Recommendations for the treatment and prevention of malaria: Update for the 2015 season in South Africa

Notified malaria cases in South Africa (SA) decreased significantly over the past 14 years, from over 60 000 in the 1999/2000 malaria season to less than 13 000 in 2013/2014. However, the past two seasons have seen increases in both local and imported cases. Mozambique contributes the highest number of imported cases in SA. This update provides recommendations for malaria treatment and prevention (in travellers and residents) for 2015

COVID-19: Current Challenges and Future Perspectives.

[Extract] This article belongs to the Special Issue COVID-19: Current Challenges and Future Perspectives. At the time of submission for publication (7 January 2022), COVID-19, named by the World Health Organization (WHO) on 11 February 2020, had caused more than 296.5 million cases and over 5.5 million deaths with over 2.6 million new cases in the past 24 h [2]. The COVID-19 pandemic has greatly affected the capacity of health systems providing essential health care [1], but more than 9.195 billion vaccine doses have been administered as of 10 January 2021 [2]

COVID19: Current Challenges and Future Perspectives

This Special Issue focuses on recent global research on the current coronavirus (COVID-19) pandemic. The disease is caused by a novel virus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The International Committee on Taxonomy of Viruses (ICTV) named the virus SARS-CoV-2, as it is genetically related to the coronavirus responsible for the SARS outbreak of 2003. While related, the two viruses are quite different in their behaviour. At the time of submission for publication (7 January 2022), COVID-19, named by the World Health Organization (WHO) on 11 February 2020, had caused more than 296.5 million cases and over 5.5 million deaths with over 2.6 million new cases in the past 24 h. The COVID-19 pandemic has greatly affected the capacity of health systems providing essential health care, but more than 9.195 billion vaccine doses have been administered as of 10 January 2021. There have been 22 papers published upon peer review acceptance in this Special Issue, including one editorial, twelve research papers, three review papers and seven other papers, including one perspective, two case reports, one brief report, two viewpoints and one commentary. They each contribute to a much better understanding of COVID-19

Rabies post-exposure prophylaxis: A systematic review on abridged vaccination schedules and the effect of changing administration routes during a single course

International audienceRabies is a fatal zoonotic disease preventable through timely and adequate post-exposure prophylaxis (PEP) to potentially exposed persons i.e. wound washing and antisepsis, a series of intradermal (ID) or intramuscular (IM) rabies vaccinations, and rabies immunoglobulin in WHO category III exposures. The 2010 WHO position on rabies vaccines recommended PEP schedules requiring up to 5 clinic visits over the course of approximately one month. Abridged schedules with less doses have potential to save costs, increase patient compliance, and thereby improve equitable access to life-saving PEP for at-risk populations. We systematically reviewed new evidence since that considered for the 2010 position paper to evaluate (i) the immunogenicity and effectiveness of PEP schedules of reduced dose and duration; (ii) new evidence on effective PEP protocols for special populations; and (iii) the effect of changing routes of administration (ID or IM) during a single course of PEP. Our search identified a total of 14 relevant studies. The identified studies supported a reduction in dose or duration of rabies PEP schedules. The 1-week, 2-site ID PEP schedule was found to be most advantageous, as it was safe, immunogenic, supported by clinical outcome data and involved the least direct costs (i.e. cost of vaccine) compared to other schedules. To supplement this evidence, as yet unpublished additional data were reviewed to support the strength of the recommendations.Evidence suggests that changes in the rabies vaccine product and/or the route of administration during PEP is possible. Few studies have evaluated PEP schedules in persons with suspect or confirmed rabies exposures. Gaps exist in understanding the safety and immunogenicity of novel PEP schedules in special populations such as infants and immunocompromised individuals. Available data indicate that administering rabies vaccines during pregnancy is safe and effective

Management of uncomplicated malaria

The original publication is available at http://www.cmej.org.za/index.php/cmejThe key issues in the successful management of malaria are early and accurate diagnosis and urgent treatment with effective drugs. Disease presentation is, however, not specific – progression to complicated disease may be rapid in non-immune persons, particularly in young children and pregnant women, and parasite drug resistance significantly influences treatment outcome.Publishers' Versio

Odyssean malaria outbreaks in Gauteng Province, South Africa, 2007 - 2013

Background. Odyssean malaria refers to malaria transmitted by translocated mosquitoes and is a diagnosis of exclusion, as the probability of finding the responsible vector is miniscule. We believe that road traffic from endemic areas in and around South Africa is the source of most of the infected mosquitoes. Because of the unexpected nature of the disease, diagnosis is often delayed and severe and complicated malaria is common.Objectives. To describe outbreaks of odyssean malaria during the period 2007 through 2013 in Gauteng Province, South Africa, and to educate healthcare workers about this form of malaria.Methods. Site visits, environmental hygiene inspections, patient interviews, and entomological investigations for adult mosquitoes and larvae in potential breeding sites were done in each identified outbreak.Results. Over the period, 14 laboratory-proven and 7 probable cases of odyssean malaria were investigated. There were 2 deaths (9.5% case fatality rate, approximately 10 times higher than the national fatality rate for malaria). We describe two recent clusters of cases in detail, and emphasise the importance of clinician awareness of this rare but frequently severe form of malaria.Conclusion. Odyssean malaria cases are inevitable in South Africa, given the volume of road, rail and air traffic from malaria risk areas into Gauteng and other non-endemic provinces. It is likely that many cases are missed, owing to the rare and sporadic nature of the condition. Malaria should always be kept in mind as a cause of unexplained fever and thrombocytopenia, even in the absence of a travel history.