“As a scientific worker we need innovation spirit to find new things” commented Tu Youyou in a telephone interview following the announcement of the 2015 Nobel Prize in Physiology or Medicine. The Chinese scientist was awarded the Prize for her discovery of artemisinin in the 1970s, now a life-saving antimalarial drug. Leading a small team of researchers, she was the first to isolate the active ingredient from the Artemisia plant, using ether to extract it.
This innovative spirit is still needed and across all disciplines in research and development to kill the malaria parasite, to beat back the mosquitoes and to stop transmission. At MESA (Malaria Eradication Scientific Alliance) we are marking World Malaria Day 2016 by highlighting some of today’s most exciting research. We asked five experts from around the world to recommend a recently published paper which, in their eyes, takes us a step forward in ending malaria for good. All the papers are open access. Here are their top picks.
- 'Contrasting Transmission Dynamics of Co-endemic Plasmodium vivax and P. falciparum: Implications for Malaria Control and Elimination' from Noviyanti R and colleagues, published in PLOS Neglected Tropical Diseases is Shwe Sin Kyaw’s (Mahidol Oxford Tropical Medicine Research Unit) top pick. In order to move towards more targeted implementation of resources to eliminate malaria, we need to know how frequently and how focally parasites are transmitted. The paper describes a study in Indonesia which used genotyping techniques to answer these questions. Shwe Sin works in health economics and applies economic-epidemiological modelling for malaria elimination in South East Asian settings, “understanding local variation of malaria species will facilitate selection of targeted malaria interventions”. Results described in the paper point to the importance of the dormant stage of P.vivax, the hypnozoite in sustaining malaria transmission.
- Melissa Kapulu (KEMRI-Wellcome Trust Programme) enthusiastically recommended a whole reading list, “I work on gametocytes and transmission. These papers in my view made it to the honours list”. [3-7] For Melissa, a critical component to achieving malaria elimination is “understanding the dynamics and factors influencing transmission”. Two papers in particular highlight some of the challenges and offer different approaches: ‘Changing Trends in P. falciparum Burden, Immunity, and Disease in Pregnancy’ from Mayor A, et al published in The New England Journal of Medicine and ‘Modeling malaria genomics reveals transmission decline and rebound in Senegal’ from Daniels R, et al published in PNAS.[3,4] Both papers examine trends in malaria transmission in sub-Saharan African settings and discuss the importance of preventing resurgence and maintaining a downward trend in malaria transmission through malaria control programmes and the implementation of tools. The methodologies tested to track trends in transmission are novel. Mayor and colleagues test pregnancy-specific antibodies as markers of infection and Daniels and colleagues describe SNP genotyping in combination with an epidemiological model and incidence data to track parasite population dynamics.
- ‘Targeting Human Transmission Biology for Malaria Elimination’ from Nilsson S et al, published in PLOS Pathogens is what Lotus van den Hoogen (London School of Hygiene and Tropical Medicine) recommends fellow scientists to read. The review focuses on the transmission biology of P. falciparum gametocytes, which is the developmental stage of malaria parasites which mosquitos can pick up when they bite an infected human. She commented that “when I read it, a lot fell into place regarding transmission biology” although she reminds us not to forget that there is another player in malaria transmission – the mosquito. This review by Nilsson and colleagues was also an important paper for Melissa Kapulu, “if we don’t have interventions dealing with gametocytes, the parasites responsible for transmission, malaria elimination in some countries might remain but a pipe dream”.
- Wuelton Marcelo Monteiro (Fundação de Medicina Tropical Dr. Heitor Vieira Dourado) is a specialist in P.vivax malaria. His work examines both clinical and epidemiological factors and their implications on malaria elimination in the Amazonian Region. He recommended 'Current Mathematical Models for Analyzing Anti-Malarial Antibody Data with an Eye to Malaria Elimination and Eradication' from Sepúlveda N and colleagues, plublished in Journal of Immunology Research.(8) This paper reviews a set of models using antibodies as biological markers signalling malaria infection, together with mathematical and statistical analyses. The applicability of the models is tested using data from Equatorial Guinea, the Brazilian Amazonia and western Kenya.
- Chigozie Jesse Uneke (Ebonyi State University Nigeria) reminds us of the need for evidence-based policy-making if malaria eradication is going to become a reality. Jesse leads research in evidence-informed health policy and health systems and selected ‘Malaria Policy Advisory Committee to the WHO: conclusions and recommendations of eighth biannual meeting (September 2015)’ from the WHO Malaria Policy Advisory Committee (MPAC) and Secretariat and published in Malaria Journal. He commented that “the paper provided me with valuable insights...especially regarding reforms to improve innovation, efficiency and quality in vector control tools.” The discussions, conclusions and recommendations generated from each MPAC meeting are published in a dedicated series in Malaria Journal and accessible to all. Recommendations reported in this paper include those on mass drug administration, malaria in pregnancy and scaling back vector control. For Jesse “this series undoubtedly makes a significant contribution towards malaria elimination. If the recommendations are implemented there is great likelihood that they can lead to malaria defeat in many low income settings.”
