Equatorial Guinea is expanding an ambitious malaria elimination plan - The Washington Post

MALABO, Equatorial Guinea (AP) — With its torrential rains, tropical forests and omnipresent humidity, Equatorial Guinea provides the perfect conditions for mosquitoes to breed. For centuries, mosquito-borne diseases, in particular malaria, have dictated the fate of residents of this central African nation, impacting how they lived, worked and died. But Bioko island, off mainland Equatorial Guinea, has managed to sharply reduce malaria infections and deaths. Bioko, roughly half the size of Rhode Island, has used familiar tools: indoor spraying, mosquito nets and keeping control of the larvae population. Its success, however, has depended on something less easily replicated: two decades of painstaking data collection, sustained funding and workers going door to door to win residents' trust. Now the tiny, oil-rich country wants to bring that approach to its mainland and eliminate malaria altogether. But the expansion of Bioko's strategy presents formidable challenges, from porous international borders to the sheer scale of the territory.

A roar of laughter erupts from a crowd inside a large conference room at the De Vere Cranage Estate hotel. The joke? The idea that visiting the doctor could help treat a serious illness. On stage the controversial Australian proponent of natural remedies Barbara O’Neill is taking part in a question-and-answer session during a five-day wellness conference, where science mixes uncomfortably with Bible verse and potentially deadly pseudo-scientific practices. She is advising people attending at the event in Cheshire on a variety of medical ailments, and dismisses the use of antibiotics, vaccines or scientifically proven cancer treatment. Tickets for the residential retreat can cost up to £1,300. An undercover reporter for the Guardian attended for one day, observing four sessions covering topics including the immune system and one titled Barbara Under Attack. The audience’s rapturous laughter is prompted by a woman asking O’Neill if there is anything that could help her lupus, which she says has not responded well to the doctor’s treatments. “Yes, keep away from the doctor,” quips O’Neill.

Patients receiving oral anticoagulation (OAC) for atrial fibrillation frequently have concomitant coronary artery disease (CAD), raising questions about the duration of additional antiplatelet therapy. Triple antithrombotic therapy combines OAC with aspirin and a P2Y₁₂ inhibitor, usually clopidogrel, whereas dual antithrombotic therapy combines OAC with a single antiplatelet agent. Early aspirin withdrawal from triple therapy and subsequent withdrawal of the remaining antiplatelet are separate decisions requiring assessment of the coronary timeline and current treatment indications. This narrative editorial examines randomized evidence and proposes a structured medication review framework. The evidence generally supports OAC monotherapy in appropriately selected patients with stable CAD, with reduced bleeding and favourable net clinical outcomes compared with combined treatment. However, aspirin-specific findings require distinction from comparisons involving clopidogrel or mixed antiplatelet regimens. Overall trial results do not establish identical benefits or harms across patients with previous myocardial infarction, multivessel disease, or complex coronary intervention. Differe

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