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UOA01-03: Knowledge is Power: Informing Local Governments in the Global Fight Against Malaria

Summary of the impact

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.

Submitting Institution

University of Oxford

Unit of Assessment

Clinical Medicine

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Medical Microbiology, Public Health and Health Services

Developing a new approach to malaria prevention in children: seasonal malaria chemoprevention in West Africa

Summary of the impact

Research in West Africa by LSHTM and partners has shown that monthly treatment with effective antimalarial drugs during the rainy season provides children with a very high degree of personal protection against malaria, can be delivered on a large scale by community health workers at moderate cost, and with no serious side-effects. Based on this research, WHO now recommends that children living in Sahel areas where malaria is a major problem should receive such `seasonal malaria chemoprevention' (SMC) with sulfadoxine-pyrimethamine plus amodiaquine. Ten countries have incorporated SMC into their strategic plans for malaria control.

Submitting Institution

London School of Hygiene & Tropical Medicine

Unit of Assessment

Public Health, Health Services and Primary Care

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Clinical Sciences, Medical Microbiology, Public Health and Health Services

UOA01-01: Introducing Artemisinin to the World

Summary of the impact

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.

Submitting Institution

University of Oxford

Unit of Assessment

Clinical Medicine

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Medical Microbiology, Pharmacology and Pharmaceutical Sciences

04_Blood donations are screened for malaria exposure with an immunoassay

Summary of the impact

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 [6] which was an international consortium to which UoE contributed recombinant malaria antigens and technical expertise.

Submitting Institution

University of Edinburgh

Unit of Assessment

Biological Sciences

Summary Impact Type

Technological

Research Subject Area(s)

Medical and Health Sciences: Clinical Sciences, Immunology, Medical Microbiology

UOA01-05: Alerting the World to Artemisinin Resistance

Summary of the impact

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.

Submitting Institution

University of Oxford

Unit of Assessment

Clinical Medicine

Summary Impact Type

Technological

Research Subject Area(s)

Medical and Health Sciences: Clinical Sciences, Medical Microbiology

UOA05-10: Mapping vector-borne diseases to inform global planning for control and elimination

Summary of the impact

Innovative research into the spatial ecology of vector-borne disease at the University of Oxford led to the setting up of the Malaria Atlas Project (MAP), a programme which has provided sophisticated models of malaria distribution to inform planning and policy decisions of national governments and international agencies. MAP data underpinned the 2012 World Health Organization World Malaria Report and has influenced WHO's policy on malaria. Mapping has also been used in planning and resource allocation by other key players in the fight against malaria: the African Leaders Malaria Alliance, the Roll Back Malaria partnership, the Global Fund and the Global Health Group. More recent research to map the global distribution of dengue risk has been used in vaccine planning by the GAVI Alliance in conjunction with the Gates Foundation.

Submitting Institution

University of Oxford

Unit of Assessment

Biological Sciences

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Medical Microbiology, Public Health and Health Services

Malarial Retinopathy has Redefined the Diagnosis of Cerebral Malaria and Improved the Management of Coma in African Children

Summary of the impact

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.

Submitting Institutions

University of Liverpool,Liverpool School of Tropical Medicine

Unit of Assessment

Clinical Medicine

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Clinical Sciences, Medical Microbiology, Neurosciences

UOA01-02: Malaria Treatment in Pregnancy

Summary of the impact

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.

Submitting Institution

University of Oxford

Unit of Assessment

Clinical Medicine

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Clinical Sciences, Paediatrics and Reproductive Medicine

Improving methodologies for the detection and identification of malaria parasites in human blood

Summary of the impact

Work by LSHTM researchers has led to a greater understanding of Plasmodium malaria parasite species and contributed new methodologies for diagnosis. As a result, patients with the uncommon species P. knowlesi and many hundreds with P. ovale spp. have been correctly diagnosed by polymerase chain reaction (PCR), and the rapid detection of parasite DNA is revolutionising clinical trial design. The work has led to the successful commercialisation of a low-cost, easy-to-use malaria testing kit for use in developing countries. Through media outputs and further research, the work has taken awareness of the issues surrounding malaria diagnostics to an international audience.

Submitting Institution

London School of Hygiene & Tropical Medicine

Unit of Assessment

Clinical Medicine

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Medical Microbiology

Integrated Vector Management for the Control of Vector Borne Diseases

Summary of the impact

Integrated Vector Management (IVM) was developed by the World Health Organisation to control vector borne diseases using combinations of interventions. Professor Steve Lindsay and his team have contributed to the development and assessment of many of the tools used for vector control, including insecticide-treated bed nets (ITNs), larval source management and house screening for malaria control. This research has influenced international policy on the control of malaria and other important diseases. It is estimated that 294 million ITNs have been purchased for malaria control, and have helped save 1.1 million lives over the past decade.

Submitting Institution

University of Durham

Unit of Assessment

Biological Sciences

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Medical Microbiology

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