Akira Kaneko Project - Malaria elimination on islands

Malaria is a disease related to poverty. Islands provide a natural environment for ecological experiments and a great potential for intervention studies. Cooperating with endemic communities on islands in Vanuatu, Oceania since 1987 and in Lake Victoria, Kenya since 2008, Akira has studied the feasibility and sustainability of malaria elimination with the ultimate aim of proposing a community-directed strategy of sustainable malaria freedom and development towards global malaria eradication.

researcher Akira Keneko amongst kids in Africa.

Human and parasite polymorphism on islands in Lake Victoria: implications for mass drug administration and malaria elimination

Using island models in Lake Victoria, Kenya, we examine the feasibility of malaria elimination in tropical Africa. Today, 11 countries in Africa are embarking upon malaria elimination. Although malaria elimination should be feasible for countries in peripheral Africa with low and unstable malaria transmission, it is unclear how feasible it is to eliminate malaria in tropical Africa, where malaria transmission is hyper-endemic.

Kenya launched its second National Malaria Strategy for the period 2009-2017 with a notably ambitious vision for a “malaria free Kenya”. We believe that the current scaling-up of interventions in the national malaria control programs (ITN, ACT, & RDT) is capable of bringing parasite rates down to lower than 1% in low to moderate transmission settings. However these tools are not sufficient in hyper-endemic settings such as our project site in Lake Victoria, Kenya, where more specific measures are necessary in the attack phase.

Low-density submicroscopic infections, most of which are asymptomatic, represent a major challenge for malaria elimination programs. Interventions that aim to eliminate malaria should ideally include all symptomatic and asymptomatic parasite carriers. While sensitive molecular detection methods are increasingly common in malariometric surveys, logistical difficulties prevent the detection of all parasitemic individuals prior to drug administration. However, this can be circumvented by treating all individuals in mass drug administration (MDA) campaigns, regardless of parasitaemia.

Together with schizontocidal drugs primaquine has been an important but underused partner drug. The main limitation to the use of primaquine is the risk of hemolysis in patients who are glucose 6-phosphate dehydrogenase (G6PD) deficient. Recent review of studies suggests that a lower primaquine dose would be equally effective but safer. These lower doses could be safely deployed together with ACTs without prior testing of G6PD status in Africa to interrupt malaria transmission. Human cytochrome P-450 isoenzyme 2D6 (CYP2D6) may be a key enzyme involved in metabolizing primaquine into redoxactive metabolites that kill gametocytes.

On Aneityum island in Vanuatu, Oceania, we previously demonstrated that malaria can be eliminated on isolated islands with well-adapted short-term MDA and sustained vector control if there is a high degree of community participation (Kaneko A, et al. Lancet 2000). We intend to apply the Aneityum strategy to our study site on islands in Lake Victoria, to examine whether malaria can be eliminated by well-adapted short-term mass drug administration of ACT with a low dose of primaquine and sustained vector control with a high degree of community participation. We specifically aim to examine: 1) the efficacy (against P. falciparum gametocytes) and safety (risk of intravascular hemolysis) of a low dose of primaquine with ACT, in relation to CYP2D6 and G6PD status, respectively, 2) the impacts of MDA on P. falciparum population dynamics, and 3) the roles of community involvement in malaria elimination. We ultimately aim to address the feasibility of malaria elimination in hyper-endemic settings, and to propose a community-directed malaria elimination strategy for tropical Africa.


Akira Kaneko graduated from Hirosaki University School of Medicine, Japan in 1982 (M.D.) and after clinical training got D.T.M.&H. from Mahidol University, Thailand in 1984 As malariologist AK worked in the coastal Asahan, North Sumatra, Indonesia, 1985-1987 (JICA), and on islands in Vanuatu, 1987 - 1994 (WHO). He was Associate Professor in Tokyo Women's Medical University, 1994-2004. Akira Kaneko defended thesis, Malaria on islands in 1999 (PhD) and got docent in 2004 at Karolinska Institutet.

He has organized multidisciplinary malaria research ventures between Sweden, Japan, UK and USA since 1995 with partners from Vanuatu, PNG, Malawi, Kenya, Ghana, Cambodia, Madagascar and Zanzibar.

Akira Kaneko has been Professor of Global health, Karolinska Institutet since 2011 and holds Island Malaria Group at MTC. He is also affiliated to Osaka City University Graduate School of Medicine and Nagasaki University Institute of Tropical Medicine, Japan.

