In a commitment to improve the control and elimination of malaria worldwide, the National Institute of Allergy and Infectious Diseases (NIAID) – a part of the National Institutes of Health – announced on April 21, 2017, that UC San Francisco researcher Grant Dorsey, MD, PhD, will receive a renewal award for an International Center for Excellence in Malaria Research (ICEMR).
The award will fund Dorsey’s project, the Program for Resistance, Immunology, Surveillance and Modeling of Malaria in Uganda (PRISM) for seven years at about $1 million annually.
“We’re extremely excited,” said Dorsey. “We feel very fortunate to continue the work we started.”
Dorsey, Professor of Medicine in UCSF’s Division of HIV, Infectious Diseases and Global Medicine, received a seven-year ICEMR award from NIAID in 2010. His research has informed new guidelines to antimalarial care throughout Africa, enabling thousands of children and pregnant women to live malaria-free.
PRISM is one of seven ICEMR programs selected worldwide, comprising a global network of research centers in malaria-endemic settings, including Africa, Asia, the Pacific Islands and Latin America. PRISM is based in Tororo, a rural town in Eastern Uganda, and its goals are to perform surveillance of malaria in order to improve understanding and to measure the impact of population-level control interventions. With the award, Dorsey aims to build upon the work of the last seven years.
“With the initial grant, we aimed to understand epidemiology of malaria,” said Dorsey. “Now, we want to understand its biology.”
To control malaria, Dorsey and his team has primarily relied on insecticide-treated bed nets and artemisinin-based combination therapy (ACTs) for symptomatic malaria. The interventions have been extremely effective in reducing the incidence of malaria.
Between 2010 and 2015, the rate of new cases fell by 21 percent globally. In the same period, malaria mortality rates have fallen globally by nearly 30 percent. Despite these gains, the burden of disease persists in “asymptomatic” malaria – a malaria infection that doesn’t result in typical symptoms like chills, fever and sweating, yet still causes harmful health outcomes.
Dorsey is particularly interested in understanding how malaria transmission – particularly of “asymptomatic” infections – continues in a setting where malaria burden has been reduced. “In Tororo (Uganda), incidences are now low, yet we still have a significant portion of people infected with malaria parasites,” Dorsey said. “We want to understand why this is.”
Despite high hopes for eradication and elimination, Dorsey anticipates challenges ahead. “Key interventions for the malaria parasite and mosquito are drugs and insecticides,” he said. “Yet the parasite and mosquito are constantly evolving to develop resistance to interventions. I hope that our understanding of how parasites are maintained in the human population will inform the development of new interventions.”