With the overall goal of reducing the burden of malaria and other parasitic diseases that mostly affect vulnerable populations, the programme contributed with a number of relevant publications and activities in 2023.

Improving malaria treatment and prevention

We identified a candidate biomarker to detect and quantify brain damage in children with malaria (1), and potential biomarkers for early identification and treatment of severe cases of malaria in returning travellers (2). We tested an oral drug as an adjunct therapy in children with severe malaria: the drug was safe but showed no significant benefit (3). We have also explored more efficient systems to deliver drugs for malaria and leishmaniasis, another neglected parasitic disease (4).

Regarding malaria immunity, we continued to analyse antibody responses elicited by RTS,S, the first licensed malaria vaccine currently being administered in many sub-Saharan countries (5) and investigated the effect of prenatal malaria exposure on malaria susceptibility during the first year of life (6). In vector control, we highlighted the need to study the impact of insecticides used to control malaria-transmitting mosquitoes on other disease vectors (7).

Strengthening malaria surveillance

We increased our knowledge of innovative and cost-effective surveillance approaches by demonstrating that pregnant women at their first antenatal care visit provide data on P. falciparum temporal and spatial trends (8), and significantly strengthened genomic surveillance capacities in Mozambique through the recently renewed GenMoz project (9).

In Papua New Guinea, which accounts for about 90% of all malaria cases and deaths in the Western Pacific region, we found that travellers may be an important source of malaria infections in an island setting, and that their screening could help reduce the malaria importation into mining areas (10). In migrant populations arriving in the EU, we found that the prevalence of malaria infection varies considerably according to their region of origin (11).

Improving diagnosis and treatment of Chagas disease

We continued our work in endemic areas to improve early detection of people infected with T. cruzi by contributing to the development of a rapid and sensitive point-of-care test based on rapid purification and amplification of parasite DNA (12). By following a cohort of Chagas patients treated at our Platform in Cochabamba, Bolivia, we confirmed the need for new, early biomarkers of treatment efficacy (13). In non-endemic areas, many at-risk Latin American migrants have not been screened for T. cruzi infection. Almost half of those attending the International Health Service of the Hospital Clinic were infected, and 18% had developed cardiac complications (14). Our preclinical research demonstrated potent anti-T. cruzi activity of an alkaloid extracted from the leaves of a plant native to Argentina (15).

Testing a more effective treatment against intestinal worms

The STOP project successfully completed its clinical trial to test the efficacy of a single pill combining a fixed dose of ivermectin and albendazole to treat soil-transmitted helminths in schoolchildren. The trial, conducted in Kenya, Ethiopia and Mozambique, showed that the pill is safe and more effective against whipworm than the standard treatment (albendazole alone).

New approaches to better understand parasite biology

We validated an organ-on-a-chip technology to study P. vivax infections in bone marrow and spleen, and co-authored a document outlining new guidelines for the use of circulating extracellular vesicles to improve our understanding of host-parasite interactions and facilitate the early diagnosis, treatment and prevention of parasitic diseases (16). In P. falciparum, we described a radically novel approach based on heterochromatin patterns to predict gene expression patterns (17) and reviewed the role of glycans (sugar-based molecules) in parasite survival and virulence (18).

Measuring costs, benefits and perceptions

Our modelling analysis showed that community-based provision of preventive antimalarial drugs to pregnant women is a cost-effective strategy in several sub-Saharan countries (19). Using another type of modelling, we investigated how risk perceptions and social norms influence preventive behaviour for vector-borne diseases in Guyana (20).

References

  1. Balanza N et al. J Infect Dis.
  2. Balerdi-Sarasola L et al. Travel Med and Infect Dis.
  3. Varo R et al. Int J Infec Dis.
  4. Román-Álamo L et al. Pharmaceutics.
  5. Jairoce C et al. J Infect Dis.
  6. Natama HM et al. Infection and Immunity.
  7. Bassin N et al. Lancet Planet Health
  8. Pujol A et al. Nat Comm
  9. da Silva C et al. Biol.
  10. Millat-Martínez P et al. Malaria J.
  11. Requena-Mendes A et al. Clin Microbiol Infect
  12. Longhi S et al. Plos Negl Trop Dis.
  13. Pinto J et al. Plos Negl Trop Dis
  14. Laynez-Roldán P et al. Plos Negl Trop Dis.
  15. Ortiz JE et al. Phytomedicine
  16. Fernandez-Becerra C et al. J Extracell Biol.
  17. Michel-Todó L et al. Spectr.
  18. Izquierdo et al. Biotechnol Advances.
  19. Cirera L et al. BMJ Glob Health
  20. Lopes-Rafegas I et al. Sci Rep.

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