Tracking malaria parasites using genomics surveillance

Prof Isabella Oyier, leading Molecular Biologist, Associate Professor and Head of Bioscience at the KEMRI-Wellcome Trust Research Programme in Kenya.

Malaria remains a major global health priority and one of the deadliest diseases in Africa.

According to the World Health Organization's (WHO) World Malaria Report 2022, half the world was at risk of malaria, with 247 million cases of malaria and 619,000 malaria deaths. In Kenya, nearly 6.7 million clinical malaria cases are reported annually, and an estimated 4,000 die majority of whom are children.

Fortunately, malaria is preventable and treatable, historically relying on drugs like Chloroquine and Sulfadoxine-pyrimethamine (SP). However, the most recent and widely used treatment is Artemisinin-based combination therapies, such as Coartem. Yet, mutations in the malaria parasite have rendered it increasingly resistant to these drugs as they have compromised the accuracy of traditional malaria diagnostic tests, making it difficult to detect infections in clinical settings.

To address these challenges, our team of researchers at the KEMRI-Wellcome Trust Research Programme in Kenya are moving genomic research from the lab and into the field in 14 Kenyan counties, in a programme aimed at helping health authorities stay ahead of mutations in the malaria parasite. Using molecular epidemiology as part of routine malaria surveillance, we are working to better understand and track mutations in malaria parasites such as Plasmodium falciparum.

In the past, this research did not directly influence public health decision-making, but it is playing an increasingly important role. Our team has been able to develop its research tools in-country and is working with Kenya's Ministry of Health (MoH) to support molecular work locally. Working together with the National Malaria Programme in Kenya, the team is scheduled to collect a target of 300 dry blood spot samples in each of the 14 counties over the coming year and establish a national data repository to inform policy decision-making for the National Malaria Programme.

One of the critical needs highlighted by this work is the imperative to raise awareness of the significance of genomic research in impacting public health outcomes in Africa. The team has achieved a milestone by bridging the knowledge gap with MoH, sharing genomic data promptly, similar to the lessons learned from the Covid-19 pandemic, where genomic surveillance was crucial. Collaboration between public health authorities and genomic researchers is now recognised as essential for staying ahead of new malaria variants and ultimately reducing the malaria burden in Africa.

-- The author is a leading Molecular Biologist, Associate Professor and Head of Bioscience at the KEMRI-Wellcome Trust Research Programme in Kenya