Akira Kaneko has been academic coordinator to Japan since 2011.

Group members

Akira Kaneko Publications

Factors Contributing to Symptom Duration and Viral Reduction in Outpatient Children With Respiratory Syncytial Virus Infection.
Utsunomiya T, Hibino A, Taniguchi K, Nagai T, Saito N, Tanabe I, et al
Pediatr. Infect. Dis. J. 2020 Feb;():

CYP2D6 genotyping analysis and functional characterization of novel allelic variants in a Ni-Vanuatu and Kenyan population by assessing dextromethorphan O-demethylation activity.
Gutiérrez Rico EM, Kikuchi A, Saito T, Kumondai M, Hishinuma E, Kaneko A, et al
Drug Metab. Pharmacokinet. 2020 Feb;35(1):89-101

Malaria resurgence after significant reduction by mass drug administration on Ngodhe Island, Kenya.
Kagaya W, Gitaka J, Chan CW, Kongere J, Md Idris Z, Deng C, et al
Sci Rep 2019 Dec;9(1):19060

Psychosocial distress among women following a natural disaster in a low- to middle-income country: "healthy mothers, healthy communities" study in Vanuatu.
Pomer A, Buffa G, Ayoub MB, Taleo F, Sizemore JH, Tokon A, et al
Arch Womens Ment Health 2019 12;22(6):825-829

Using multiple correspondence analysis to identify behaviour patterns associated with overweight and obesity in Vanuatu adults.
van Horn A, Weitz CA, Olszowy KM, Dancause KN, Sun C, Pomer A, et al
Public Health Nutr 2019 06;22(9):1533-1544

Functional characterization of 50 CYP2D6 allelic variants by assessing primaquine 5-hydroxylation.
Saito T, Gutiérrez Rico EM, Kikuchi A, Kaneko A, Kumondai M, Akai F, et al
Drug Metab. Pharmacokinet. 2018 Dec;33(6):250-257

Coming to grips with economic development: Variation in adult hand grip strength during health transition in Vanuatu.
Olszowy KM, Little MA, Lee G, Pomer A, Dancause KN, Sun C, et al
Am. J. Phys. Anthropol. 2018 12;167(4):760-776

Rapid selection of sulphadoxine-resistant Plasmodium falciparum and its effect on within-population genetic diversity in Papua New Guinea.
Mita T, Hombhanje F, Takahashi N, Sekihara M, Yamauchi M, Tsukahara T, et al
Sci Rep 2018 04;8(1):5565

Relationships between psychosocial distress and diet during pregnancy and infant birthweight in a lower-middle income country: 'healthy mothers, healthy communities' study in Vanuatu.
Pomer A, Buffa G, Taleo F, Sizemore JH, Tokon A, Taleo G, et al
Ann. Hum. Biol. 2018 May;45(3):220-228

Improvement of malaria diagnostic system based on acridine orange staining.
Kimura M, Teramoto I, Chan CW, Idris ZM, Kongere J, Kagaya W, et al
Malar. J. 2018 Feb;17(1):72

Rapid and sensitive multiplex single-tube nested PCR for the identification of five human Plasmodium species.
Saito T, Kikuchi A, Kaneko A, Isozumi R, Teramoto I, Kimura M, et al
Parasitol. Int. 2018 Jun;67(3):277-283

Selections, frameshift mutations, and copy number variation detected on the surf 4.1 gene in the western Kenyan Plasmodium falciparum population.
Gitaka JN, Takeda M, Kimura M, Idris ZM, Chan CW, Kongere J, et al
Malar. J. 2017 03;16(1):98

Surveillance for malaria outbreak on malaria-eliminating islands in Tafea Province, Vanuatu after Tropical Cyclone Pam in 2015.
Chan CW, Iata H, Yaviong J, Kalkoa M, Yamar S, Taleo G, et al
Epidemiol. Infect. 2017 01;145(1):41-45

High and Heterogeneous Prevalence of Asymptomatic and Sub-microscopic Malaria Infections on Islands in Lake Victoria, Kenya.
Idris ZM, Chan CW, Kongere J, Gitaka J, Logedi J, Omar A, et al
Sci Rep 2016 11;6():36958

Ownership of consumer electronics is associated with measures of adiposity during health transition in Vanuatu.
Sun C, Pomer A, Dancause KN, Chan CW, Olszowy KM, Silverman H, et al
Am. J. Hum. Biol. 2017 Mar;29(2):

