Reading summary

Steeven Toor
March 29th 2017

This weeks readings were focused on the topic of disease prevention and
the first reading of this week was focused on Febrile illness diagnostics and
the malaria-industrial complex: a socio-environmental perspective. This
paper analyzed the febrile illness found in sub-Saharan Africa and began by
looking at the economical contribution to diseases and stated that global
funding for malaria was 2.7 billion dollars in 2013. Malaria is the most
common diagnosis for febrile (fever-like symptoms) patients in low-resource
health care settings. The study also mentions that there is an inaccurate
diagnosis done where there are patients that are being misdiagnosed with
malaria. This has in turn caused and has created a malaria-industrial
complex) that causes a high rate of malaria when there isnt that high of a
rate and underrepresentation of what the actual burden of disease is. The
interesting take away I had form this study was that there was a socio-
environmental approach proposed that should be undertaken that would help
increase diagnostics and management and etiology that in turn helps create
a more efficient malaria control that helps increase the overall help in sub-
Saharan Africa. I found it interesting that we were seeing this issue in low-
resource settings where there was the misdiagnosing happening, but it made
me question if we could potentially see this issue happening in a developed
country or a high-resource country, where diagnoses there may also
potentially be being based off of predictor symptoms. The next reading was
on the surveillance response systems and how they can be the key to
eliminating tropical disease. The study acknowledged that there is a decline
in infectious diseases worldwide and that this was due to the responses of
basic health problems and improving healthcare delivery to those most
vulnerable in society. The study also touches on the London Deceleration on
Neglected Tropical Disease (NTD) and how they propose strategies and NTD
roadmaps and what year they should be eliminated from. As I was personally
reading this I was actually quite intrigued by the push for a surveillance
response system and the 5 steps that were stated in the paper (resource-
sharing, development of new strategies etc.). These were implemented in
china where there was an experimentation where surveillance-response was
successful. The overall study seemed to have been focused on actually
eliminating these tropical diseases rather then focusing on reducing it, or
reducing them within a specific area, or a specific population (vulnerable
population). The last reading of this week was again focused on malaria and
was focused on reducing microscopy based malaria misdiagnosis in a low-
resource area of Tanzania. This study took place in Tanzania, specifically in
the rural areas where the focus was on reducing the misdiagnosis of malaria.
The study was using a simple intervention and a social-entrepreneurship
approach that would reduce malaria in low-transmission areas such as rural
Tanzania. What I found really intriguing was that the paper mentioned that
WHO had guidelines for when presumptive diagnosis and treatment could be
done and it was only for children 5 and younger in endemic areas as well as
when the diagnostic tests were unavailable. The simple intervention
consisted of training local staff to WHO standards, addition of institutionally
trained lab tech, training on local epidemiological information and lastly
feedback on current levels of malaria microscopy sensitivity specificity and
misdiagnosis magnitude. Accurate lab work and diagnosis of malaria can
help guide proper clinical decisions and reduce the use of unnecessary
antimalarials.