News / Health

    Antibiotics Overuse is Price of Success in Africa Malaria Fight

    FILE-  A child is vaccinated during a malaria vaccine trial in Bagamoyo, Tanzania in Aug. 2007. FILE- A child is vaccinated during a malaria vaccine trial in Bagamoyo, Tanzania in Aug. 2007.
    x
    FILE-  A child is vaccinated during a malaria vaccine trial in Bagamoyo, Tanzania in Aug. 2007.
    FILE- A child is vaccinated during a malaria vaccine trial in Bagamoyo, Tanzania in Aug. 2007.
    As malaria rates decline across much of Africa, a new study seeks to fight another problem.

    Drug-resistant bacteria are a growing concern as antibiotics have become the automatic choice for treating a child with a fever.

    Research from Tanzania, published in the New England Journal of Medicine, shows that most illnesses are caused by viral infections.  Antibiotics do not kill viruses, and overuse of these important drugs is decreasing their effectiveness.

    Success and challenge

    Until recently, malaria has been so prevalent in many African countries that health workers assumed any child with a fever had it.  But after a decade of intensive efforts and billions of dollars of global investment, malaria rates are declining across the continent. 

    A recent report found lower rates in 40 of 44 African countries studied.

    But that leaves doctors with a new set of challenges: If malaria is not causing a child’s fever, what is? And how should it be treated?

    “Their tendency is to prescribe an antibiotic instead of an anti-malarial,” said infectious disease expert Valerie D’Acremont with the Swiss Tropical and Public Health Institute, “which is also bad, because we just shift from one problem to the other.”

    Alarming resistance

    Where D’Acremont works in Tanzania, antibiotic resistance is so serious that she estimates half her patients with pneumonia do not respond to the first-line drug.  Second-line drugs are more expensive or not available.

    But without better data on what made Tanzanian kids sick, no one could say how often antibiotics were the wrong treatment.

    So D’Acremont and her colleagues studied about 1,000 children seen at two clinics in Tanzania, one urban and one rural.  They performed exams and blood tests, cultures, molecular tests and more to identify all the types of illness and their causes.

    Less is more

    About 10 percent of the children had malaria.

    For the rest, far more illnesses were viral than bacterial. About half had respiratory infections, mostly caused by viruses such as influenza.

    So the authors recommend that except in severe cases, children should be sent home without antibiotics and seen again a few days later if they don't improve on their own. 

    Severe cases present a challenge, and D’Acremont says new tools are needed to help diagnose them.

    “But this does not justify prescribing antibiotics to all just to be on the safe side,” she said.  “We cannot afford that.”

    Outdated message

    “For the last 30 years at least we have been telling mothers of young children in Africa, ‘If your child has a fever, get treatment for malaria within 24 hours,’” said Matthew Lynch, director of the Global Program on Malaria at Johns Hopkins University, who was not involved in the research. “That message is now not only outdated, but wrong.”

    That creates a communication challenge for public health workers, Lynch says, and also calls for a major effort to ensure caregivers seek testing to find out what is causing a child’s fever before deciding on treatment.

    That's not to say that malaria is no longer a threat.

    "There are plenty of places in Africa where malaria is still horrible," says economist Jessica Cohen at the Harvard School of Public Health. Her studies in parts of Kenya and Uganda found 80 percent of people coming to drug shops for medication tested positive for malaria.

    And while public health officials have shifted away from recommending anti-malarials to anyone with a fever, Cohen says that shift may have gone a bit too far.

    "Under-treatment is a real problem, too, and is likely the main driver of lingering child mortality from malaria," she said.

    The price of success in the fight against malaria is that treating fevers has become much more complicated.

    Steve Baragona

    Steve Baragona is an award-winning multimedia journalist covering science, environment and health.

    He spent eight years in molecular biology and infectious disease research before deciding that writing about science was more fun than doing it. He graduated from the University of North Carolina at Chapel Hill with a master’s degree in journalism in 2002.

    You May Like

    Russian-speaking Muslim Exiles Fear Possible Russia-Turkey Thaw

    Exiled from Russia as Islamic radicals and extremists, thousands found asylum in Turkey

    US Presidential Election Ends at Conventions for Territorial Citizens

    Citizens of US territories like Guam or Puerto Rico enjoy participation in US political process but are denied right to vote for president

    UN Syria Envoy: 'Devil Is in the Details' of Russian Aleppo Proposal

    UN uncertain about the possible humanitarian impact of Russian proposal to establish escape corridors in Aleppo

    This forum has been closed.
    Comment Sorting
    Comments
         
    by: anonymous
    February 27, 2014 2:11 PM
    Mr. Baragona and editor(s), would it be better if the February 26, 2014 edition of this article mentioned insecticide-treated nets and artemisinin?

