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Although the overall number of annual deaths due to malaria have declined by 27% over the past 23 years, the disease continues to exact a global burden. Researchers envision a future defined by malaria elimination and eradication, and new US Federal funding awarded to malaria researcher, Distinguished Prof. Christian Happi, PhD, and global partners may help. The collaborators won a multi-million-dollar National Institutes of Health grant award to develop evidence-based strategies over the next 5 years to support the malaria eradication and elimination effort.
The research grant, from the US National Institute of Allergy and Infectious Diseases (NIAID), will establish a new International Center of Excellence in Malaria Research (ICEMR) focused on west-central Africa with in-country expertise in Nigeria and Cameroon. Professor Christian Happi, PhD, Redeemer’s University in Nigeria and the Harvard T H Chan School of Public Health, share lead-investigator status with Professor Charles Wondji, PhD, of the University of Liverpool School of Tropical Medicine, and Prof. Rhoel Dinglasan, PhD, MPH, of the University of Florida. The researchers will use artificial intelligence to support surveillance of invasive mosquitos that can carry malaria parasites.
“Malaria is a disease that causes a lot of havoc in children and pregnant women in west and central Africa,” said Happi, a Distinguished Professor at Redeemer’s University, Founder and Director of the African Centre of Excellence for Genomics of Infectious Diseases. “The disease has been neglected for a long time but can now be eradicated with the right combination of drugs and vaccines.”
Why West-Central Africa?
After initial successes in lessening the burden of malaria globally, progress has stalled in recent years. The World Health Organization estimates that 243 million people were sickened with malaria globally in 2023 and that 608,000 people, mostly children under 5 years of age, died from it.
But Africa is disproportionately affected with 508,000 deaths reported in 2022, and 233 million malaria infections, according to the WHO World Malaria Report 2023. In a concerning trend, several African countries, including Nigeria, saw their death rates from malaria increase in recent years. And other countries, like Cameroon, face a potentially troubling expansion of invasive mosquito species that can carry malaria parasites.
Malaria parasites are in the genus Plasmodium. One species, P. falciparum, is responsible for most of the deaths from malaria, but a second species, P. vivax, is more widespread. Both species can be spread to people through bites of the invasive mosquito vector Anopheles stephensi, which is expanding into new areas and is well-suited to living in urban areas.
“The new center will provide a better understanding of plasmodia and mosquito vector genetic diversity and their resistance to drugs and insecticides,” said Happi. “It will also provide a unique opportunity to do translational genomics research on malaria in Africa, with the potential to develop the next-generation vaccines against different species of Plasmodium circulating in Nigeria and Africa.”
The research team named the new ICEMR the West-Central Africa Enhancing Malaria Epidemiology Research through Genomics & Translational Systems biology, or ÉMERGENTS for short. The name is a nod to both the French-speaking population of Cameroon, and several neighboring countries, and the concept of classical infectious diseases such as malaria emerging in new places or hosts.
“The ÉMERGENTS center will act as a catalyst in the efforts to reduce malaria burden in Cameroon by tackling key challenges that are currently jeopardizing control programmes,” said Wondji, who is also executive director of the Centre for Research in Infectious Diseases in Cameroon. The fight against malaria is entwined with Wondji’s family history: He lost his younger sister to the disease when she was just 5 years old.
What will the ÉMERGENTS ICEMR do?
The ÉMERGENTS ICEMR will focus on gathering, synthesizing, and analyzing data targeting three major knowledge gaps in Nigeria and Cameroon:
- Understanding malaria disease dynamics involving parasites other than falciparum
- Surveying the geographic range expansion, and its causes, of stephensi into new areas
- Determining how insecticide resistance in multiple mosquito species that transmit falciparum, P. vivax and two other neglected species, P. ovale and P. malariae, drives malaria infection cycles locally
“We will essentially be doing the same work in both countries,” said Dinglasan. “We’ll be studying malaria caused by parasites other than P. falciparum, assessing insecticide resistance, and also hunting for A. stephensi which, while in Nigeria, hasn’t been introduced into Cameroon yet — or maybe it has been missed.”
The main thrust of efforts to eliminate malaria have focused on P. falciparum. “But malaria elimination across Sub-Saharan Africa means targeting all malaria parasite species, not just P. falciparum,” said Dinglasan.
A. stephensican transmit P. falciparum and P. vivax parasite species, and this mosquito has recently expanded its range into Nigeria. This has raised alarms about the potential of increased transmission in urban areas. “It is unclear if the introduction has resulted in a fully established population or if the introduction was transient,” said Dinglasan. “To date, it is unclear why neighboring countries, such as Cameroon have not reported an introduction of this invasive species.”
Research partner Jonathan Juliano, MD, MSPH, of the University of North Carolina at Chapel Hill will participate in the genomic analysis of Plasmodium parasite species isolated from trapped mosquitoes in Cameroon and Nigeria.
“The genomic tools for studying non-falciparum malaria are lacking, and this project will allow us to develop these tools and improve our understanding of the biology of these parasites,” said Juliano, who is a professor in the UNC School of Medicine and the Gillings School of Public Health.
Understanding how mosquitoes develop resistance to insecticides is also a key area of focus.
“ÉMERGENTS will significantly contribute to managing key obstacles to control such as development of resistance by mosquitoes, especially to insecticides used in bed nets,” said Wondji. “Moreover, ÉMERGENTS will help train a new generation of African scientists able to lead the fight against this disease from Africa.”
