The reduction in the global burden of malaria has stagnated with only marginal annual gains in the case burdens since 2015. According to the latest World Malaria Report, the total number of cases in 2018 was 228 million compared to 231 million in 2017, representing only a 1% reduction year-on-year, while the number of deaths due to malaria decreased by just 2.5%, from 415, 000 to 405, 000 during the same period. Furthermore, Sub-Saharan Africa still accounted for 94% of global deaths, with Africa’s most populous country Nigeria, contributing an astonishing one quarter of the entire global malaria burden. Approximately 85% of the Nigerian population live in meso-endemic transmission areas, of which communities living in and around the capital (Lagos) have been considered the hotbed of malaria transmission.
Artemisinin is currently the first line treatment for malaria. Artemisinin (ART) resistance has been established in South-East Asia (SEA) and despite efforts to contain ART resistance in SEA, it is feared that it will spread to Africa and erode the gains achieved in malaria control over the past decades. The spread of artemisinin resistant Plasmodium falciparum in SEA has increased the need for molecular surveillance for markers of resistance in Africa. However, not much data is available on the molecular markers that may potentially mediate resistance to ART and its partner drugs. Using samples obtained from Nigeria, I carry out whole genome sequencing to scan for known drug-resistance associated mutations in P. falciparum genomes.
The overaching aim of my research is to establish ongoing drug-resistance surveillance in Nigeria using whole genome sequencing.
Prof. Dyann Wirth