The treatment of severe malaria

Artemisinins are very poweful tools in the treatment of malaria, and the emerging loss of their activity has the potential to create a major public health problem. MALARIA TREATMENT Dr Charlie Woodrow is based at MORU in Bangkok, Thailand, where he coordinates clinical and laboratory studies on resistance to artemisinins. Bringing together diverse datasets of clinical, in vitro and molecular data has helped better understand the emerging resistance, particularly in Myanmar.

Too high a dose can result in toxicity and side-effects, too low a dose can cause the illness to come back and at worse develop resistance. Professor Joel Tarning is Head of Clinical Pharmacology in our MORU Unit in Bangkok, Thailand. He's working towards drug dose-optimisation using novel pharmacometric modelling approaches. He is particularly interested in antimalarial treatments for children and pregnant women.

Professor Nick White talks about the future of artemisinin and other drug therapies for malaria. Malaria kills more than half a million people every year. Following a number of groundbreaking clinical trials, Professor Nick White and his Thailand team successfully demonstrated the effectiveness of artemisinin drug therapy for malaria in adults, children and infants. He also pioneered artemisinin combination therapy, the first-line treatment for malaria worldwide.

Dr Sumi Biswas talks about the development of a vaccine aimed at the mosquito stage of the malaria parasite cycle. Malaria transmission-blocking vaccines aim to induce immunity against the parasites that infect mosquitoes. Such vaccines will prevent malaria transmission on a wider scale, focusing on the community rather than the individual. Dr Sumi Biswas is working on the development of transmission-blocking vaccines to prevent the spread of malaria.

Dr Simon Draper tells us about his progress in malaria vaccine research. The malaria parasite is a 'master of disguise'. Whilst the development of a vaccine has proved difficult, targeting a pathway for the parasite has led to the neutralisation of all strains of Plasmodium falciparum. Dr Simon Draper's research interests include studies of vaccine-induced malaria immunity and trials of vaccine candidates. Focusing on translational medicine, his group will take their most promising vaccine candidates and manufacture them as clinical grade material; the next step is proof of concept clinical trials in healthy volunteers.

Dr Arturo Reyes-Sandoval tells us about his research on a vaccine against Plasmodium vivax. Plasmodium vivax, one of the four malaria parasites that affect humans, is difficult to eradicate due to its ability to lay dormant in the liver for long periods of time. This parasite is found in Africa, Asia, Latin America and the Western Pacific. 40 percent of the world's population is exposed to the disease that is responsible for around 130 to 350 million clinical cases every year. Dr Arturo Reyes-Sandoval aims to develop a novel malaria vaccine against Plasmodium vivax.

Professor Arjen Dondorp tells us about his work on severe malaria and the development of new therapies. Current malaria therapies using artesunate aim to kill malaria parasites before they mature. Such medications have high success rates but need to be developed further. Based in Bangkok, Thailand, Professor Arjen Dondorp works on the pathophysiology and treatments of severe malaria, antimalarial drug resistance, and improvements in intensive care practice within developing countries.

Professor Kevin Marsh tells us about his research on Tropical Medicine in Kenya. Professor Kevin Marsh has a broad research interest in child health in the tropics, with a particular focus on the immune epidemiology of malaria. Malaria remains a major world health problem, particularly among children in Africa. Based in Kenya, Professor Marsh is working on preventing and curing malaria in Africa. Professor Marsh is director of the KEMRI Wellcome Programme in Kenya; he also coordinates the malaria immunology group within the programme.

Dr Climent Casals-Pascual tells us how new tools can help us diagnose and manage malaria more effectively. In tropical countries, poor diagnosis of malaria often results in sub-optimal treatments. Clinical symptoms of severe malaria are similar to those of other diseases like pneumonia and meningitis. Dr Climent Casals-Pascual is researching the diagnosis and clinical management of severe malaria in tropical populations. Integrating proteomic, genomic and clinical data will help us explain differences in clinical outcome in severe malaria, helping to decrease morbidity and mortality in affected areas.

Professor Adrian Hill talks about recent developments of vaccines against malaria. Around half of the world's population is at risk of contracting malaria. After studying malaria susceptibility in African children for many years, Professor Adrian Hill is now developing a vaccine against malaria by inducing cellular immune responses (T lymphocytes), instead of taking the more common research approach of stimulating antibodies. Prophylactic vaccines developed in Oxford are now showing great promise in clinical trials.