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US-Mali Researchers Work Together to Fight Malaria - 2002-01-22


U.S. researchers in Mali are trying to find out if a certain genetic mutation protects against malaria. Research clinics set up for the project are also bring health care services to impoverished parts of the west African country that are frequently affected by the mosquito-borne disease.

U.S. researchers working in tandem with their Malian counterparts at Bamako's Malaria Research Training Center are preparing for the next rainy season, from June to December.

With the rains, mosquitoes carrying malaria will infect countless people. What is known here as the sickness of the green season will kill many infants and pregnant women.

Rick Fairhurst, a research fellow with the U.S. National Institute of Allergy and Infectious Disease, says in recent decades malaria has become deadlier because of its growing resistance to the cheapest anti-malarial drug, chloroquine.

"In the last 50 years, the malaria parasite has developed resistance to a drug called chloroquine," he said. "Chloroquine has been used for about 50 years. We have a lot of experience with its safety and effectiveness. It's an extremely safe and well tolerated drug which can actually be taken by the two populations at the greatest risk of dying from malaria, namely children under the age of five and pregnant women. Although other drugs exist for the treatment of malaria, these drugs are currently much too expensive for use in Africa and in fact have some side effects."

As chloroquine resistance grows in Mali, it is estimated about a quarter of children are now dying of the disease before the age of five.

Mr. Fairhurst is leading a team of U.S. and Malian researchers to find out if a gene mutation in the oxygen-carrying molecule in red blood cells protects against malaria.

A study in the northern Dogon region of Mali indicates the presence of hemoglobin C significantly reduces the mortality risk of the mosquito-borne disease. The Dogon people who traditionally live in cliffs are an extremely isolated population, well suited for a medical study. They fought hard to resist colonialism and Islam. Research shows 16 percent of the population carry the C mutation, leading scientists to believe it might have occurred due to natural selection in the presence of malaria.

There are also no known health hazards of carrying hemoglobin C.

In the south of Mali, close to the Guinea border, Mr. Fairhurst and his team are gathering data at a new site in the towns of Kangaba and Keila. They have chosen the site because the Malinke people there are ancestors of the Dogons. "We've moved our study principally to reconfirm our results earlier with hemoglobin C, reducing the risk of severe malaria in the Dogon by 80 or 90 percent," he said. "We hope to show the same results at Kangaba Keila, chiefly because this group of people gave rise to the Dogon about 600 years ago."

U.S. scientists want to find out how and why hemoglobin C appears in specific geographical areas and ethnic groups.

Researcher Abdoulaye Djimde says the joint project is important to Malians because the scientists also set up clinics that give free care to malaria victims.

Mr. Djimde says it is crucial to have Malians in the research team working with village leaders, including traditional healers, to make sure everybody agrees to the project. Traditional healers are then told to refer children with malaria symptoms to the researchers and when the children are treated in the clinic where their blood is also collected, the researchers give public credit to the healers, saying they quickly identified malaria and took the right steps to save the child's life.

Mr. Djimde says this makes the research both useful to find new treatment for malaria and to provide crucial medical services for impoverished communities.

The U.S.-trained Malian scientist says that if more international funds were available collaboration efforts like these could be multiplied to make a real impact in the fight against malaria.

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