Is malaria immunity a possible protection against severe symptoms and outcomes of COVID-19?

Malaria-endemic areas of the world are noted for high morbidity and mortality from malaria. Also noted in these areas is the majority of persons in the population having acquired malaria immunity. Though this acquired malaria immunity does not prevent infection, it resists the multiplication of Plasmodium parasites, restricting disease to merely uncomplicated cases or asymptomatic infections. Does this acquired malaria immunity in endemic areas protect against other diseases, especially outbreak diseases like COVID-19? Does malaria activation of innate immunity resulting in trained or tolerance immunity contribute to protection against COVID-19? In an attempt to answer these questions, this review highlights the components of malaria and viral immunity and explores possible links with immunity against COVID-19. With malaria-endemic areas of the world having a fair share of cases of COVID-19, it is important to direct research in this area to evaluate and harness any benefits of acquired malaria immunity to help mitigate the effects of COVID-19 and any possible future outbreaks

Childhood respiratory morbidity and cooking practices among households in a predominantly rural area of Ghana

Background: Household air pollution is a leading risk factor for respiratory morbidity and mortality in developing countries where biomass fuel is mainly used for cooking. Materials and Method: A household cross-sectional survey was conducted in a predominantly rural area of Ghana in 2007 to determine the prevalence of respiratory symptoms and their associated risk factors. Household cooking practices were also assessed as part of the survey. Results: Household heads of twelve thousand; three hundred and thirty-three households were interviewed. Fifty-seven percent 7006/12333) of these households had at least one child less than five years of age. The prevalence of symptoms of acute lower respiratory infections (ALRI) was 13.7% (n= 957; 95% CI 12.8 - 15.5%). A majority (77.8%; 95% CI; 77.7 - 78.5%) of households used wood as their primary fuel. Majority of respondents who used wood as their primary fuel obtained them by gathering wood from their neighborhood (95.6%; 9177/9595) and used a 3-stone local stove for cooking (94.9%; 9101/9595). In a randomly selected subset of respondents; females were the persons who mostly gathered firewood from the fields (90.8%; 296/326) and did the cooking (94.8%; 384/406) for the household. Conclusion: Symptoms of ALRI reported by caregivers is high in the Kintampo area of Ghana where biomass fuel use is also high. There is the need to initiate interventions that use improved cook stoves and to test the health benefits of such interventions

Determination of the Vitamin A Status and Body Pool Size of Ghanaian Infants Given Fortified Home Based Complementary Foods.

Objectives: Vitamin A deficiency is a public health problem which can be addressed using micronutrient powders in single dose sachets known as “Sprinkles”. This food-based approach offers an alternative to high dose Vitamin A supplements given directly to young infants. This strategy was evaluated by assessing the Vitamin A body pool using deuterium or 13C-retinol as a tracer. The primary objective was to investigate the impact of Vitamin A home fortification on the infant’s Vitamin A pool size using stable 13C2-retinol as a tracer among children who receive Sprinkles with or without VA. The Vitamin A status of infants at baseline was assessed using the modified relative dose response (MRDR) test and the 13C-retinol dilution test at follow-up. Methods: This was a community-based study involving 93 infants aged 7-9 months and randomised to receive daily Sprinkles with or without Vitamin A. Mothers were instructed to mix a single sachet of Sprinkles with a small amount of food which was given to the child. Infants were followed for 5 months. Results: At baseline the mean ratio (95%CI) of MRDR for infants in the intervention group was 0.032 (0.025-0.038) compared to 0.031(0.024-0.038) in the control group (p =0.80). At end line the mean Vitamin A concentration of infants in the intervention and control group 304.711 µmol vs. 252.207 µmol respectively but difference was not statistically significant. Conclusions: The vitamin A status of the infants was found to be adequate and the study demonstrated the use of stable isotopes as tracers to quantitatively estimate total body stores.

Adherence to Behavioral Symptoms Therapy for Uncomplicated Malaria in Rural Ghana: A Randomised Trial of Supervised Versus Unsupervised Drug Administration

Introduction.To enhance effective treatment; african nations including Ghana changed its malaria treatment policy from monotherapy to combination treatment with artesunate-amodiaquine (AS+AQ). The major challenge to its use in loose form is adherence. Objective. The objectives of this study were to investigate adherence and treatment outcome among patients treated with AS+AQ combination therapy for acute uncomplicated malaria. Methodology. The study was conducted in two rural districts located in the middle belt of Ghana using quantitative methods. Patients diagnosed with acute uncomplicated malaria as per the Ghana Ministry of Health malaria case definitions were randomly allocated to one of two groups. All patients in both groups were educated about the dose regimen of AS+AQ therapy and the need for adherence. Treatment with AS+AQ was supervised in one group while the other group was not supervised. Adherence was assessed by direct observation of the blister package of AS+AQ left on day 2. Results. 401 participants were randomized into the supervised (211) and unsupervised (190) groups. Compliance in both supervised (95.7) and unsupervised (92.6) groups were similar (P=.18). The commonest side-effects reported on day 2 among both groups were headaches; and body weakness. Parasite clearance by day 28 was 95in both groups. Discussion/Conclusions. Administration of AS-AQ in both groups resulted in high levels of adherence to treatment regimen among adolescent and adult population in central Ghana. It appears that high level of adherence to AS-AQ is achievable through a rigorous education programme during routine clinic visits