan was launched to improve upon the efforts of the previous action plan, as AMR-related deaths are estimated to kill 25,000 Europeans every year. The new plan aims to address a wide range of issues related to AMR in the EU, including the varying levels of resistance around the Union, controlling agricultural practices, and controlling antimicrobial use. Quality-assured malaria drugs undergo substantial testing and verification from international organizations such as the World Health Organization (WHO). A recent study published in Malaria Today found that the private sector has made many non-quality-assured medicines available in several malaria-endemic countries. For instance, over 40 percent of private sector organizations in Kenya stock non-quality-assured drugs. These drugs have not been patient tested, have not gone through adequate clinical trials, or may have even been denied approval by regulating bodies such as WHO. Thus, not only is patient health and safety is compromised, but also these drugs have the potential to exacerbate vector- or malaria-resistance, making combating this disease more difficult.  

In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week. Researchers at the University of Maryland are employing innovative techniques in their efforts to eradicate malaria. Their approach involves injecting spider and scorpion venom into already toxic fungi, in order to kill the malaria vector. By targeting the vector using this technique, scientists may be able to kill larger populations of disease-carrying and insecticide-resistant mosquitoes. The venom acts as a neurotoxin, and the fungus acts as the catalyst to transfer the toxin into the mosquito. The effects of this method were clear: First, the mosquito stopped feeding. Then, the neurotoxin killed the vector. While there are concerns about using venom in wild settings, the Environmnetal Protection Agency (EPA) has approved this method and has noted that neither the venom nor the fungus pose a threat to birds, mammals, or other insects. Not all mosquitoes carry diseases—some are simply a nuisance. When it comes to vector control, methods such as insect traps trap and kill all mosquitoes indiscriminately. This makes identifying the species known to carry diseases from among hundreds of dead vectors quite difficult. However, new traps created by Microsoft have the capacity to scan each mosquito that enters the system. If the wings match the wings of a disease-carrying species, the system traps the mosquito in its own cell. This system correctly identifies disease-carrying vectors 90 percent of the time, thus making catching and identifying specific mosquito species much easier. The system is currently expensive, with each system costing several thousand dollars. However, scientists hope to drive the price down to a few hundred dollars to allow for worldwide distribution. Researchers at EcoHealth Alliance studied viruses in animals to investigate which species pose the greatest threat to humans. The researchers found that about one-third of known animal viruses—about 200 viruses total—are zoonotic, or capable of animal-to-human transmission. The researchers then categorized which animals would most likely pose a threat to humans based upon how many of the zoonotic diseases affect each animal species, and which of those animals interact the most with humans. They found that rodents and non-human primates were the two most virally promiscuous creatures, with the highest chance of transmitting viruses to humans. 

In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week. Brazilian researchers have created a low-cost biosensor product capable of detecting proteins in the membranes of cells infected with dengue, providing a diagnosis in just a few minutes. During its initial testing process, the tool was able to confirm the presence of dengue in all contaminated blood samples tested. While this is a positive start, more testing needs to be done to ensure the tool is continuously reliable in diagnosing dengue and explore options to reduce the price further. If the device proves to be both inexpensive and reliable down the road, it could be a revolutionary tool for diagnosing dengue around the world. In a research lab in Seattle, Washington, Gary Buchko and his team are studying the foundation of the world’s most infectious diseases: proteins. The team is responsible for some of the most groundbreaking work in this niche area of science and have recently identified their 1,000th protein structure responsible for infectious diseases in humans. With the size of a protein being one ten-thousandth the width of a human hair, the work they do is tedious and complex and could take months or years to unlock one single protein structure. But it’s revealing critical information to help design molecules to disrupt or disable the process of these pathogens, paving the way for new vaccines, treatments, and other solutions A compound in Italian soil has been found to have impressive antibiotic properties. The compound, pseudouridimycin (PUM), mimics an RNA building block and is capable of blocking specific polymerase, or enzymes capable of transcribing DNA into RNA. This is important because it can block bacterial polymerase–bacterial enzymes that can make you sick–but it leaves human polymerase intact, allowing PUM to be a highly specific antibiotic tool. Because of this ability as well as the unique structure of the compound, PUM is ten times less likely to trigger a resistance. While this compound has only been tested on animals, results have been promising, and scientists are hoping to advance to human trials within the next three years.

