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The Nuffield Department of Medicine (NDM) at the University of Oxford has a global reach and significant breadth in terms of capabilities and capacity.
Bob Taylor: Primaquine for vivax and falciparum malaria
Primaquine can be used both to treat vivax malaria and to prevent the transmission of falciparum malaria from human to mosquito. A shorter and age-based primaquine regimen would reduce the burden of vivax malaria. It would also allow primaquine to be used more widely to block the transmission of falciparum malaria.
Lisa White: Mathematical modelling for tropical diseases
Mathematical modelling, particularly when combined with economical modelling, allows researchers and policy makers to determine the most effective interventions to fight infectious diseases such as malaria. We can use those models to explore ‘what ifs’ scenarios, at country or province level, save more lives and limit costs.
Ric Price: Curing Plasmodium vivax malaria
Vivax malaria used to be considered benign but is now recognised as an important cause of morbidity and mortality. Resistance to chloroquine (given to treat the parasite blood stage) is growing and ACT (artemisinin-based combination therapy) is becoming common treatment for vivax malaria. New drugs and better public health strategies can help elimination targets, anticipated for 2030.
Olivo Miotto: Genomics and global health
Genomics is the study of the complete DNA sequence, for example of a particular parasite, allowing us to analyse its evolution and the impact of human interventions. Alongside clinical date, we use genomics to identify mutations that are markers for drug resistance. Mapping out drug resistance then helps inform elimination programmes.
Frank Smithuis: Fighting malaria in Myanmar
Although malaria is decreasing in Myanmar, resistance to anti-malarials is on the rise in the region and the focus is now to treat people early, particularly in remote communities. MOCRU has set up a network of community health workers, trained and supplied with diagnostics, bednets and treatments, to help improve access to healthcare as well as produce the evidence to encourage policy changes.
Andrea Ruecker: Blocking malaria transmission
In the falciparum malaria parasite cycle, the gametocyte stages are responsible for the transmission from person to mosquito, then to other persons. A better understanding of how gametocytes respond to malaria treatments would help us block transmission and ultimately eliminate malaria.
Rob van der Pluijm: Tracking antimalarial resistance and treatment of malaria using Triple ACTs
Anti-malaria drug resistance is spreading throughout Southeast Asia and we need to find new treatments. Our researchers at MORU use a combination of artemisinin and two partner drugs instead of one. If confirmed safe and tolerable, triple artemisinin combination therapies might be a good option to treat multi-drug resistant malaria, as well as slow down the emergence and spread of anti-malarial resistance.
James Watson: Primaquine and vivax malaria
Primaquine is a drug used to eliminate vivax malaria from the liver and prevent relapses. However, it causes anaemia in patients with G6PD deficiency. A new, slightly longer regimen with increasing doses of primaquine could allow to safely treat all patients with vivax malaria.
Xin Hui Chan: Using big data to eliminate malaria
Malaria is the most important parasitic infection to still affect humans, and a safe use of antimalarial drugs is paramount. The current explosion of clinical data is causing a jungle of data; making sense of all this data will greatly help us in our fight to eliminate malaria.
Bob Snow: Malaria control in Africa
Quality data is vital to design better malaria control programmes. This project helps various African countries gather epidemiological evidence to better control malaria. Professor Bob Snow showed how sub-regional, evidence-based platforms can effectively change malaria treatment policies.
Lorenz von Seidlein: Malaria elimination in the Greater Mekong sub-region
Multidrug resistant P. falciparum malaria is now established in parts of Thailand, Laos and Cambodia, causing high treatment failure rates for artemisinin combination therapies, the main falciparum malaria medicines.
Georgina Humphreys: Optimising malaria treatment
WWARN is a network of research that analyses pooled data of numerous clinical trials. The sheer size of those data sets allows study groups to answer questions that couldn't be asked of a normal size clinical trial, such as the efficacy of an anti-malarial drug on malnourished or severely anaemic children. This research helps design policies to maintain the efficacy of current anti-malaria drugs, currently threatened by growing resistance.
Mehul Dhorda: Finding the best malaria treatments
For malaria, parasite resistance and treatment efficacy is dynamic. Resistance to artemisinin, sometimes induced by poor quality medicines, causes artemisinin-based combination therapies (ACTs) to start failing. A robust system for surveillance of resistance can help ensure people get the right treatment at the right time.
Richard Maude: Epidemiology and malaria elimination
Malaria epidemiology focuses on two main challenges to malaria elimination: antimalarial drug resistance and the movement of people that are spreading the malaria parasite. Travel surveys and cellphone records, combined with population parasite genetics help predict the spread of malaria and of drug resistance. Close coordination with all groups and agencies involved is crucial to malaria surveillance and elimination strategies.
Kesinee Chotivanich: Malaria laboratory at MORU
More effective diagnosis and treatments are needed to reduce the morbidity and mortality affecting malaria patients. Researchers at the Malaria Laboratory at MORU study the pathophysiology of the disease, and test new compound drugs for anti-malarial activity. In the context of growing artemisinin resistance, this research will have a global impact.
Philip Bejon: Malaria in Kenya
Understanding the variation of malaria risk between houses, villages or region, and how malaria is transmitted in and around that variability helps develop better malaria control programmes and use their resources more wisely. Since malaria control tools are becoming less effective with time, progress in vaccine design is essential.
Rose McGready: Malaria in pregnancy
In pregnant women, severe malaria is responsible for high maternal mortality, and uncomplicated malaria results in in high morbidity. Careful documentation of treatments showed that, although not all drugs are available for pregnant women, early treatment can greatly increase the outcome of the pregnancy, and give that child a better chance at a productive life.
Philippe Guérin: Sharing data to fight malaria
Over 250 Institutions participate in the effort of sharing data on the efficacy of antimalarial drugs, which involves standardising and re-analysing data. Bringing all this data together creates new evidence that can be translated into policy practice, offering new therapeutic options for particular populations.
Charlie Woodrow: Artemisinin Resistance
Artemisinins are very poweful tools in the treatment of malaria, and the emerging loss of their activity has the potential to create a major public health problem. Understanding how this resistance has developed and spread helps better treat patients, treat populations and eliminate malaria, which is the new goal in South East Asia.
Joel Tarning: Getting the dose right
Too high a dose can result in toxicity and side-effects, too low a dose can cause the illness to come back and at worse develop resistance. In the case of malaria, it is particularly important to get the dosage right for more vulnerable patients such as children and pregnant women. Professor Joel Tarning's findings have now been adopted by the World Health Organisation.