Toward a malaria-free world

You’ll be finding out all about malaria and some of the research projects currently underway with the aim of eradicating the disease (from prevention to finding a vaccine).

Find out more, form an opinion and share it!

Malaria is one of the leading issues in world health. It mainly affects women and children under the age of five in countries with low incomes and is responsible for hundreds of thousands of deaths each year. Have a look at this link to see the magnitude of just how quickly this disease spreads.

Measures aimed at controlling the spread of the disease, education and research are essential in the fight against the spread of malaria, but will we maybe see a world without malaria one day? Are we even getting close to the possibility? Can we ensure that everyone is receiving the best treatment available?

One of the debates at an upcoming conference on malaria is the strategy that should be adopted in order to eradicate the disease in accordance with the aims established by malERA (the Malaria Eradication Research Agenda). Unfortunately, another one of the main topics of the conference will be the limited resources destined by different states to following malERA’s aims. As well as the current economic climate, the conference will have to be well aware of the fact that the disease continues to decimate populations in only the poorest of countries.

As part of the meeting, leading figures in the international community will have to decide which of the following theoretical positions would be the best and should be implemented:

  • Position 1: distribute the reduction in investment proportionally across all of the different fields of activity: prevention, treatment and diagnosis, programmes and research.
  • Position 2: reduce investment in prevention, programmes and research but keep the same budget for treatment and diagnosis.
  • Position 3: reduce the money spent on diagnosis and programmes and research but keep the same budget for prevention.
  • Position 4: spend less on prevention, treatment, diagnosis and programmes but keep the same budget for research.
  • Position 5: make reductions across all areas (prevention, treatment and diagnosis, programmes and research), but make the cutbacks according to the level of poverty in the region.

In this activities guide, we invite you to investigate the decisions you think need to be made in the political arena regarding this topic and, in your capacity as representatives of the educational community, to share your opinions on blogs and social networks so that they reach society as a whole and the politicians who actually do make these decisions.

To help you with this task, Dr. Pedro Alonso, director of the Barcelona Institute for Global Health (ISGlobal) has worked together with Xplore Health to come up with a training plan which will help you find out more about this disease and how it spreads, as well as the ethical, legal and social issues involved, so that you can contribute to the debate on the 5 different theoretical positions detailed above with a more solid knowledge base.

In order to follow this training plan, we’ll need you to do the following:

  1. Organise yourselves into groups of five.
  2. Watch a short video and work through some basic documentation for you to get an idea of the biology of the disease.
  3. Interact with a virtual simulation to raise your awareness of factors involved in controlling malaria.
  4. Take on one of the positions described in the introduction (each member should adopt one of the positions) and fight for it in the debate.
  5. Consider and evaluate which position you as a group feel is the most ideal.
  6. Make a digital poster to explain the decision you have come to as a group.
  7. Share your position in a blog and across social networks.

But before you start, check out the message that Dr. Pedro Alonso has left for you by clicking on the following link.

Ready to begin? Find out more, investigate, debate and share!

Let’s get started...

  1. Introduction to the disease’s biology (3rd and 4th year of secondary school version)

The aim of this first activity in the training programme is to introduce you to the world of malaria.

  1. Organise yourselves into groups of five (initial work groups).
  2. Watch the short video entitled Working for a malaria-free world. Note down individually the ideas you think are most important and the things you don’t fully understand in a table like this one: NB: we recommend watching the video at least three times.

Most important ideas / I don’t really understand...
  1. In your work groups, compare which ideas you thought were most important and then try to come up with a summary of the things you didn’t fully understand. Choose a spokesperson in each group and write down all of the ideas suggested on the board. Try to clear up any remaining doubts with the help of your classmates and teacher.
  2. Once you’ve finished working on the video, each member of the small group should choose one of the following topics to study in a new work group:
  1. What is malaria? How is it transmitted?
  2. What does the life cycle of malaria look like?
  3. Fighting malaria: vaccines.
  4. Preventative measures. The Roll Back Malaria programme.
  5. The disease’s epidemiology.

The aim of these new work groups is to pool your knowledge and investigate your topic in more detail with the help of the links below. You will then be able to come up with an answer to each of the questions and pass on this knowledge to the others in your initial groups.

What is malaria? How is it transmitted? / What is malaria?
What does the life cycle of malaria look like? / Video: the life cycle of malaria
Fighting the disease. / Research on malaria
Preventative measures. The Roll Back Malaria programme. / Solutions
RBM Mandate
RBM Vision
Epidemiology / Key malaria facts
Endemic countries
The challenge

Participate in the work group you decided on and write down an answer to the question.