In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week. A study recently published in Science Immunology found that mice infected with malaria had shorter thigh bones than their control counterparts by ten percent, suggesting if the same effect takes place in human, children could suffer stunted growth due to malaria infection. Researchers found the malaria parasite left behind waste which killed the mice’s bones, resulting in the disruption of cells responsible for breaking down and rebuilding bones. The researchers found a possible solution, however. By giving the mice a derivative of vitamin D, they were able to stimulate more bone regrowth and suppress the breakdown of bone. Fifteen children have died in a rural South Sudanese village after one needle was used over the course of multiple days with a vaccine that was not stored properly. Almost 50 individuals fell ill after being inoculated on the same day, resulting in 15 deaths due to either sepsis or a related toxicity. According to the World Health Organization (WHO), the series of events were a result of a lack of training and qualification from the individual administering the vaccines, who failed to adhere to WHO immunization safety standards. South Sudan has been affected by a years-long civil war which has reduced the ability to carry out health care services. Immunization coverage has fallen from 77 percent before the conflict down to 44 percent.  The National Institute of Allergy and Infectious Diseases and the National Institutes of Health have sponsored a phase 1-2 Chikungunya vaccine trial at three different sites around the United States, including Emory University, Baylor College of Medicine, and the University of Iowa in Iowa City. The study will focus on three groups, one receiving a high-dose vaccine, one receiving a low-dose vaccine, and a control group. The results will help establish the best dosage and timing for the vaccine. If this trial is successful, the vaccine could become an important tool to combat the Chikungunya endemic in Eastern Africa and prevent the spread of cases within the United States.  

In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week. CRISPR-cas9, a revolutionary gene editing tool, has been hailed a breakthrough device for microbiologists and geneticists—but not without certain reservations. In a study recently published in Nature, researchers attempting to target and edit genetic blindness in mice analyzed nucleotides—the single-unit building blocks for DNA—in the edited and control mice in order to evaluate success of the tool. CRISPR successfully targeted the alleles—or mutated nucleotides—causing blindness in the mice, but the editing also caused 1,600 off-target, unpredicted mutations, including 100 “large changes” in the DNA structure. This is important because single-nucleotide mutations are associated with many diseases, such as sickle-cell anemia, Huntington's disease, cystic fibrosis, and more. The researchers stressed that more needs to be done to study off-target mutations before CRISPR can be considered risk-free, but that the outlook for the tool is still positive, as any scientific tool has side effects. The science behind creating an effective vaccine that is capable of completely eradicating a disease is complex and hard-won. The only vaccine that has been used to successfully eradicate a disease in humans is the smallpox vaccine. Edward Jenner used cowpox, a similar but much less dangerous bovine variation of the disease, to create a successful vaccine against smallpox—and now scientists are going back to that methodology in an attempt to eradicate malaria. Scientists plan to genetically modify a rodent-variation of the malaria parasite to then use on healthy human volunteers. The hope is that the variation will result in a protective response in humans. The first phase of trials will begin in 2018 and will involve studying initial protection against the disease, with future phases focusing on continued efficacy of the vaccine. Motivated by a lack of awareness and funding for tuberculosis (TB), Médecins Sans Frontières, or Doctors Without Borders, launched a clinical trial, entitled  TB PRACTECAL, aimed at finding a new, improved treatment for drug-resistant TB. The trial, which officially launched in January 2017, is testing an innovative combination of TB drugs that will only need to be taken for six months. Current treatments for drug-resistant TB are physically and emotionally arduous, painful, and only successful about 50 percent of the time, which is why shorted, improved treatment regimens are needed. The first set of trial results is expected to be released within two years with final results within four. If successful, the organization hopes the new treatment will be rolled out in countries around the world and mark an important step forward in combatting the global epidemic.