In spite of recent reductions in transmission, malaria continues to kill
over half a million people annually. To assist in fighting the global
burden of malaria, Kenya-based Oxford research team, the Malaria Public
Health Department (MPHD) has spent the past decade analysing malaria risk,
interventions, and control methods, to better define and target malaria.
This research has been used to inform local governments, the World Health
Organization (WHO), and international funding organisations about malaria
risk, interventions and control methods to better define and target
Malaria in pregnancy causes the deaths of 200,000 newborns and 10,000
mothers annually. The Liverpool School of Tropical Medicine is the
coordinating centre of the global Malaria in Pregnancy Consortium.
LSTM-led research from 2007 has contributed to the World Health
Organisation's (WHO) estimates of the global burden of malaria in
pregnancy, showing that 125M pregnancies are at risk, more than double
previous estimates. The Consortium has also contributed to a better
understanding of the low uptake of existing interventions by pregnant
women, and identification of the best prevention strategies. Consequently,
WHO updated its policy recommendations in 2007on
intermittent-preventive-treatment for prevention of malaria in pregnancy,
adopted in 37 sub-Saharan countries, and in 2012, already adopted in 9
Malaria in Africa, traditionally diagnosed from fever symptoms, has been
and other causes of fever missed. This research demonstrated the magnitude
undertook trials of rapid diagnostic tests, identified alternative
bacterial diagnoses, completed
economic appraisals and studied prescriber behaviour. The research
underpinned a major change
in policy by WHO (2010), substantial investments by the Global Fund to
fight HIV, TB and Malaria
(GFATM), and changed clinical practice, to direct antimalarials to malaria
patients only. In one
country alone, 516,576 courses of inappropriate artemisinin-based
combination therapy (ACT)
were averted, worth in excess of $1m.
Impact on health and welfare: The malaria screening assay allows
early re-admittance of malaria-risk donors to blood donation programmes
whilst maintaining protection against transfusion-transmitted malaria.
Increasing the availability of safe blood for donation through use of the
malaria assay saves lives.
Impact on commerce: The malaria EIA is the front-line assay in at
least ten countries today. Almost 2.5 million tests have been sold in the
REF impact census period through a number of distributors, including
Bio-Rad worldwide, [text removed for publication].
Beneficiaries: Individuals requiring blood transfusions, national
blood transfusion services and hospitals; commercial companies marketing
the malaria EIA.
Significance and Reach: Over 700,000 assays are now performed per
year in the UK, France, Belgium, Portugal, Spain, Italy, Netherlands, New
Zealand and Australia. In the UK alone, more than 345,000 blood donations
from malaria-risk donors have been cleared for clinical use.
Attribution: All research was led by Dr Jana McBride, Dr David
Cavanagh, and Eleanor Riley, at the University of Edinburgh (UoE), except
output  which was an international consortium to which UoE contributed
recombinant malaria antigens and technical expertise.
Earth Surface Processes and Environmental Change (ESPEC) Research Group
developed the Liverpool Malaria Model (LMM). When integrated with various
short range and long
term climate models as part of wider research into a complex cross cutting
`grand challenge', the
LMM helps decision makers understand when an area is likely to become at
risk from malaria in
short and over longer time frames by indicating which areas are likely to
become centres for
epidemics. The impact of the research has been to advance policy makers'
understanding of this complex issue, enhancing their capacity to manage
Research by the University of Oxford's Shoklo Malaria Research Unit
(SMRU), Mae Sot (Thailand), has had a significant impact on the health
outcomes of pregnant women and infants in malaria affected areas, with
findings leading to major changes in World Health Organization
recommendations for the prevention and treatment of malaria in pregnancy.
Its studies have established the optimum treatment regimes (using
artemisinin-based drugs) and have shown that early detection and treatment
of malaria, including asymptomatic infection, during pregnancy prevents
maternal mortality, morbidity, and improves the outcome of pregnancy.
Researchers at the Mahidol-Oxford Research Unit (MORU) in Thailand
performed the first comparative trials to unambiguously show artemisinin
resistance in Plasmodium falciparum parasites in western Cambodia,
as well as its emergence on the Thailand-Myanmar border. These studies
emphasised the importance of urgent containment, leading to rapid
responses from the World Health Organization (WHO) and international
governments for the tracking and containment of drug-resistant malaria.
Since 1997 University of Liverpool (UoL) investigators have led global
research into malarial retinopathy, the fundus features associated with
severe malaria. The work has propelled this phenomenon from little-known
curiosity to an essential component in the diagnosis of cerebral malaria
(CM) and has altered understanding of how CM causes coma and kills. It has
changed medical practice of those diagnosing one of the commonest fatal
diseases in tropical countries. Malarial retinopathy is now considered an
essential clinical feature of CM aiding the appropriate management of coma
in infants. This change in practice has expanded from African research
settings to clinical practice required by WHO guidelines and disseminated
in major clinical textbooks from 2008.
The University of Oxford's Professor Nick White and his colleagues
successfully demonstrated the effectiveness of artemisinin (an ancient
Chinese remedy) in the treatment of malaria. They also pioneered
artemisinin-combination therapy (ACT), the most effective and fast-acting
malaria treatment in the world. Responsible for saving hundreds of
thousands of lives every year, ACT was recommended by the World Health
Organization (WHO) in 2006 as the primary method of malarial treatment
globally. Malaria kills more than half a million and affects over 225
million people every year.
Malaria kills around 650,000 children a year but can be prevented by
killing the mosquito vectors. As mosquitoes become resistant to
insecticides the prevention measures can become ineffective. Research at
the Liverpool School of Tropical Medicine (LSTM) led by Professor
Hemingway FRS has been instrumental in the development of current World
Health Organisation (WHO) guidelines to manage resistance, and has led to
improved resistance diagnostics and novel monitoring software to integrate
entomological and human health outcomes. LSTM's research led to the
creation of the Innovative Vector Control Consortium (IVCC) which was
established as an independent Product Development Partnership (PDP) in
2008. New, longer lasting formulations of insecticides developed by IVCC
are now in operational use, and several novel public health insecticides
are under development.