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.

You May Like

Video Genome Initiative Urgently Works to Freeze DNA Before Species Go Extinct

Smithsonian senior research botanist Vicki Funk says ultimate goal is 'trying to get one-half of the diversity of plant life on Earth at the genus level in two years' More

Video Russia Accused of Abusing Interpol to Pursue Opponents

Report from member of British think tank says Russian extradition requests keep targets from traveling More

US Lawmakers Weigh Turkish Anti-terror Moves

Turkey’s two-pronged campaign against Islamic State militants, Kurdish PKK forces provokes mixed reactions on Capitol Hill More

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.
Russia Accused of Abusing Interpol to Pursue Opponentsi
X
Henry Ridgwell
July 28, 2015 9:53 PM
A British pro-democracy group has accused Russia of abusing the global law enforcement agency Interpol by requesting the arrest and extradition of political opponents. A new report by the group notes such requests can mean the accused are unable to travel and are often unable to open bank accounts. VOA's Henry Ridgwell reports.
Video

Video Russia Accused of Abusing Interpol to Pursue Opponents

A British pro-democracy group has accused Russia of abusing the global law enforcement agency Interpol by requesting the arrest and extradition of political opponents. A new report by the group notes such requests can mean the accused are unable to travel and are often unable to open bank accounts. VOA's Henry Ridgwell reports.
Video

Video Genome Initiative Urgently Moves to Freeze DNA Before Species Go Extinct

Earth is in the midst of its sixth mass extinction. The last such event was caused by an asteroid 66 million years ago. It killed off the dinosaurs and practically everything else. So scientists are in a race against time to classify the estimated 11 million species alive today. So far only 2 million are described by science, and researchers are worried many will disappear before they even have a name. VOA’s Rosanne Skirble reports.
Video

Video Scientists: One-Dose Malaria Cure is Possible

Scientists have long been trying to develop an effective protection and cure for malaria - one of the deadliest diseases that affects people in tropical areas, especially children. As the World Health Organization announces plans to begin clinical trials of a promising new vaccine, scientists in South Africa report that they too are at an important threshold. George Putic reports, they are testing a compound that could be a single-dose cure for malaria.
Video

Video Special Olympics Athletes Meet International Friends

The Special Olympics are underway in Los Angeles, California, with athletes from 165 countries participating in an event that gives people with intellectual disabilities the chance to take part in an international competition. VOA's Mike O'Sullivan reports that for athletes and their families, it's also an opportunity to make new friends in an international setting.
Video

Video 'New York' Magazine Features 35 Cosby Accusers

The latest issue of 'New York' magazine features 35 women who say they were drugged and raped by film and television celebrity Bill Cosby. The women are aged from 44 to 80 and come from different walks of life and races. The magazine interviewed each of them separately, but Zlatica Hoke reports their stories are similar.
Video

Video US Calls Fight Against Human Trafficking a Must Win

The United States is promising not to give up its fight against what Secretary of State John Kerry calls the “scourge” of modern slavery. Officials released the country’s annual human trafficking report Monday – a report that’s being met with some criticism. VOA’s National Security correspondent Jeff Seldin has more from the State Department.
Video

Video Iran Nuclear Pact Wins Few New US Congressional Backers

Later this week, President Barack Obama returns from a trip to Africa to confront a U.S. Congress roiled by the nuclear accord with Iran, an agreement that has received the blessing of the U.N. Security Council. Days of intensive lobbying and testimony by top administration officials have won few new congressional supporters of the pact. VOA’s Michael Bowman reports.
Video

Video Washington DC Underground Streetcar Station to Become Arts Venue

Abandoned more than 50 years ago, the underground streetcar station in Washington D.C.’s historic DuPont Circle district is about to be reborn. The plan calls for turning the spacious underground platforms - once meant to be a transportation hub, - into a unique space for art exhibitions, presentations, concerts and even a film set. Roman Mamonov has more from beneath the streets of the U.S. capital. Joy Wagner narrates his report.
Video

Video Europe’s Twin Crises Collide in Greece as Migrant Numbers Soar

Greece has replaced Italy as the main gateway for migrants into Europe, with more than 100,000 arrivals in the first six months of 2015. Many want to move further into Europe and escape Greece’s economic crisis, but they face widespread dangers on the journey overland through the Balkans. VOA's Henry Ridgwell reports.
Video

Video Stink Intensifies as Lebanon’s Trash Crisis Continues

After the closure of a major rubbish dump a week ago, the streets of Beirut are filling up with trash. Having failed to draw up a plan B, politicians are struggling to deal with the problem. John Owens has more for VOA from Beirut.
Video

Video Paris Rolls Out Blueprint to Fight Climate Change

A U.N. climate conference in December aims to produce an ambitious agreement to fight heat-trapping greenhouse gases. But many local governments are not waiting, and have drafted their own climate action plans. That’s the case with Paris — which is getting special attention, since it’s hosting the climate summit. Lisa Bryant takes a look for VOA at the transformation of the French capital into an eco-city.
Video

Video Racially Diverse Spider-Man Takes Center Stage

Whether it’s in a comic book or on the big screen, fans have always known the man behind the Spider-Man mask as Peter Parker. But that is changing, at least in the comic book world. Marvel Comics announced that a character called Miles Morales will replace Peter Parker as Spider-Man in a new comic book series. He is half Latino, half African American, and he is quite popular among comic book fans. Correspondent Elizabeth Lee reports from Los Angeles.
Video

Video Critics of Japan Defense Policy Focus on Okinawa

In Okinawa, many locals have long complained that Tokyo places an unfair burden on the tiny island by locating most of Japan's U.S. military bases there. As Japan's government moves toward strengthening and expanding the country's defense policies, opponents of those plans are joining local protesters in Okinawa, voicing concern about where the country is headed. VOA’s Brian Padden reports from Okinawa.
Video

Video IS Uses Chemical Weapons in Syrian Attack

Islamic State militants have added a new weapon in their arsenal of fear: chemical weapons. VOA Kurdish service reporter Zana Omer was on the scene within hours of a recent attack in Hasakah, Syria, and has details of the subsequent investigation, in this report narrated by Miguel Amaya.
Video

Video Historic Symbol Is Theme of Vibrant New Show

A new exhibit in Washington is paying tribute to the American flag with a wide and eclectic selection of artwork that uses the historic symbol as its central theme. VOA’s Julie Taboh was at the DC Chamber of Commerce for the show’s opening.

VOA Blogs