Research shapes policy for dengue and malaria
6 January 2010
The World Health Organization has issued new guidelines for the diagnosis, treatment, prevention and control of dengue - the first update in 12 years.
The research findings of the Wellcome Trust's Major Overseas Programme in Viet Nam played a central part in shaping the changes.
The new guidelines acknowledge the dramatic increases in cases of dengue globally including recent epidemics in Africa where the disease has not previously been regarded as a major health threat.
Among the changes are a new clinical simplified classification system aiming to help standardise disease surveillance, improve triage and clinical management of patients, and aid future intervention and pathogenesis studies. The guidelines also consider strategies and methods to help control the mosquitoes that spread the dengue virus.
"The new dengue guidelines are an excellent example of inter-institutional team work across three continents and with investigators in eleven countries," says Professor Axel Kroeger of the WHO's Special Programme for Research and Training in Tropical Diseases (WHO-TDR) Programme.
"Nobody would have gone so far in moving research into policy and now practice without the help of the others. The Wellcome group in Viet Nam, TDR-WHO and the European Union funds in particular have helped to make this process and progress a reality."
Malaria policy in Kenya has also been influenced by Trust-funded work. For example, research by Dr Abdisalan Noor from the Kenya Medical Research Institute-University of Oxford-Wellcome Trust Collaborative Programme has fed directly into the Kenyan government's 10-year plan for the monitoring and evaluation of malaria.
Dr Noor's research uses data from community malaria surveys and earth-orbiting satellites and other sources to plot high-resolution maps, offering fresh insights into the prevalence and spread of malaria, as well as the effect of treatment and prevention methods.
One of the maps, highlighting the prevalence of Plasmodium falciparum malaria in different regions of Kenya, features prominently in the government's published Malaria Monitoring and Evaluation Plan 2009-2017.
"In the plan, our map is the basis upon which the Division of Malaria Control has defined the distribution of populations at risk under various levels of malaria endemicity," says Dr Noor.
"As the plan moves to the implementation phase, the Kenya malaria map will be used to target appropriate suites of interventions tailored to the underlying malaria risk."
"What is encouraging is that risks can be measured using survey data of infection prevalence; we have shown here that their spatial distribution can be modelled and mapped with accuracy; and that this can become the basis for judging the future success of control nationwide using data that does not depend upon opportunistic historical surveys."
Image: Strategies and methods for controlling mosquitoes are among the issues considered in new WHO dengue guidelines. Credit: James Jordan on Flickr
Reference
Noor et al. The risks of malaria infection in Kenya in 2009. BMC Infectious Diseases 2009, 9:180
