Dr Casals-Pascual’s research is aimed at understanding the molecules involved in the pathophysiology of severe malaria to improve its diagnosis and clinical management.
Severe malaria can develop from uncomplicated malaria in just a few hours in those people with low levels of immunity to malaria, which usually means those who have not been exposed to repeated episodes of the disease. Young African children are particularly at risk and even with good hospital treatment 20% will die. It is an important cause of global mortality and morbidity.
Dr Casals-Pascual stressed that “it is shocking how few strategies we have to reduce severe malaria”. In situations where children are suffering from respiratory distress, they require accurate diagnosis to determine if they have severe malaria or severe pneumonia. The clinical symptoms of severe malaria frequently overlap with those of other severe diseases like pneumonia, meningitis and bacteraemia. In these situations, malaria microscopy is a poor diagnostic tool for clinical management and empirical antibiotic treatment is recommended. The most common clinical presentations of severe malaria are cerebral malaria, severe respiratory distress and severe malarial anaemia.
A long-term vision would be a simple diagnostic tool for use in resource-poor settings, which uses a simple drop of blood to determine if the patient has severe malaria. But until then Dr Casals-Pascual is looking at biomarkers that can help in the decision making process to actually improve the management of these patients.
Within his presentation and discussion Dr Casals-Pascual outlined that the lack of accurate clinical case definitions for severe malaria limits our ability to diagnose and manage adequately these cases. And from a public health perspective, it limits our ability to have real estimates of the malaria burden and to monitor the efficacy of interventions and malaria control programmes. Therefore better markers of severe malaria with high sensitivity and specificity are required.
Alongside colleagues at the Centre for Cellular and Molecular Physiology, Dr Casals-Pascual thanked research partners at the University of Oxford Mathematical Institute and the UK Medical Research Council.