Malaria Research Unit

Current projects

The Malaria Research Unit (MRU) has national, regional and continental (Africa) malaria related research as its priority. The major thrust of the research conducted by MRP is to markedly reduce the public health burden of malaria in southern Africa. To this end the MRP has been instrumental in implementing and managing large scale malaria control programmes in many southern African countries.  Through research, the most appropriate and sustainable malaria control strategy in accordance with the country’s epidemiological profile is developed and implemented. The benefits of this approach can be seen in the Lubombo Spatial Development regions were malaria prevalence has dropped markedly since control programmes were implemented.

Lubombo Spatial Development Initiative (LSDI)

The Lubombo Spatial Development Initiative (LSDI), a trilateral malaria control initiative involving Mozambique, Swaziland and South Africa was launched in 1999, under the leadership of the MRP. This initiative, the first African cross border malaria control collaboration, was initiated using private sector money. Currently the LSDI is being funded by the Global Fund and the Mozambican government. The control programme comprises two arms, vector control using indoor insecticide residual spraying and parasite control through effective malaria diagnosis and treatment. Following the successes in controlling malaria, particularly in Maputo Province, Mozambique, the LSDI was extended northwards into Gaza Province, Mozambique in 2006.  At present the area under malaria control across the three countries involved in the LSDI exceeds 200 000 km2.  

Bio-prospecting

A major obstacle to effective malaria control has been the emergence and spread of insecticide resistant vectors. Resistance to all commercially available insecticides has been detected. As part of the Novel Drug Development Platform, the MRU is currently involved in the screening and testing of indigenous plants as potential mosquitocidal agents.

Malaria Information System

The Malaria Information System (MIS) is a computerised system that facilitates the input, management and output of malaria case data. The system includes a spatial component using a geographic information system (GIS) which can be customised to minimise end-user skill requirements while optimising access to different data sets. The MRU has implemented and maintains a MIS in each of the three countries participating in the LSDI, Bioko Island, mainland Equatorial Guinea, Conakry Guinea, the DRC, Zambia and Malawi.

Drug Resistance

The MRU is involved in two areas of drug resistance research. In collaboration with the London School of Hygiene and Tropical Medicine the MRU is investigating and mapping the spread of Sulphadoxine-Pyrimethamine (SP) resistance in Africa using genotyping studies. Research from this collaboration showed that African pyrimethamine resistant malaria parasites originated in Southeast Asia. As part of its monitoring and evaluation role within the LSDI, the MRU conducts routine surveillance for molecular markers of resistance to the first line antimalarials within the Lubombo region. Results from this routine surveillance have informed drug policy within the LSDI region. In light of artemisinin resistance being observed in South East Asia more intensive surveillance is being conducted within the LSDI region, given that all countries in the southern Africa are using artemisinin combination therapies as first line treatment for uncomplicated malaria.

Long Lasting Insecticides

As part of the Innovative Vector Control Consortium, a Gates funded project, the MRU is working with the private sector insecticide companies to evaluate new formulations of insecticides for use in indoor residual spray programmes. The MRU is conducting laboratory and field trials to determine the efficacy and durability of these new formulations.

Health GIS

The Health GIS Centre of the South African Medical Research Council (MRC) was established by the Malaria Research Lead Programme in 1999 to both bring spatial contexts to the existing malaria research projects (LSDI and MARA), and to support and encourage the use of GIS within the health sector at large in the southern African region. The broad objectives of the health GIS centre are to develop GIS capability in order to support major public health interventions in the region, to develop capacity within appropriate sectors and individuals by supporting the research community, and to maintain a comprehensive GIS database relevant to health research.
Routing GIS support to all projects of the Malaria Research Programme includes the LSDI, IVCC-funded Malaria Decision Support Systems (MDSS), the Swaziland Malaria Elimination Effort, RTI International, and the Bioko Island Malaria Control Programme.

Spatio-temporal modelling of Malaria in Southern Africa

This project aims to map the geographical patterns and estimating the disease burden which is critical for malaria control programme design, implementation and evaluation. Furthermore, the project aims to develop malaria risk maps for Southern Africa by track temporal changes in malaria transmission across the region using different datasets and statistical approaches. This work is part of the development of the third generation of MARA maps.

Towards the development of epidemic forecasting models

Accurate forecasting models are extremely important for disease surveillance for monitoring, forecasting, detection, prevention and control of malaria epidemics. However, more work needs to be done for developing operational and reliable forecasting models and very few published studies have been conducted in Southern Africa. A range of different models will be fitted taking into account temporal correlations, trends, seasonality and effect of climatic factors.

Development of empirical models of malaria seasonality for Africa

Seasonality affects the dynamic relationship between vector mosquito densities, inoculation rate, parasite prevalence and disease outcome. Quantitative description and mapping of malaria seasonality is therefore important for modelling malaria transmission dynamics. The aim of this work is to develop disease and transmission based seasonality models using clinical and entomological indices, respectively.

Highlights

• Development of a seasonality model through cooperation with the ecology and epidemiology group at Oxford University and the STI modelling team.
• The Malaria Atlas Project (MAP) group at Oxford will also use this approach to adjust for seasonality in their next generation of global map of malaria.