Product Name : Commercial production of Sterile maggots of Lucilia cuprina
Centre : Infectious Disease Research Centre
Unit : Entomology Unit
Treatment of intractable wounds is often dependent on surgery, antibiotics, oxygen therapy etc. The appearance of multiple resistance strains of bacteria renders such treatment ineffective and resulting in limb amputation. Use of blowfly maggots to treat wounds has a long and successful history in the west. The pre-requisite to provide maggots for such treatment is the ability to mass produce bacteria-free maggots. In the west, maggots of the temperate species, Lucilia sericata are used. This fly, however, is not found in the tropics. The local species, Lucilia cuprina has been found by IMR researchers to be as effective as its western counterpart. A local company in 2008 has started commercial production of the maggots to be used in all hospitals in Malaysia under the trade name STERILARVA.
IMPACT OF MDT
The prevalence of diabetes for all age-groups worldwide was estimated to be 2.8% in 2000 and 4.4% in 2030 (WHO, 2004). The total number of people with diabetes is projected to rise from 171 million in 2000 to 366 million in 2030. In the Middle Eastern Crescent, the number of diabetics is expected to increase from 20 million in 2000 to 52 million in 2030 (a 163% increase). Based on the world figures in 2000, assuming 10% of these patients develop diabetic ulcers, the number will be about 17 million worldwide. Assuming that 25% of these patients require amputation, the number of amputee in 2000 will be 4.25 million. Since the prevalence of diabetic ulcers is increasing yearly, it is extrapolated that at least 4-5 million amputations due to diabetic wounds will be performed yearly. The cost of treating a diabetic ulcer is estimated to be about USD 3,000 in Malaysia, while an amputation is estimated to be about USD 2,000. Hence, the total cost of treating diabetic ulcer will be USD 5.1 billion and cost of amputation will be 1 billion per year. This represents a heavy burden & toll on the healthcare system, especially in developing and under-developed nations. In addition, the social cost, psychological pains, stigma, mortality & morbidity of amputation cannot be estimated in monetary terms. Since MDT has been proven to be effective in treating intractable wounds, amputation can be avoided. MDT is also much lower in cost. A complete treatment (5 applications of maggots) is estimated to cost about USD 100-200 only. This translated into huge saving besides saving limbs and lives and psychological well-being.
In comparison with conventional wound treatment using surgery, hyperbaric oxygen, wound-cleaning, MDT only requires 10 minutes for applying the larvae onto the wound areas, without use of any sophisticated equipment or apparatus.
- As MDT is simple & can be carried out easily, many more patents can be treated within a short period of time. Most of these patients can also be treated as out-patients without the need of hospitalization, thus freeing the hospital wards for other patient's needs.
- The need for skilled human resources is also greatly reduced as such operation can be conducted by other medical staff, other than medical doctors
- Since MDT requires minimum care after application, nursing staff can also be freed to care for other needy patients
4. Client Satisfaction
As mentioned, most patients were satisfied that no amputation was required and that their wounds were successfully treated. In addition, almost all patients did not experience any pains or undesirable effects, making the acceptance of MDT widespread.
MDT is safe and not a single patients treated by us experienced any pain, discomfort or side-effects. The safety track record of MDT using L. cuprina is very good.