Surveillance for malaria outbreak on malaria-eliminating islands in Tafea Province, Vanuatu after Tropical Cyclone Pam in 2015.
Chan CW, Iata H, Yaviong J, Kalkoa M, Yamar S, Taleo G, et al
Epidemiol. Infect. 2017 01;145(1):41-45

Genetic Diversity and Population Structure of Plasmodium falciparum in Lake Victoria Islands, A Region of Intense Transmission.
Mulenge FM, Hunja CW, Magiri E, Culleton R, Kaneko A, Aman RA
Am. J. Trop. Med. Hyg. 2016 Nov;95(5):1077-1085

Little Polymorphism at the K13 Propeller Locus in Worldwide Plasmodium falciparum Populations Prior to the Introduction of Artemisinin Combination Therapies.
Mita T, Culleton R, Takahashi N, Nakamura M, Tsukahara T, Hunja CW, et al
Antimicrob. Agents Chemother. 2016 06;60(6):3340-7

Impact of modernization on adult body composition on five islands of varying economic development in Vanuatu.
Olszowy KM, Pomer A, Dancause KN, Sun C, Silverman H, Lee G, et al
Am. J. Hum. Biol. ;27(6):832-44

A prescription for sustaining community engagement in malaria elimination on Aneityum Island, Vanuatu: an application of Health Empowerment Theory.
Watanabe N, Kaneko A, Yamar S, Taleo G, Tanihata T, Lum JK, et al
Malar. J. 2015 Jul;14():291

Improved detection of malaria cases in island settings of Vanuatu and Kenya by PCR that targets the Plasmodium mitochondrial cytochrome c oxidase III (cox3) gene.
Isozumi R, Fukui M, Kaneko A, Chan CW, Kawamoto F, Kimura M
Parasitol. Int. 2015 Jun;64(3):304-8

Plasmodium vivax gametocyte proteins, Pvs48/45 and Pvs47, induce transmission-reducing antibodies by DNA immunization.
Tachibana M, Suwanabun N, Kaneko O, Iriko H, Otsuki H, Sattabongkot J, et al
Vaccine 2015 Apr;33(16):1901-8

Plasmodium vivax and Plasmodium falciparum at the crossroads of exchange among islands in Vanuatu: implications for malaria elimination strategies.
Chan CW, Sakihama N, Tachibana S, Idris ZM, Lum JK, Tanabe K, et al
PLoS ONE 2015 ;10(3):e0119475

Novel mutations in K13 propeller gene of artemisinin-resistant Plasmodium falciparum.
Isozumi R, Uemura H, Kimata I, Ichinose Y, Logedi J, Omar AH, et al
Emerging Infect. Dis. 2015 Mar;21(3):490-2

Determinants of the use of insecticide-treated bed nets on islands of pre- and post-malaria elimination: an application of the health belief model in Vanuatu.
Watanabe N, Kaneko A, Yamar S, Leodoro H, Taleo G, Tanihata T, et al
Malar. J. 2014 Nov;13():441

Improved detection of malaria cases in island settings of Vanuatu and Kenya by PCR that targets the Plasmodium mitochondrial cytochrome c oxidase III (cox3) gene.
Isozumi R, Fukui M, Kaneko A, Chan CW, Kawamoto F, Kimura M
Parasitol. Int. 2015 Jun;64(3):304-8

Single nucleotide polymorphisms in Plasmodium falciparum V type H(+) pyrophosphatase gene (pfvp2) and their associations with pfcrt and pfmdr1 polymorphisms.
Jovel IT, Ferreira PE, Veiga MI, Malmberg M, Mårtensson A, Kaneko A, et al
Infect. Genet. Evol. 2014 Jun;24():111-5

Characteristic age distribution of Plasmodium vivax infections after malaria elimination on Aneityum Island, Vanuatu.
Kaneko A, Chaves LF, Taleo G, Kalkoa M, Isozumi R, Wickremasinghe R, et al
Infect. Immun. 2014 Jan;82(1):243-52

Iron deficiency and severe Plasmodium falciparum malaria.
Awah NW, Kaneko A
Clin. Infect. Dis. 2012 Apr;54(8):1145-7

Geographic differentiation of polymorphism in the Plasmodium falciparum malaria vaccine candidate gene SERA5.
Tanabe K, Arisue N, Palacpac NM, Yagi M, Tougan T, Honma H, et al
Vaccine 2012 Feb;30(9):1583-93

Further Akira Kaneko Publications


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