Elevating Malaria Research: How CARTA’s Support Fueled My Breakthrough in NIH-Funded Study

My journey to becoming a researcher in malaria prevention and control began with the invaluable support of the Consortium for Advanced Research Training in Africa (CARTA), which not only funded my PhD tuition at the University of Nairobi but also provided me with high-level mentors. Their vast expertise and unwavering support were instrumental in shaping my PhD research. In addition, CARTA supported my initial post-PhD research career through a CARTA re-entry grant. This foundation paved the way for my first independent research grant from an external founder, which focuses on maximizing the benefits of Long-Lasting Insecticidal Nets (LLINs) through consistent utilization.

The re-entry grant that I received from CARTA in 2018 was part of the building blocks leading  to the prestigious R01 grant from the National Institutes of Health (NIH). Titled “Real-world Impact of Next-Generation Insecticidal Nets for Malaria Control in Rural Western Kenya,” this grant marks a significant milestone in my academic and research journey. The grant amounting to over USD 600,000 commenced on April 1, 2024 and will continue until March 30, 2029, spanning five years. 

The project will investigate the efficacy of Next Generation LLINs, which combine a pyrethroid with a synergist to combat insecticide resistance, an escalating threat to malaria control. With the World Health Organization now endorsing these nets, their distribution in high-burden counties in Kenya has set the stage for our research.

Our team leverages an existing longitudinal cohort of 500 individuals established in Webuye Sub-County in 2017 to assess the real-world impact of piperonyl-butoxide (PBO) nets. In recruiting the cohorts, we identified villages that were hotspots and coldspots for malaria and randomly sampled households while tracking malaria indicators. Our goal is to understand the human and entomological factors that may affect the nets’ effectiveness, ultimately informing strategies to maximize their impact.

Securing the R01 grant isn’t solely a personal achievement; it signifies an opportunity to contribute significantly to the fight against malaria. By studying the newly distributed PBO LLINs, we want to identify any factors that could reduce the effectiveness of these nets and address them early before they become a bigger problem.

I am forever grateful to CARTA for the opportunities that have propelled me towards my mission of eradicating malaria. CARTA’s support has been invaluable in my transformation into the research leader I aspired to be. I am committed to advancing our understanding of malaria control, aiming to not only save lives, but also to improve health outcomes in Kenya and beyond.

Judith Mangeni, Cohort 3

Senior Lecturer, Department of Epidemiology and Medical Statistics, School of Public Health, Moi University

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Olufunke Fayehun, promoted to professor

Olufunke Fayehun, CARTA’s co-focal person at the University of Ibadan, has been promoted to Professor in the Department of Sociology. Before her promotion, Fayehun served as an Associate Professor in the same department.

A distinguished demographer, Fayehun has dedicated her research to vulnerable groups, including children, women, and the elderly. Her work involves collaboration on numerous multi-country and multi-disciplinary studies, contributing significantly to the field.

CARTA extends heartfelt congratulations to Professor Olufunke Fayehun on her well-deserved promotion.

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James Kang’ethe, Cohort 10, and a PhD candidate in the Department of Medical Microbiology and Immunology at the University of Nairobi received the prestigious Joep Lange Award for his exceptional presentation at the 2024 International Conference on HIV Treatment, Pathogenesis, and Prevention Research in Resource-Limited Settings (INTEREST).

Held in Cotonou, Benin, from May 14 to 17, INTEREST 2024 brought together scientists focused on HIV research in Africa. James presented his study titled “The Dynamic Interplay of High-Risk Human Papillomavirus in Women Living with HIV: Persistence, Clearance, Incidence, and Synergies with Human T-lymphotropic Virus-1 Infections,” which earned him the distinction of best oral presenter.

The annual INTEREST Conference is a significant platform for scientists engaged in HIV research in Africa, offering opportunities to share key findings, promote collaboration, and discuss local solutions for managing and preventing HIV in resource-limited settings. The conference highlights advancements in HIV diagnosis, treatment, and prevention, fostering a community of African physicians and scientists dedicated to tackling HIV in resource-limited settings.

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Lilian Njagi, cohort 9, graduate from the University of Nairobi, attended the second EU-Africa PerMed summer school that took place from May 21-23, 2024, at the KCB Leadership Centre in Nairobi, Kenya. During the workshop, she presented on ‘HIV and TB under a Personalised Medicine point of view’, where she shed light on the burden and current management of TB and HIV in Kenya, including TB preventive therapy. This treatment targets high-risk populations with HIV, diabetes, and household contacts. “What is needed is having a mixed workshop where policymakers and big funders hear presentations like yours to convince them that it is not only non-communicable diseases but also communicable diseases that need funding for personalized medicine, and so we might contact you if we have the opportunity to one of our policy-oriented workshops because your presentation was very clear,” said Erika Sela the EU-Africa PerMed coordinator. Lilian is a Clinical Research Scientist at the Kenya Medical Research Institute (KEMRI), Centre for Respiratory Disease Research, with interests in Tuberculosis/HIV co-infection research looking at novel solutions to monitoring the treatment of latent TB to improve outcomes, including assessing the role of immune response and pharmacogenetics.

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Imagine a secret green garden filled with plants that can cure your diseases. For thousands of years, people have acknowledged the healing power of plants. And have used them to create various remedies. Even today, many of our medicines are plant-based,turning plants into our small health heroes!

Take the bark of the Cinchona spp  tree, for instance.It yields quinine, a strong medicine to fight malaria. Artemisia annua provides artemisinin, another essential compound. Even today, many of our medicines are plant-based, a testament to the remarkable abilities of these natural healers.

