Transactions of The Royal Society of Tropical Medicine and Hygiene

Winstanley, Peter

doi: 10.1016/j.trstmh.2009.01.020pmid: 19243804

Taylor, Terrie E.

doi: 10.1016/j.trstmh.2008.10.049pmid: 19128813

SummaryClinicians treating patients with severe malaria in endemic areas confront a variety of challenges inherent to resource-poor settings, but it is possible to provide excellent care. The basic requirements, in addition to a thorough clinical examination of the patient, include assessing parasitaemia; determining anaemia (via haematocrit or haemoglobin); estimating blood glucose and lactate concentrations; establishing and maintaining i.v. access; measuring oxygen saturation and providing supplemental oxygen when necessary; grouping, cross-matching and transfusing blood. This paper provides practical information on determining the Blantyre Coma Score, collecting cerebrospinal fluid and measuring the opening pressure, and administering controlled volumes of i.v. fluids. Included is a narrative protocol describing the approach to patients with cerebral malaria used on the research ward at the Queen Elizabeth Central Hospital in Blantyre, Malawi.

Broadhead, Robert L.

doi: 10.1016/j.trstmh.2009.02.001pmid: 19278705

SummaryA good scientist develops within a context. There is the context of the chosen discipline itself. This encompasses the uncertainties and challenges of unresolved questions in that discipline, which may inspire and stimulate the scientist to search and research again. Just as important, there is the personal context of the individual. This background may be composed of many elements; some may relate to personal history or be due to influences from mentors, other interests and talents. This paper seeks to demonstrate the rich and varied influences that have played a part in Professor Malcolm Molyneux's life and have informed him as a medical scientist, as well as played a part in his contribution to academic developments in Malawi, with particular reference to the College of Medicine at the University of Malawi.

Greenwood, Brian

doi: 10.1016/j.trstmh.2008.10.027pmid: 19062058

SummarySince the perceived failure of the Global Programme for Malaria Eradication in 1969, the eradication of malaria has not been considered a feasible goal. However, in October 2007 the goal of malaria eradication was resurrected by Melinda and Bill Gates, and this aspiration has subsequently been endorsed by the WHO and by the Roll Back Malaria Partnership. This change in direction of malaria control has provoked a vigorous debate within the malaria research and control communities as to whether resurrection of the goal of eradication at this point in time is helpful or likely to be counterproductive. The consensus that has emerged is that eradication of malaria, although theoretically possible, is not likely to be feasible within the medium term using existing control tools. However, malaria elimination (cessation of local transmission) is a realistic short- to medium-term goal for an increasing number of countries that are already bringing malaria under control.

Mwandumba, Henry C.

doi: 10.1016/j.trstmh.2009.01.017pmid: 19232656

SummaryMalawi is one of many developing countries conducting research in collaboration with developed countries. These partnerships have facilitated the sharing of ideas, knowledge, technology and resources, as well as developing and strengthening the country's research capacity. Professor Malcolm Molyneux, who recently retired as director of the Malawi-Liverpool-Wellcome Trust (MLW) clinical research programme, the Wellcome Trust's major overseas programme in Malawi, played a substantial role in developing Malawi's capacity to conduct relevant and competitive clinical research by encouraging and promoting collaboration between clinicians, researchers and sponsors from within Malawi and abroad. Not only have these developments resulted in better patient care in Malawi and beyond, they have also advanced understanding of the epidemiology, pathogenesis and treatment of important communicable diseases. This paper discusses Malcolm Molyneux's remarkable contribution to research capacity development in Malawi.

Plowe, Christopher V.

doi: 10.1016/j.trstmh.2008.11.002pmid: 19084883

SummaryMolecular epidemiological investigations have uncovered the patterns of emergence and global spread of Plasmodium falciparum resistance to chloroquine and sulfadoxine-pyrimethamine. Malaria parasites highly resistant to chloroquine and pyrimethamine spread from Asian origins to Africa, at great cost to human health and life. If artemisinin-resistant falciparum malaria follows the same pattern, renewed efforts to eliminate and eradicate malaria will be gravely threatened. This paper, adapted from a talk given in honour of Professor Malcolm Molyneux in Liverpool in September 2008, reviews the rise and fall of clinically important forms of drug-resistant falciparum malaria and considers how lessons learned from studying the evolution of drug-resistant malaria can be applied to efforts to prevent and deter resistance.

Malenga, Grace; Wirima, Jack; Kazembe, Peter; Nyasulu, Yohane; Mbvundula, Michael; Nyirenda, Cooper; Sungani, Francis; Campbell, Carl; Molyneux, Malcolm; Bronzan, Rachel; Dodoli, Wilfred; Ali, Doreen; Kabuluzi, Storn