Tropical Health Matters

During the first day of the 2008 Global Ministerial Forum on Research for Health in Bamako we were told that while not every country needs a national airline, all need indigenous health research capacity. How else could the unique ecological, cultural and administrative context for providing appropriate health services be discerned? The objectives for the forum follow:

• Strengthening leadership for health, development and equity
• Engage all relevant constituencies in research and innovation for health
• Increase accountability of research systems

While the forum is featuring improtant processes such as capacity building research ethics, civil society involvement, operations research application, among others, specific health issues like malaria are a subtext running throughout.  Mali itself has been developing strong malaria research capacity, and not surprisingly Ogobara Doumbo, the Director of the Malaria Research and Training Center (MRTC), University of Bamako, is a member of the program committee.

This month in The Lancet Stephen Pincock presents a short biography of Ogobara Doumbo, which starts with a childhood commitment to health care from someone clearly rooted in his culture and thus, able to ground his future health research in his country’s needs.

“One day towards in the late 1960s, a doctor came to visit a small village in eastern Mali where the young Ogobara Doumbo and his family lived. He asked the 10-year-old what he wanted to be when he grew up. “I said, ‘I am planning to be a doctor like you’”, Doumbo recalls. “He was very surprised for a small child to be so convinced he wanted to be a doctor.” Considering Doumbo’s father and grandfather were both traditional healers, perhaps his response was not really so surprising. From that year, Doumbo began travelling with his grandfather to other mountain villages, absorbing his strongly ethical approach to treating ailments ranging from infectious diseases to breast inflammation. “I spent enough time to see his practice and follow him carefully.”

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According to US National Institutes for Health, which is one of the supporter the MRTC, “The MRTC is viewed by many as a model for research centers in developing countries, as its research is planned, directed, and executed by African scientists.” Thus the MRTC can certainly hold pride of place equal to if not greater than a national airline. A small sample of findings from recent MRTC publications include –

• Artesunate-mefloquine is well-tolerated and is as effective as artemether-lumefantrine for the treatment of P. falciparum malaria. Artesunate-mefloquine also prevented more new infections (AMJMH).
• Maps provide valuable information for selective vector control in Mali (insecticide resistance management) and may serve as a decision support tool for the basis for future malaria control strategies including genetically manipulated mosquitoes (Malaria Journal).
• The magnitude of antibody response against Plasmodium falciparum may not be as important as it is believed to be. Instead, the fine specificity or function of the response might be more critical in protection against malaria disease (Acta Tropika)
• Given the delay in the time to first malaria episode associated with HbAS, it would be advisable for clinical trials and observational studies that use this end point to include Hb typing in the design of studies conducted in areas where HbAS is prevalent. (J Infect Dis)
• Altogether, these results suggest that indoor mating is an alternative mating strategy of the M molecular form of An. gambiae. Because naturally occurring mating couples have not yet been observed indoors, this conclusion awaits validation. (J Med Entomol)

Keep track of the Bamako Forum via TropIKA.net and learn more about health systems research, the challenges of eHealth and other health research issues that will affect the future of malaria research.

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