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Our work on severe malaria includes study sites in Bangladesh and Kinshasa, DRC

Image15.jpeg © MORU 2019
MORU’s long-standing collaboration with Chattogram Medical College Hospital (CMCH) includes the SEAQUAMAT trial, a large multicentre, multinational trial comparing parenteral artesunate and quinine in the treatment of severe malaria, which showed a huge survival benefit in favour of artesunate. The research agenda has now broadened and includes causes and management of bacterial sepsis.

Chattogram (formerly Chittagong), Bangladesh

MORU has a long-standing collaboration with Chattogram Medical College Hospital (CMCH), involving collaborative research projects and the exchange of medical knowledge. Formerly known as Chittagong, Chattogram is the 2nd largest city in Bangladesh. CMCH was one of the main centres in the SEAQUAMAT trial, a large multicentre, multinational, trial comparing parenteral artesunate and quinine in the treatment of severe malaria, which showed a huge survival benefit in favour of artesunate. Since then, MORU Malaria & Critical Illness have collaborated in several important studies on the pathophysiology, treatment and management of severe falciparum malaria. The research agenda has now broadened and includes causes and management of bacterial sepsis. In addition to research activities, MORU organised, together with the Academic Medical Centre in Amsterdam, training courses in ICU medicine.

CMCH is currently hosting MORU clinicians for the 2nd recruitment season for the PERFuSE study. Funded by Wellcome, PERFuSE is a two-year study focused on using bedside methods to assess haemodynamics and tissue perfusion in malaria and sepsis patients. PERFuSE aims to evaluate simple clinical measures of peripheral perfusion, fluid responsiveness and lung congestion and their relationship with administered fluids in low resource settings.

Kinshasa, DR Congo, directed by Dr Caterina Fanello and Dr Marie Onyamboko

Working closely with the University of British Columbia (UBC)'s Support Program to Advance Research Capacity (SPARC), MORU Malaria Researcher Dr Katherine Plewes (right) was recently awarded a 3-year, C$971,551 grant for her study on Evaluating the renoprotective effect of acetaminophen in pediatric severe falciparum malaria: A randomized controlled trial.

The study, a much larger version of Katherine’s earlier randomized controlled trial in adults with severe malaria in Chattogram (formerly Chittagong), Bangladesh that showed that paracetamol improved kidney function and reduced the odds of developing Acute kidney injury (AKI), an important problem that contributes to an estimated 1.7 million deaths annually.

As children bear the major burden of malaria, Katherine’s study will test this protective effect in on African children, where AKI affects up to 45% of patients. With an ultimate goal to assess the role of paracetamol as a renoprotective adjunctive therapy in severe malaria, Katherine with Dr Caterina Fanello and the team at DR Congo will conduct at KIMORU, Kinshasa a randomized controlled trial of adjunctive paracetamol in 460 African children with severe malaria. The study is expected to begin in September 2019.

Arjen Dondorp (MORU) is co-primary grant applicant. Dr Caterina Fanello, Dr Marie Onyamboko (both KIMORU), Prof Kevin Kain (University of Toronto), Dr Adeera Levin (UBC) and Dr Mavuto Mukaka (MORU) are co-applicants, and Prof John Oates (Vanderbilt University) is collaborator.