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Following the large multi-centre multi-country TRAC II study on triple ACTs (TACTs) to treat multi-drug resistant falciparum malaria, DeTACT, a large project funded by DFID, will expand the evaluation of TACTs to African countries and aims to have 2 different TACTs ready for deployment by the end of the project.

The Malaria & Critical Illness Department’s future vision includes work in:

Antimalarial drug resistance in P. falcIparum | Malaria elimination | Severe malaria | Vivax malaria | Critical Illness

Antimalarial drug resistance in P. falciparum

• Develop fixed dose triple ACTs (TACT) for treating multidrug resistant falciparum malaria

• Understanding the biology of artemisinin and partner drug resistant falciparum malaria

• Effects of drug resistance on gametocyte production and transmissibility

• Transcriptomic changes and biological correlates in multidrug resistant P. falciparum

• The spread and genetic epidemiology of multidrug resistant P. falciparum

• Testing new antimalarial compounds

Malaria elimination

• Role of malaria vaccines in malaria elimination in Southeast Asia

• Role of ivermectin in malaria elimination

• Forest worker malaria prophylaxis

• Improving housing in hot humid regions to reduce vector entry and prevent malaria

• Molecular epidemiology and phenotypes of PfHRP2/3 and PfLDH deleted P. falciparum in relation to their detection with rapid diagnostic tests

• Testing Highly Sensitive (HS)-RDTs to guide FSAT / MSAT approaches for malaria elimination

Severe malaria

• Paracetamol as reno-protective therapy in African children with severe falciparum malaria

• The free haemoglobin-oxidative stress-AKI pathway in severe malaria

• The role of the gut microbioma in severe malaria

• Fluid management in severe falciparum malaria

Vivax malaria

• Optimising radical treatment of vivax malaria with primaquine: adapting current dosing recommendations to develop optimised weight and age-based dosing regimens of primaquine

• Developing innovative primaquine regimens for different regions to obviate the need to test for G6PD deficiency

• CYP2D6 genetic variants and their impact on primaquine efficacy

• Plasmodium vivax Controlled Human Infection Models (with HVCTU)

• Studies on the roll out of the radical cure for P. vivax at village and health post level.

Critical Illness

• Understanding the contributors to intensive care performance in LMICs

• Developing sustainable training models to improve ICU care in LMICs

• Developing and implementing setting adapted ICU registries in LMICs

• The role of lung ultrasound in ICU in LMICs

• Probiotics to prevent ventilator associated pneumonia in LMICs

• Optimising mechanical ventilation strategies in LMICs

• Translating ICU guidelines developed in HIC to LMIC settings