Projects - Malaria

The main malaria projects in the malaria research unit at Karolinska Institutet include new strategies for malaria control, anti-malarial treatments and evolution of drug resistance, and new tools and strategies for malaria diagnosis.

New strategies for malaria control - aiming at elimination in Zanzibar?

Zanzibar was first in Sub-Saharan Africa to implement partly novel malaria control methods on a wide scale, including tools such as rapid malaria diagnostic tests, artemisinin-based combination therapies, insecticide-treated bed nets and indoor residual spraying. The Zanzibar project has therefore developed into a pilot project for modern control interventions in endemic malaria situations commonly found in Sub-Saharan Africa.

Our first results have shown a decrease in malaria transmission and public health burden (reduced morbidity and mortality), creating hope for the potential elimination of malaria on the isles of Zanzibar.

Specific studies are now being undertaken to develop novel methods for malaria incidence surveillance, drug resistance monitoring, and understanding the sustainability of intervention usage and community uptake.

The implications of successful control on the socio-economic development of Zanzibar will also be studied.

Modern artemisinin-based combination drugs against malaria - malaria drugs and evolution of resistance

The global strategy for malaria control/elimination relies on sustained high efficacy of artemisinin-based combination therapies (ACT) as an anti-malarial drug.

ACT efficacy depends primarily on fast acting artemisinins, but importantly also on the long acting partner drugs.

Plasmodium falciparum has throughout history proven its capacity to develop resistance to virtually all previously deployed antimalarial drugs.

It is therefore of great importance to identify genetic markers for, and to understand the mechanisms of, malaria parasite tolerance and resistance at a molecular level.

We use in vivo and in vitro methods to study the selection of resistant parasite populations following drug exposures. Specific attention is given to the artemisinin family of compounds as well as their partner drugs included in the new recommended combination therapies.

New tools and strategies for malaria diagnosis

Rapid diagnostic tests (RDTs) are emerging as the most efficient diagnostic tools for malaria diagnosis in the field.

Their effectiveness is being studied at different health care levels. Molecular technologies are also being assessed as future tools for diagnosis and surveillance purposes.

The malaria RDTs have also greatly improved the targeting of treatments to non-malarial patients. One study therefore focuses on non-malarial, microbial manifestations of childhood fever and the efficiency of Integrated Management of Childhood Illness (IMCI) algorithms for optimal management of fever patients.