Severe malnutrition remains common in low-income countries, principally among young children. It usually arises from poor sanitation and infections, besides food insecurity. This comprehensive review by Professor James Berkley describes how research is needed, using modern clinic and laboratory tools, to better understand changes in metabolism, infections and the immune system to improve treatment.
Changing the practices of health care workers in multiple hospitals in low-income settings is a major contemporary challenge that requires people to think about the complex set of influences that affect clinicians’ behaviour. In this report, Professor Mike English describes a multi-layered strategy utilising a new implementation typology linked to overarching theories of change.
Adjuvants are key components used to enhance vaccine efficacy. Their use has been well characterised to stimulate antibody responses but very little has been investigated regarding their effect on cytotoxic T cell responses. In this study, an extensive group of adjuvants has been assessed to investigate immunity enhancement against liver-stage malaria through stimulation of T cell responses. Two were found to improve vaccine efficacy against a sporozoite challenge and the mechanism is presented.
Although naive human T cells underpin the adaptive arm of the immune system, John Todd, Marcin Pekalski, Linda Wicker and colleagues have discovered that these cells express the innate complement receptors, CR2 (or CD21, the EBV receptor) and CR1, opening a new avenue of research in microbial defence in newborn children.
In more than 50,000 pregnancies where 16% of women had malaria infection the odds of small for gestational age and preterm birth following falciparum, and vivax malaria, were quantified. These newborn effects have life-long implications and efforts to effectively prevent malaria in pregnancy must be pursued.
Selecting and trialling therapeutics for preventing congenital Zika disease is challenging. The target product should be low risk, acceptable to the mother, highly effective in preventing adverse fetal outcomes, and practical for widespread clinical use in resource-limited settings. Professor Peter Horby and fellow researchers discuss strategies for addressing these challenges in a recent paper.
A recently-published article by Professor Robert Gilbert in the Royal Society's Philosophical Transactions, following an international meeting in June last year, showcasing pore-forming proteins. Such proteins break open cellular membranes and are used by attacking pathogens, immune systems and in processes as diverse as neurodevelopment and programmed cell death. They also have many technological applications including in DNA sequencing.
Malaria transmission is patchy at local levels, and when a group of houses is located in a high transmission patch this is labelled a "hotspot". Looking at 19 studies in 7 African Countries, we see that hotspots are the norm, and especially prominent when malaria transmission falls according to a recent article published in BMC Medicine by Prof Philip Bejon, Director of the Wellcome-KEMRI-Oxford Collaborative Research Programme