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The Malaria & Critical Illness team published 96 papers in 2018, and 222 papers from 2015-2017, of which many in leading journals. Since its conception in 1979, the Malaria team has published over 1,000 papers.

Image11.png © 2019 MORU
A summary of published results showing the improved performance and reduction in mortality of a large ICU training effort by the MORU ICU team in India, Bangladesh and Nepal

Some most recent scientific accomplishments (in 2018) include:

Malaria elimination | Antimalarial drug resistance | Treatment of falciparum malaria | Vivax malaria | Severe malaria | Malaria laboratory studies | Intensive care in resource limited settings

Malaria elimination

• Large trials in Myanmar, Cambodia, Laos and Vietnam on the use of targeted mass drug administration (MDA) with dihydroartemisinin/piperaquine +/- low dose primaquine showed that the intervention achieved large reductions in falciparum malaria prevalence and highlighted the importance of community engagement to achieve high population coverage. Using a novel ultrasensitive qPCR detection method, the importance of asymptomatic parasite carriage for maintaining malaria transmission in the region was described.

Antimalarial drug resistance

• A series of studies showed increasing antimalarial drug resistance with spread of a single multi drug resistant parasite lineage in the region.  

• Laboratory transcriptomic and cell biology studies described important underlying mechanisms of artemisinin resistance in P. falciparum.

Treatment of falciparum malaria

• A large multinational trial testing triple artemisinin combination therapies (TACTs) for the treatment of drug resistant falciparum malaria (TRAC II) showed high efficacy and acceptable safety and tolerability of TACTs.

Vivax malaria

• The largest ever multicentre study on primaquine radical treatment of vivax malaria (IMPROV) was completed and offers an efficacious and tolerated double dose primaquine regimen over 7 days.

Severe malaria

• The contribution of intravascular haemolysis to acute kidney injury was described, and a randomised clinical trial showed a reno-protective effect of paracetamol in adult severe malaria through an anti-oxidative mechanism.

• In-depth studies on the metabolic acidosis in severe malaria identified important contributing acids with a likely source in the gut microbioma.

Malaria laboratory studies

• Large molecular surveillance studies of antimalarial drug resistance in the Greater Mekong Subregion were continued and shared on publicly accessible maps.

Intensive care in resource limited settings

• A low-cost electronic ICU registry was developed in Sri Lanka and is now implemented in the region.