By Professor Kathryn Maitland, Professor of Tropical Paediatric Infectious Diseases and Director of IGHI’s new Centre for African Research and Engagement (ICCARE).
Across large parts of sub-Saharan Africa the major rains have got underway; which typically means that in a few weeks, hospitals will witness a seasonal upsurge of admissions into the children’s wards. Most of these will be children suffering a new bout of malaria, with around ten percent of these malaria admissions having life-threatening complications such a coma (cerebral malaria), severe anaemia (requiring urgent life-saving transfusion) and rapid breathing (to try to compensate for the build up of acids in their bodies). Outcome remains poor. Despite implementation of the new fast-acting effective antimalarial drugs, in-patient mortality remains unacceptably high (~10%).
In many parts of the world, including several sub-Saharan African (sSA) countries, the scale-up of control efforts has led to substantial reductions in the burden of malaria since 2000. The World Health Organization estimated that severe malaria killed up to 500,000 African children in 2013. Whilst the last decade has witnessed a transformation in the epidemiological landscape of malaria, with many areas reporting substantially less malaria. However, this has not occurred equally within or across countries in Africa. In parts of the continent, where the pattern of transmission has not changed appreciably, malaria continues to contribute most to the global disease burden (e.g. Nigeria, DRC, Uganda, Mozambique). Early optimism that the most promising malaria vaccine candidate developed to date (RTS,S) would reduce the burden of severe and fatal malaria has proved premature with the recent publication of long term follow up data reporting a waning vaccine efficacy after 20 months. There seems little prospect for further reducing the substantial mortality burden from severe malaria within the foreseeable future hospitalized with malaria serves as a “barometer” of how well local, national and regional malaria control is performing.
Today is World Malaria Day and this year’s theme is “End Malaria For Good”.
‘Imperial has an extensive research portfolio in malaria encompassing the whole cycle of malaria transmission from the mosquito to the bedside of the critically sick child in Africa with life-threatening infection.
Imperial’s laboratories are home to tens of thousands of mosquitoes that are specially bred to help researchers understand and prevent the spread of devastating diseases such as malaria.
Our researchers include those seeking to probe the fundamental biology of how malaria parasites power their movement (Dr Jake Baum); understanding how common human inherited defects of the red blood cell in Africa (the classic example is the sickle haemoglobin) have lead to protection against malaria and other diseases (Professor Thomas Williams); modelling of disease epidemiology to help how interventions can be optimally combined to reduce transmission and ultimately to lead to local elimination. (Epidemiology and control of Malaria group); understanding how malaria causes life-threatening disease (Dr Aubrey Cunnington) and finally conducting clinical trials to improved outcome (Professor Kathryn Maitland).