Improving the evaluation of severe malaria

In areas of high malaria transmission, individuals are repeatedly inoculated with malaria parasites. At any one time, most infected individuals control their infection and are asymptomatic, but some develop life-threatening severe disease. Because malaria parasitaemia is so common, it is difficult to diagnose whether malaria is the cause of illness or whether the parasites are coincidental. In clinical studies of severe malaria, mis-diagnosis leads to the false inclusion of patients who do not have severe malaria, impacting the accuracy of results. I will develop a biomarker based diagnostic model of severe malaria, using easily measured biomarkers such as platelet counts and white blood counts. I will use this model to improve our understanding of the genetic susceptibility to malaria; the impact of blood transfusion in severe malaria; and how to better design clinical trials in malaria endemic areas. These three research questions rely on a precise definition of severe malaria.