Thank you to the experts who recommended papers. This blog was written by Kate Whitfield, MESA Coordinator. MESA is hosted at ISGlobal, Barcelona Institute for Global Health. This blog is one of the #EndMalariaForGood World Malaria Day 2016 blog series http://www.worldmalariaday.org/blog.
- Youyou Tu interview http://www.nobelprize.org/nobel_prizes/medicine/laureates/2015/tu-interview.html
- Noviyanti R, Coutrier F, Utami RAS, Trimarsanto H, Tirta YK, Trianty L, Kusuma A, Sutanto I, Kosasih A, Kusriastuti R, Hawley WA, Laihad F, Lobo N, Marfurt J, Clark TG, Price RN, Auburn S. Contrasting Transmission Dynamics of Co-endemic Plasmodium vivax and P. falciparum: Implications for Malaria Control and Elimination. PLOS Neglected Tropical Diseases. 2015 May 7, 9(5): e0003739. doi:10.1371/journal.pntd.0003739 < http://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0003739 >
- Mayor A, Bardají A, Macete E, Nhampossa T, Fonseca AM, González R, Maculuve S, Cisteró P, Rupérez M, Campo J, Vala A, Sigaúque B, Jiménez A, Machevo S, de la Fuente L, Nhama A, Luis L, Aponte JJ, Acácio S, Nhacolo A, Chitnis C, Dobaño C, Sevene E, Alonso PL and Menéndez C. Changing Trends in P. falciparum Burden, Immunity, and Disease in Pregnancy. N Engl J Med. 2015 Oct 22;373(17):1607-17. doi: 10.1056/NEJMoa1406459. < http://www.nejm.org/doi/full/10.1056/NEJMoa1406459#t=article >
- Daniels RF, Schaffner SF, Wenger EA, Proctor JL, Chang HH, Wong W, Baro N, Ndiaye D, Ba Fall F, Ndiop M, Ba M, Milner DA Jr, Taylor TE, Neafsey DE, Volkman SK, Eckhoff PA, Hartl DL and Wirth DF. Modeling malaria genomics reveals transmission decline and rebound in Senegal. Proc Natl Acad Sci U S A. 2015 Jun 2;112(22):7067-72. doi: 10.1073/pnas.1505691112. < http://www.pnas.org/content/112/22/7067.long >
- Bhatt S, Weiss DJ, Cameron E, Bisanzio D, Mappin B, Dalrymple U, Battle KE,Moyes CL, Henry A, Eckhoff PA, Wenger EA,Briët O, Penny MA, Smith TA, Bennett A, Yukich J, Eisele TP, Griffin JT, Fergus CA, Lynch M, Lindgren F, Cohen JM, Murray CLJ, Smith DL, Hay SI, Cibulskis and Gething PW. The effect of malaria control on Plasmodium falciparum in Africa between 2000 and 2015.Nature. 2015 Oct 8;526(7572):207-11. doi: 10.1038/nature15535. < http://www.nature.com/nature/journal/v526/n7572/full/nature15535.html >
- Cameron E, Battle KE, Bhatt S, Weiss DJ, Bisanzio D,Mappin B, Dalrymple U, Hay SI, Smith DL, Griffin JT, Wenger EA, Eckhoff PA, Smith TA, Penny MA and Gething PW. Defining the relationship between infection prevalence and clinical incidence of Plasmodium falciparum malaria. Nature Communications. 2015 Sep 8. 6:8170. doi: 10.1038/ncomms9170.< http://www.nature.com/ncomms/2015/150907/ncomms9170/full/ncomms9170.html >
- Nilsson S, Childs LM, Buckee C and Marti M. Targeting Human Transmission Biology for Malaria Elimination. PLoS Pathog. 2015 Jun 18;11(6):e1004871. doi: 10.1371/journal.ppat.1004871 < http://journals.plos.org/plospathogens/article?id=10.1371/journal.ppat.1004871 >
- Sepúlveda N, Stresman G, White MT, Drakeley CJ. Current Mathematical Models for Analyzing Anti-Malarial Antibody Data with an Eye to Malaria Elimination and Eradication. Journal of Immunol Research. 2015 Oct 19. 738030. doi: 10.1155/2015/738030. < http://www.hindawi.com/journals/jir/2015/738030/ >
- WHO Malaria Policy Advisory Committee and Secretariat. Malaria Policy Advisory Committee to the WHO: conclusions and recommendations of eighth biannual meeting (September 2015). Malaria Joutnal. 2016 Feb 24;15(1):117. doi: 10.1186/s12936-016-1169-x. < http://malariajournal.biomedcentral.com/articles/10.1186/s12936-016-1169-x >