Sandra participated in the studies designed to reduce malaria transmission at the Macha Research Trust and Johns Hopkins Malaria Research Institute, Macha, Zambia (1). There she and her colleagues found that decreasing exposure to P. falciparum in southern Zambia should lead to decreased levels of immunity. This has motivated Sandra to explore disease research from a different point of view: the body’s immune response. Sandra enrolled in a master’s program in infection and immunity to further her understanding of how human immunity affects disease susceptibility (2). She is a Masters student at Erasmus Medical Center Rotterdam, Netherlands, actually doing an internship in Hematology until the end of this summer. Then she will move to the department of Immunology until the end of August next year 2012.
Quite an interesting background. So we did a short interview via Email:Hi Sandra, how did you notice the Lindau Meetings?
I didn’t know about the Lindau Meetings until last year when I attended a meeting at the American Society for Tropical Medicine and Hygiene for a presentation on my work. I met Professor Peter Agre one of the laureates who was attending the meeting at the time. He told me about the Lindau meeting. I was later nominated by Professor Agre Johns Hopkins Malaria Research Insitute (JHMRI) and seconded by Dr Philip Thuma the Senior Scientific Advisor Macha Research Trust for this years meeting.
You suffered from Malaria yourself: How is the medical system in your country Zambia prepared for Malaria patients?
The medical system is trying to get more prepared. The doctors and nurses who have been trained to notice the symptoms are being told to treat on the basis of rapid diagnostic testing and the lab specialists results detected by microscopy.
Sometimes the first line of treatment which is Coartem is no longer in stock in the hospitals and clinics and at about that time we see a difference in malaria transmission. It increases. Not rural health posts are well prepared – especially with health specialists and equipment. Despite government attempts to achieve more.
Are costs payed via the Zambian health system?
The costs are covered via the health system at the clinics and at hospital level a small fee is payed when tests have to be done on a patient. I’m not sure if these fees can be met by the poorest of the poor. But one thing I know is they don’t turn them away despite the patient not having money.
You battle Malaria in your job: What exactly is your research about?
I have been monitoring the changes of malaria transmission in an area which was once malaria endemic but has low transmission rates today after intense malarial control interventions over the years. I have performed immunology studies. These studies monitor the immune responses to the parasite in the population.
When do you expect better treatment of the malaria disease?
First of all the malaria parasite is one difficult parasite to study. It has several developmental stages and has two hosts the human and the mosquito. It has the ability to mutate under drug pressure. But what I do know now after participating in several malaria studies is that transmission of the parasite in populations can be brought down to levels close to zero once intensified comprehensive community based efforts are introduced to control the disease. Some of the efforts would be the first line drug of treatment; one that the parasites have not developed resistance to, community screenings, the use of mosquito nets, indoor residual spraying and treatment upon identification of malaria infection. By this I mean once a case is reported at the hospital or health post a health team goes to the particular area where the patient came from and screens the entire community to identify cases and treat those with malaria. These are some examples. And members of the community all the way down to the grass root need to be involved.
What do you hold of the Gates Foundation and its engagement in this field?
The Gates foundation has been of great help to researchers in this field. Most governments are not able to support research due to lack of funds.As a result most research is grant based and that’s where foundations such as the Gates Foundation come in to help provide the financial support.
On which topics should Malaria research be focused in the next years?My focus would be the need to control the disease all the way down to zero transmission and this has to be community based , as I mentioned before. There is also a need to monitor changes in population immunity as there will be a risk of resurgence. And we continuously need to monitor the parasites in the population and resistance to malaria drugs.
What do you expect of the Lindau Nobel Laureate Meeting?
I hope to meet people who are intellectually stimulated who I can make connections with and hopefully have collaborations with them in the future. I also hope to pick up some ideas that I can use in my research. It would be nice to discuss with some of the laureates about possible possibilities for a PhD student to work in their labs. Scientists like to share ideas. This will happen at the Lindau Meeting.
Thank you Sandra. Have an inspiring time in Lindau!
(1) Macha Research Trust collaborates with Johns Hopkins Malaria Research Institute. The organisation was formerly called Malaria Institute at Macha/Johns Hopkins Malaria Research Institute. The Malaria Institute at Macha (MIAM) is a malaria research field station and training center established in 2003 with the signing of a collaborative Memorandum of Understanding between four partners — the Johns Hopkins Bloomberg School of Public Health and its Malaria Research Institute, the Zambian government, the Macha Mission Hospital and the Macha Malaria Research Institute. With major sponsorship from the Johns Hopkins Malaria Research Institute (JHMRI)] The organisation is based in Southern Province, Zambia close to the Macha Hospital in a small village called Macha.
(2) Papers by Sandra as a second author:
– Escalating Plasmodium falciparum antifolate drug resistance mutations in Macha, rural Zambiadoi: doi: 10.1186/1475-2875-7-87.
– Validation of oral fluid samples to monitor serological changes to Plasmodium falciparum: an observational study in southern Zambia doi:10.1186/1475-2875-10-162