  1. Return to your initial group members and share your answer with them. Then try to answer the following questions in your groups:

a)In the past, malaria was also known under a different name: paludism. Each of the different names has a meaning - where do they both come from? What relationship do these names have with the ecosystem where the Anopheles mosquito lives?

b)Imagine that one of these mosquitoes bites you on the arm outside of the classroom. Still in your work groups, draw up a report of the likelihood of your contracting malaria.

Introduction to the disease’s biology (5thand 6thyear of secondary school version)

The aim of this first activity in the training programme is to introduce you to the world of malaria.

The WHO is the world authority on directing and coordinating different activities related to health. The WHO’s World Malaria Report 2013 highlights the constant progress being made in reaching the international goals aimed at combatting malaria set for 2010-2015. The report contains a summary of all of the information from the different countries suffering from endemic malaria.

  1. Organise yourselves into groups of five (initial work groups).
  2. Watch the short video entitled Working for a malaria-free world. Note down individually the ideas you think are most important and the things you don’t fully understand in a table like this one: NB: we recommend watching the video at least twice.

Most important ideas / I don’t really understand...
  1. In your initial work groups, compare which ideas you thought were most important and then try to come up with a summary of the things you didn’t fully understand. Choose a spokesperson in each group and write down the most important ideas suggested on the board. Try to clear up any remaining doubts with the help of your classmates and teacher.
  2. Once you’ve finished working on the video, each member of the small group should choose one of the following topics to study in a new work group:
  1. Policy development + financing malaria control
  2. Progress in vector control
  3. Progress on chemoprevention
  4. Progress in diagnostic testing and malaria treatment
  5. Malaria surveillance, monitoring and evaluation + impact of malaria control

The aim of these new work groups is to pool your knowledge and investigate your topic in more detail with the help of the information you will find in the document entitled Executive summary and key points World Malaria Report 2013. You will then be able to come up with an answer to each of the questions and pass on this knowledge to the others in your initial groups.

Participate in the work group you decided on and write down an answer to the question.

  1. Return to your initial group members and share your answer with them.
  2. Imagine that one of these mosquitoes bites you on the arm outside of the classroom. Still in your work groups, draw up a report of the likelihood of your contracting malaria.
  3. Finally, complete the data sheet on malaria you’ll find on the next page to summarise all the knowledge you’ve gained. Note: all of the data can be found either in the video entitled Working for a malaria-free world or in the Executive summary and key points World Malaria Report 2013. For further information, you can read the following report which appears in the El País newspaper:
Malaria or paludism
Cause
Vector
Number of new cases across the globe (2010)
Number of new cases in Sub-Saharan Africa (2010)
Number of newly-infected people
Number of deaths across the globe (2010)
% of deaths in Africa compared to overall figure (2010)
% of infected children under the age of 5 compared to the overall figure (2010)
Number of countries where malaria is endemic
Symptomatology
Types of treatment
% of suspected malaria cases receiving a diagnostic test in Sub-Saharan Africa
Types of prevention
% of families in Sub-Saharan Africa with access to insecticide-treated mosquito nets (ITN) (2011)
Post-treatment follow-up
Resistance to treatments
International financing for controlling the disease (2011)
International financing for controlling the disease (2010-2015)
Current areas of research
  1. Malaria and the immune system (3rd year of secondary school version)

In a video entitled A shelter from malaria, researchers Pedro Alonso and Joe Campo explain to us they research project they’re working on, known as project Mal055, which aims to find a vaccine to malaria.

At the moment, they’ve found a vaccine which only appears to protect around half of the children to which it is given. This is why it’s so important to understand the mechanisms involved in our immune system which protect some people from infection. We invite you to play a game:

THE MALARIA BOX

Materials required:

  • mosquito = box
  • Plasmodium = balloons in 4 different colours
  • vaccines = balloons in 4 different colours cut up into pieces
  • B cells = green ball made of modelling clay
  • T cells = blue ball made of modelling clay
  • antibodies = needles

a)How easy do you think it is to identify how many people are infected with the malaria parasite?Are there any external signs that might give it away?

Get into groups of 5. Each group is given a box (the mosquito); one of the group will then decide, without the other classmates being able to see, whether to put theballoon (Plasmodium) in the box or whether to leave it empty. They should also decide on the colour (different species of Plasmodium) and the number of balloons (more than four). Only mosquitoes carrying the Plasmodium parasite will infect your classmates.

