Malaria is a major cause of death in the Asia-Pacific, infecting around 250 million people each year.
The Menzies malaria research program spans a broad range of research activities aimed at both prevention and treatment, from epidemiology, diagnosis, pathophysiology, immunology, molecular parasitology, clinical trials, and evaluation of the impact and cost-effectiveness of public health interventions.
We work on all five species of the Plasmodium parasite that cause human malaria, with a particular focus on the three that cause most disease and death in the Asia-Pacific region: P. falciparum, P. vivax and P. knowlesi.
Our research focus:
- To better understand Plasmodium parasites, in particular how they become resistant to drugs, how they cause severe disease and death and how our immune system protects against them. With this knowledge, we can identify better ways to prevent and treat malaria in different environments, facilitating policy change and monitoring the impact of such change on the health of communities.
Our research impact:
- Showed that artemisinin combination therapies (ACT) have high efficacy against all species of malaria in Indonesia and Malaysia. A unified strategy of ACT for all uncomplicated malaria in Papua has led to a significant reduction in falciparum malaria, halving the risk of perinatal mortality. Clinical studies are on going to investigate better ways of using ACT in pregnancy and early life.
- Pioneered a novel laboratory test to assess new drugs against P. falciparum and P. vivax and are working with other drug discovery teams to prioritise the development of key antimalarial agents for the future.
- Observed that levels of a key protective molecule, nitric oxide, are reduced in severe falciparum malaria and that function of the very small blood vessels and the endothelial cells which line them are markedly impaired in severe falciparum malaria. This finding has helped to pioneer new adjunctive therapies to increase nitric oxide and therefore blood supply to vital organs in severe cases and these are now being trialled with partners in Asia.
- Showed P. vivax to be a major cause of severe and fatal malaria in Papua, Indonesia, primarily due to its ability to cause recurrent infections and severe anaemia. Menzies is now leading multicentred clinical trials in seven countries across the Asia-Pacific region to optimise the safe and effective use of primaquine regimens to prevent P. vivax relapse.
- Demonstrated that inflammatory responses to malaria parasites cause lung injury. While some responses to P. vivax are greater than those seen with P. falciparum, impairment of other cellular immune functions is found in all species.
- Revealed that P. knowlesi malaria incidence has increased in Sabah as the other species have been brought under control, threatening malaria elimination in areas where P. knowlesi occurs. This result was achieved through the analysis of 20 years of malaria notification data and ongoing prospective studies in collaboration with the Malaysian Ministry of Health.
- Determined that P. knowlesi malaria is three times more likely to cause severe disease than P. falciparum, but that deaths from knowlesi malaria can be avoided by early hospital referral and artesunate.