Epidemiology significant achievements
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.
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Some most recent scientific accomplishments (in 2018) include:
• 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.
• 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.
• 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.
• 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.
• 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.
• Large molecular surveillance studies of antimalarial drug resistance in the Greater Mekong Subregion were continued and shared on publicly accessible maps.
• A low-cost electronic ICU registry was developed in Sri Lanka and is now implemented in the region.