Move the boxes around the class just like mosquitoes move - randomly from one person to the next. The person in charge of the box should ensure that it is passed to at least 4 different classmates. If the box is passed onto you, you need to open it and check if it contains a balloon:

  • Does it contain a balloon?
  • Yes the mosquito bites you and the parasite enters your bloodstream. Take one of the balloons from the box, but don’t blow it up just yet - the others don’t need to know if you’ve been infected. Pass the box onto someone else in the classroom.
  • No you’ve been lucky! You’ve not been infected, so pass the box onto someone else in the classroom.
  • Don’t blow up the balloons until the box has been handed to at least 4 different students. No-one should know which of the boxes contains parasites and which ones don’t. The vector can continue to pass on the infection as the box will still contain balloons.

b)How many of your classmates have been infected with malaria?

The boxes have now been passed to four different people. Now it’s time to discover as a class who has been infected, so blow up the balloons if you have one.

  1. Find out more information on the different species of Plasmodium that can carry malaria:
  1. Assign a colour to each of the different species.
  2. Note down the number of students infected with each kind.
  3. Has anyone been infected by more than one species?

c)What vaccine can you give me?

Seeing that part of the class has been infected, the others decide to get vaccinated.

You’ll find different vaccinations in the hospital (part of the classroom should be set up). These vaccinations are represented by shreds of cut-up balloon in the different colours, each one inside an envelope. Take one of the envelopes.

Return to your seat. You’ll need the shreds of coloured balloon to come into contact with the cells in your immune system, your T cells.

d)Will my antibodies be able to prevent infection?

After a while, your B cells will have produced antibodies (needle with thread). The colour of the thread must coincide with the vaccine you’ve selected (the shreds of balloon). Place a few needles on the table which represent the antibodies you have available to fight the parasite and surround your B cells with antibodies; these will be your memory B cells.

Students who have been vaccinated are now once again among the general population and can be handed one of the boxes (i.e. are bitten by a mosquito). As before, if you are given a box, open it and see if it contains a balloon. If it does contain a parasite:

  • Does the colour of the balloon coincide with the colour of your antibodies?
  • Yes  Great! The antibody recognises the parasite. You can burst the balloon with the needle.
  • No Oh dear, bad luck! Your immune system doesn’t recognise the parasite: you’ve been given an ineffective vaccine.

e)Final activity:

  1. Write a report using the questions in the activity as a guide. Add a glossary containing definitions of some of the parts of the immune system: antigen, antibody, T cell, B cell, innate immunity, acquired immunity. Your report should include all of these words.
  2. Produce a brochure explaining the game for putting on social networks to help raise social awareness of the importance of carrying out research to combat this disease.

Malaria and the immune system (6th year of secondary school version)

The document entitled The Pillars of the Earth: How Basic Science Contributes to the Fight Against Malaria published by ISGlobal explains the importance of conducting research into the structure, metabolism and genetics of the parasite in order to achieve our goal: to eradicate malaria.

You’ll be working as scientists in a basic research lab and should now split into different working groups.

  • GROUP 1:PLASMODIUM BIOLOGY

We know different Plasmodium species that cause malaria in humans. The most common are: P. falciporum, P. vivax, P. malariae, P. ovale and P. knowlesi. Of these five species, P. falciporum and P. vivax are responsible for the vast majority of new infections and for deadly infections, some of which have developed resistance to medicines.

Once Plasmodium comes into contact with the immune system, it causes a reaction whereby the antigens from the pathogen are recognised and the body starts an immune response. You can find out more about this reaction at the following link:

Compared to Plasmodium with its gene count of approximately 5,000, viruses and bacteria have very few genes. There are thousands of different proteins which could act as antigens for our immune system.

Cell st & Microbe 10.1016/j.chom.2010.12.03

  1. Look carefully at the image on the left and think about which phases of the parasitic life cycle you would choose to study the proteins related to the immune response or for treating and preventing infection.
  2. The right-hand image shows the merozoite recognising, attaching itself to and entering an erythrocyte (figures 1, 2 and 3), as well as some substances which can help prevent the recognition and attachment phases (figures 4 and 5). Can these inhibitors be used to prevent infection? Why?
  3. The following article, which appeared in the magazine Nature, is about a protein which is essential in the development of gametocytes. Can inhibiting this protein expression help to prevent infection? Why?

d.Following in the footsteps of the researchers, the first thing you’ll need to do is find out more information on the protein PfAP2-G. You will be accessing a program called BLASTwhich is used to compare protein sequences with all of the proteins held in one of the available biological protein databases. In this case, they use the Swiss-Prot databasewhich is an annotated protein sequence database for proteins with a known function, structure and post-translational modifications. The tool will help you discover the protein’s function. There are different types of BLAST, but we will be using blastp (protein sequence database search) which we can find on the NationalCenter for Biotechnology Information’s server (NCBI). Find out more about the characteristics of the protein and read the first few papers it is quoted in.