In the October 30th article from the Toronto Star (below), reporter Debra Black speaks to Dr. Kevin Kain about the trial in Uganda.
http://www.thestar.com/news/world/article/1078341—has-malaria-met-its-match
” Hundreds of thousands of children die each year from cerebral malaria, but a new treatment developed by a Canadian could reduce the impact of the debilitating disease.
Dr. Kevin Kain, one of the world’s leading experts in malaria, is conducting a study to determine whether nitric oxide can improve the survival rates of children with cerebral malaria, as well as prevent the disease’s debilitating neurological side effects.
“To think 7.7 million kids die before they reach their fifth birthday — it’s shocking,” said the 56-year-old head of the McLaughlin-Rotman Centre for Global Health, Tropical Disease Unit in Toronto. “Almost all of those (deaths) — 98 per cent — occur in the developing world. It’s very unfair.”
Kain’s work is part of a wave of efforts focusing on malaria — a scourge in the developing world, with 200 million cases annually and a death toll of about one million a year.
The nitric oxide study has just started in a hospital in Uganda. It will take a year to 18 months to complete and if successful, could mean a sea-change in medical treatment, Kain told the Star.
Doctors could begin to use nitric oxide (not the anesthetic nitrous oxide) on children almost immediately — between two and five years after a successful trial.
In scientific terms that’s relatively fast: it’s usually many years of trials before vaccines are used on humans.
Nitric oxide is naturally produced by the body to control a variety of biological processes. Severe malaria decreases its production, leading to harmful effects.
Kain turned to the gas because it’s the only thing that appears to stop malaria from creating leaky blood vessels in your brain. Fortunately, it was already used for respiratory problems in humans.
“You always want to reposition drugs,” he said. “In the developing world, if you want to develop a new drug it’s very difficult to engage funds from pharmaceutical companies because they don’t see a profit margin.”
Kain’s project comes at a time when years of collective efforts at eradicating the deadly disease seems to be reaching a critical mass.
In September, the World Health Organization announced that malaria deaths had been cut by 38 per cent over the past 10 years — and it hoped to reduce the number of deaths to near zero by 2015.
This month, an experimental vaccine from GlaxoSmithKline was found to cut the risk of the disease in young children by about 50 per cent.
“The world has made remarkable progress with malaria control,” said Dr. Robert Newman, director of the malaria program with the WHO.
“Better diagnostic testing and surveillance has provided a clearer picture of where we are on the ground,” he said.
“In 2011, with the highly effective interventions we have available, no one should die from malaria.”
Still, it may be premature to celebrate a total victory over malaria. The WHO report and new vaccine were greeted with caution by some; including Kain, who has his doubts about the eradication of malaria just yet.
Transmitted by mosquitoes, the disease can cause fever and flu-like illness, and if not treated immediately, can be fatal. Twenty-five per cent of children who survive are left with long-term brain injury and disabilities.
Kain’s passion for the children who suffer is palpable. He and his team have been tireless fundraisers for the cause. On occasion Kain has called on the star power of his famous sister, ballerina Karen Kain.
“My sister loves the project and is keen to help,” he said. “(But) there are lots of demands on her time and I try not to be one of them.”
Originally, Kain planned to be a surgeon, but a year-long Africa trip after med school changed his mind.
“It was a fundamental watershed moment in my life when I realized most of the world was dying from stuff I wasn’t even educated about,” he said.
So Kain headed back to school, becoming a specialist in infectious diseases. In the U.S., he worked on some of the first malaria vaccines, which are only now in human trials some 20 years later.
Sitting in his Toronto office — full of mementoes of Africa and Asia — on a fall morning, Kain’s thoughts remain focused on the hospital in Uganda where 180 children with cerebral malaria are part of his study.
Kain and his team have already tested nitric oxide in a study on mice. It improved the chances of survival and also substantively protected against neurological damage.
Kain is banking on the same effect on the very sick children in Uganda.
“We believe that amongst the most fundamental of human rights should be the chance to actually make it to your fifth birthday — and with your brain intact.”
Tuesday, April 24, 2012 at 5:24PM 