    Featured Videos

    Your JavaScript is turned off or you have an old version of Adobe's Flash Player. Get the latest Flash player.
    Uganda Unveils its First Solar-powered Busi
    X
    July 28, 2016 4:16 AM
    A solar-powered bus described by its Ugandan makers as the first in Africa has made its public debut. Kiira Motors' electric bus, Kayoola, displayed recently at a stadium in Uganda's capital. From Kampala, Maurice Magorane filed this report narrated by Salem Solomon.
    Video

    Video Uganda Unveils its First Solar-powered Bus

    A solar-powered bus described by its Ugandan makers as the first in Africa has made its public debut. Kiira Motors' electric bus, Kayoola, displayed recently at a stadium in Uganda's capital. From Kampala, Maurice Magorane filed this report narrated by Salem Solomon.
    Video

    Video Silicon Valley: More Than A Place, It's a Culture

    Silicon Valley is a technology powerhouse and a place that companies such as Google, Facebook and Apple call home. It is a region in northern California that stretches from San Francisco to San Jose. But, more than that, it's known for its startup culture. VOA's Elizabeth Lee went inside one company to find out what it's like to work in a startup.
    Video

    Video Immigrant Delegate Marvels at Democratic Process

    It’s been a bitter and divisive election season – but first time Indian-American delegate Dr. Shashi Gupta headed to the Democratic National Convention with a sense of hope. VOA’s Katherine Gypson followed this immigrant with the love of U.S. politics all the way to Philadelphia.
    Video

    Video Philadelphia Uses DNC Spotlight to Profile Historic Role in Founding of United States

    The slogan of the Democratic National Convention now underway in Philadelphia is “Let’s Make History Again” which recognizes the role the city played in the foundation of the United States in the 18th century. As VOA’s Kane Farabaugh reports, local institutions are opening their doors in an effort to capitalize on the convention spotlight to draw visitors, and to offer more than just a history lesson.
    Video

    Video A Life of Fighting Back: Hillary Clinton Shatters Glass Ceiling

    Hillary Clinton made history Thursday, overcoming personal and political setbacks to become the first woman to win the presidential nomination of a major U.S. political party. If she wins in November, she will go from “first lady” to U.S. Senator from New York, to Secretary of State, to “Madam President.” Polls show Clinton is both beloved and despised. White House Correspondent Cindy Saine takes a look at the life of the woman both supporters and detractors agree is a fighter for the ages.
    Video

    Video Dutch Entrepreneurs Turn Rainwater Into Beer

    June has been recorded as one of the wettest months in more than a century in many parts of Europe. To a group of entrepreneurs in Amsterdam the rain came as a blessing, as they used the extra water to brew beer. Serginho Roosblad has more to the story.
    Video

    Video First Time Delegate’s First Day Frustrations

    With thousands of people filling the streets of Philadelphia, Pennsylvania for the 2016 Democratic National Convention, VOA’s Kane Farabaugh narrowed in on one delegate as she made her first trip to a national party convention. It was a day that was anything but routine for this United States military veteran.
    Video

    Video Commerce Thrives on US-Mexico Border

    At the Democratic Convention in Philadelphia this week, the party’s presumptive presidential nominee, Hillary Clinton, is expected to attack proposals made by her opponent, Republican presidential nominee Donald Trump, to build a wall along the U.S.-Mexico border. Last Friday, President Barack Obama hosted his Mexican counterpart, President Enrique Peña Nieto, to underscore the good relations between the two countries. VOA’s Greg Flakus reports from Tucson.
    Video

    Video Film Helps Save Ethiopian Children Thought to be Cursed

    'Omo Child' looks at effort of African man to stop killings of ‘mingi’ children
    Video

    Video London’s Financial Crown at Risk as Rivals Eye Brexit Opportunities

    By most measures, London rivals New York as the only true global financial center. But Britain’s vote to leave the European Union – so-called ‘Brexit’ – means the city could lose its right to sell services tariff-free across the bloc, risking its position as Europe’s financial headquarters. Already some banks have said they may shift operations to the mainland. Henry Ridgwell reports from London.
    Video

    Video Recycling Lifeline for Lebanon’s Last Glassblowers

    In a small Lebanese coastal town, one family is preserving a craft that stretches back millennia. The art of glass blowing was developed by Phoenicians in the region, and the Khalifehs say they are the only ones keeping the skill alive in Lebanon. But despite teaming up with an eco-entrepreneur and receiving an unexpected boost from the country’s recent trash crisis the future remains uncertain. John Owens reports from Sarafand.
    Video

    Video Migrants Continue to Risk Lives Crossing US Border from Mexico

    In his speech Thursday before the Republican National Convention, the party’s presidential candidate, Donald Trump, reiterated his proposal to build a wall along the U.S.-Mexico border if elected. Polls show a large percentage of Americans support better control of the nation's southwestern border, but as VOA’s Greg Flakus reports from the border town of Nogales in the Mexican state of Sonora, the situation faced by people trying to cross the border is already daunting.

    Special Report

    Adrift The Invisible African Diaspora