Now, let’s talk about some of the deadliest diseases worldwide according to WHO: lower respiratory infections, HIV, diarrheal diseases, tuberculosis, and malaria. These health threats cause immense suffering and claim millions of lives each year. Sadly, most of these deaths occur in developing countries, to be specific, African countries.

But this is where medicinal plants come in to help us. They offer hope in the fight against these diseases. People turn to plants for relief in places where modern healthcare is scarce. These plants don’t just combat infectious diseases; they also help manage conditions like diabetes.

My work revolves around exploring the hidden powers of medicinal plants. I delve into their antibacterial, antifungal, antimalarial, and antiviral properties. Let’s take HIV, for example—a serious virus, especially prevalent in Africa. Opportunistic infections (OIs) strike harder in people with weakened immune systems due to HIV. These opportunistic infections are a major cause of illness and death among HIV/AIDS patients, especially  in poorer countries.

Guess what? People living with HIV/AIDS often turn to herbal medicines. These plants help manage opportunistic infections and boost their immune systems. Some medicinal plants even directly combat both HIV-1 and HIV-2. But here’s the twist: much of this knowledge remains hidden and not yet explored.

In 2020, we conducted a study in Uganda. Our mission? To document the traditional indigenous knowledge and practices associated with the management of HIV/AIDS infections by herbalists. We searched  the land, capturing the wisdom of herbalists. We documented 236 medicinal plant species from 70 families and 201 genera. Among these, the genus Acacia stood out as the most widely represented, with five species. Some of the plant species were used for treating most of the OI.. 

We found out that despite geographical distances, Ugandan herbalists agreed on which plants to use for different opportunistic infections. Although the herbalists relied on biomedical laboratory diagnoses for confirming the patients’ HIV  status, they were familiar with the signs and symptoms of HIV/AIDS. But a word of caution: improper use of these plants can harm patients. Some practices, like injecting herbs, raise eyebrows. And what about combining herbs with antiretroviral (ARV) drugs? It’s a delicate balance. Mistakes can cause wrong ARV doses or make people stop their treatment.

Speaking of ARVs, they’re vital in managing HIV. However, using them alongside herbal medicines requires care. Incorrect dosages and herb-drug interactions pose risks. 

But here’s the exciting part: by studying these common medicinal plants, we might uncover new treatments—not just for HIV but other diseases too. Plus, cultivating these plants can create jobs and strengthen communities. So, let’s celebrate the power of plants—they’re not just green; they’re life-changing!

 

 Anywar Godwin, Cohort 6

Lecturer, Plant Sciences, Microbiology and Biotechnology, College of Natural Sciences/ School of Biosciences, Makerere University

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Imagine a world where the buzzing of mosquitoes no longer signals the threat of malaria. This isn’t a far-off dream, it’s a vision coming to life in Africa. Despite the strides we’ve made, this ancient disease still lurks in our communities, preying on our most vulnerable, our children.

In 2022, the world witnessed 249 million cases of malaria according to WHO’s estimates, with a staggering 608,000 lives lost. This number exceeded the estimated cases before the COVID-19 pandemic marking an increase of five million over 2021. Africa, especially our children under five, suffered the worst of this damage. Despite our efforts with nets and sprays, these tools are not bearing desirable fruits. We need more than just a new tool—we need a revolution.

Enter the realm of biocontrol technologies, our new allies in the malaria fight. These aren’t everyday solutions. They’re cutting-edge technologies tailored to our African needs. Picture mosquitoes, the very carriers of malaria, turned into our unwitting protectors. Through Gene Drive Modified Mosquitoes (GDMMs) we are on the brink of turning the tide. GDMMs are not typical mosquitoes. They are engineered to be poor hosts for malaria, carrying a gene that spreads this trait like wildfire through their populations. The result? A reduction in the number of mosquitoes that can transmit the disease. We are exploring two paths: wiping out the mosquito species that plague us or disarming them so they can’t spread malaria. The obstacle? Many people get scared at the mere mention of genetically modified organisms.

At Ifakara Health Institute, we’re not just in the lab, —we’re in the field, listening to the heartbeat of Africa. In 2020, we conducted a study to explore the opinions of key stakeholders on the national progress towards malaria elimination, the potential of current vector control interventions, and the need for alternative interventions to supplement malaria elimination efforts in Tanzania. We engaged a wide range of stakeholders: policy-makers, regulators, research scientists, and community members, to ensure these biocontrol methods are not only safe and effective but also embraced wholeheartedly.

Our research revealed that techniques of mosquito modification, specifically those involving gene drives, were viewed positively by community members, policy-makers, and regulators but encountered a high degree of skepticism among scientists. Overall, policy-makers, regulators, and community members trusted scientists to provide appropriate advice for decision-making.

The fight against malaria is entering a new era and Africa is at the forefront of biocontrol technologies. It’s more than just science; it’s our collective will to protect our future. Together, we’re not merely controlling malaria; we’re reclaiming our health and our aspirations.

Incorporating the views and recommendations of African stakeholders in the ongoing research and development of GDMMs is crucial. This was highlighted in a follow up study that we conducted to explore the insights and recommendations of key stakeholders across Africa on the potential of GDMMs for malaria control and elimination on the continent. We are raising awareness, bolstering our homegrown expertise, and ensuring these breakthroughs are firmly rooted in Africa.

 

Marceline Finda (cohort 7, University of the Witwatersrand) is a Research Scientist and a deputy head of the department of Environmental Health and Ecological Sciences  at Ifakara Health Institute in Tanzania

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