Completed Mental Health Infection & Immunity

Optimising antimalarial combination therapies in an area coendemic for vivax and falciparum malaria

In plain English

AI plain-English summary

In Papua, Indonesia, a research network is changing how doctors treat malaria across a district of 180,000 people. The problem is that two different malaria parasites—*Plasmodium falciparum* and *Plasmodium vivax*—coexist in the same region, and they respond differently to the same drugs. *P. vivax* can hide in the liver and relapse months later, while *P. falciparum* is more likely to develop drug resistance. Current artemisinin combination therapies (ACTs) were designed mainly for *P. falciparum*, leaving gaps in how to treat *P. vivax* relapses and how to safely give certain drugs to people with a common enzyme deficiency called G6PD deficiency. This project will run clinical and laboratory studies to find the best drug combinations for both parasites, develop a cheap diagnostic test for G6PD deficiency, and create genetic tools to track emerging drug resistance. If successful, the results will feed directly into Indonesian Ministry of Health policy decisions and could be adopted by the World Health Organization for global malaria elimination efforts. The work is applied and policy-focused, not fundamental science—its value lies in delivering practical, evidence-based treatment guidelines for a real-world co-endemic setting.

View original technical description
I have established a large network of researchers, service providers, and policy makers in Papua, Indonesia to undertake a series of epidemiological, clinical, and laboratory studies to optimise the treatment and prevention of malaria. Previous studies led to a district-wide (population 180,000) change in policy for uncomplicated malaria to artemisinin combination therapy in 2006. The current proposal will expand our research agenda to address the next phase of ACT deployment, notably an underst anding of the co-factors that determine its impact and cost-effectiveness and how these differentially affect P. falciparum and P. vivax. Novel and complementary studies are planned to optimise the treatment of vivax relapses, improve the diagnosis of G6PD deficiency and develop genetic tools for monitoring drug resistance. This research will provide the evidence base upon which to optimise malaria control programmes. The crucial involvement of collaborative partners in the District Health Au thority, local government and Indonesian National CDC will ensure that the results of the project impact directly on MoH policy decisions not only for Papua but also elsewhere in Indonesia. My objective is that these tools will be endorsed by WHO and adopted by the current global elimination efforts.

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Researchers

Dominic Kwiatkowski (EPMC Awardee)Richard Price (EPMC Awardee)

Related Research

Grants with similar aims, by meaning.

Improving the treatment of malaria.
Improving the treatment of tropical infectious diseases
Malaria: Optimising the mix of malaria interventions including malaria vaccines (OPTiMIX study)
Improving the treatment of Plasmodium vivax
Novel tools and approaches for safer and more effective treatment of Plasmodium vivax malaria

Original classification

Senior Research Fellowship Clinical

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