Areas of interest
Malaria epidemiology in pregnancy and childhood, specifically antimalarial drug safety and dose optimisation and monitoring and evaluation of malaria control progress
I am a Dutch clinical epidemiologist trained at the University of Amsterdam (MD and PhD) and the Erasmus University in Rotterdam (MSc, clinical epidemiology). I did my PhD work on community-based studies on the epidemiology, treatment and prevention of malaria (1997-2001), at the CDC/KEMRI research unit in western Kenya and Malaria Epidemiology Branch at CDC in Atlanta, before finishing my medical training in Holland. I joined the malaria epidemiology unit of LSTM in early 2004 and am currently based at the Malawi-Liverpool-Wellcome Trust Clinical Research Programme in Malawi (MLW), where I lead the malaria theme and am the scientific lead of the MLW field site in Chikhwawa district.
The malaria research programme at MLW consists of several research groups including > 20 staff and students. An overview of our team members, projects and activities can be found on the MLW malaria webpages.
My personal areas of interest include the optimization of antimalarial treatment within control programs and assessment of disease burden and control progress.
We have a small but growing team looking into key questions on malaria treatment optimization of uncomplicated malaria, including studies of pharmacological modelling, modelling growth distributions to determine optimal age-base dosing regimens, as well as clinical PKPD studies to explore optimal dosing in vulnerable subgroups, and a project to strengthen pharmaco-vigilance of antimalarials. Several of our members are active in international expert groups that help highlight the importance to integrate research on drug safety into the standard drug development and post-marketing monitoring process. Over the coming years, this work will increasingly cover drugs use for transmission reduction.
My other key interest is how to measure malaria control progress better, particularly how to capture small scale heterogeneity in malaria transmission and burden in space and time in a way that can help guide more targeted control. We are collaborating with Prof Peter Diggle and his team at CHICAS in Lancaster to combine research on assessing improved sampling frames at field level, such as sampling easy access groups or applying adaptive sampling frames, with the latest analyses techniques in spatial statistical methodology.
Affiliations and collaborations
At MLW we have a large network of malaria research collaborations within and outside Malawi. Apart from our close links with various groups at LSTM and the MalTREC initiative, key partnerships include the College of Medicine, where several of our team members hold Honorary faculty positions, CHICAS at Lancaster (Prof Peter Diggle) in the area of method development in geospatial statistics, the University of Cape Town (Prof Karen Barnes) in the area of malaria pharmaco-epidemiology, and the University of Michigan (Prof Terrie Taylor) in the area of severe malaria pathogenesis.
We are involved in several of international research and research capacity building consortia, including the ACT consortium, the Malaria Capacity Development Consortium (MCDC) and the epistats training programme with Lancaster University. An overview of our current partnerships may be found here.
Through this collaborations we leverage a range of expertise to address key questions of importance to the population of Malawi and the wider sub-Saharan African region.
I lecture on the basics of epidemiology and malaria epidemiology at post-graduate level, Masters and Diploma course level. While based at MLW in Malawi, I mainly teach at the College of Medicine.
I supervise and mentor candidates at postdoctoral, PhD, MSc and BSc level as well as research interns. I have been a PhD examiner in the UK, Netherlands and Malawi, and am a member on PhD advisory panels. I am a steering group member of the Wellcome Trust funded Malaria Capacity Development Consortium (MCDC), and am a co-PI of an Economic and Social Research Council (ESRC) funded epidemiology/statistics PhD programme which currently supports 3 PhD students.
Overall, I manage a grant portfolio as Principal Investigator (PI)/co-PI with a variety of colleagues. Over time, this has involved a range of funders, including The Wellcome Trust (WT), The Medical Research Council (MRC), The Economic and Social Research Council (ESRC), The Bill and Melinda Gates Foundation (BMGF), MMV, The European Directive for Clinical Trials Partnership (EDCTP), MACEPA, as well as private foundations.
An overview and profiles of studies within the MLW malaria theme and projects I am involved in are available here. Current projects include:
Improving the impact of existing Malaria Products – ACTs, EDCTP (PI)
Developing a cohesive 5-year malaria research strategy at College of Medicine, Malawi and MLW with Dr Victor Mwapasa. The Wellcome Trust via MCDC (PI)
Does childhood growth depend on malaria - A spatio-temporal analysis with PDRA Daniel Hayes, collaborator Professor Stef van Buuren from TNO in the Netherlands and the malaria modelling unit at Imperial College. BMGF (PI).
Co-PI Dioraphte Majete Malaria Control Project. Lead Monitoring and Evaluation component of malaria control project around Majete Game Park. Co-PI with Professor Peter Diggle. Dutch Dioraphte Foundation.
ESRC The North West Doctoral Training Centre (DTC) International PhD Partnering scheme; Liverpool-Malawi stats/epi PhD partnership training programme; three 3-year FT PhD studentships with Professor Peter Diggle. Economic and Social Research Council (ESRC)
Special populations and label expansion studies with the fixed dose combinations artemether-lumefantrine, amodiaquine-artesunate, and dihydroartemisinin-piperaquine in Zambia, Malawi and Mozambique. Co-PI with Professor Victor Mwapasa and Professor David Lalloo. European & Developing Countries Clinical Trials Partnership (EDCTP)
Malaria Capacity Development Consortium (MCDC). Subcontract LSTM/COM, Co-PI with Professor Alister Craig. The Wellcome Trust (WT).
Other expertise, professional memberships etc.
Internal – LSTM and MLW
- Since 2014 Member MLW Research Strategy Group
- Since 2014 Member LSTM tropical Clinical Trial Unit Steering Committee
- Since 2014 Member MLW Quality Management Committee
- 2012-2015 Member MLW Heads of Group Meeting (scientists representative)
- Since 2010 Member LSTM Governance Oversight Committee
- 2006-2014 Member LSTM Research Ethics Committee
- 2007-2009 Member Liverpool Associates in Tropical Health (LATH) malaria advisory board
- 2014-2015 Member WHO antimalarial dose working group. Taskforce of the WHO Technical Expert Group on malaria chemotherapy. This task force will inform the 2015 update of the global WHO malaria treatment guidelines.
- 2012-2013 Member 2012 Malawi National Malaria Indicator Survey Steering Committee. Invited member to National Malaria Control Programme Technical advisory committee to the 2012 national Malaria Surveys which assesses intervention coverage and control progress by the National Malaria Control Programme.
- Since 2011 Steering committee member, Malaria Capacity Development Consortium (MCDC). This large consortium funded by The Wellcome Trust (>£6 million) supports a cohort of PhD and post-doctoral level African scientists to undertake high-quality research that will enhance the research capacity of their home institutions.
- Since 2006 Member RBM Malaria Monitoring and Evaluation Reference Group (MERG). This group provides recommendations on core indicators and recommended malaria monitoring and evaluation tools at global level.
- 2009 External advisor WHO Technical Expert Group on malaria chemotherapy, on the update global Malaria Treatment Guidelines (task force on dosing). This task force informed the 2010 update of the global WHO malaria treatment guidelines.
- Since 2010 Member American Society of Tropical Medicine and Hygiene (ASTMH), USA
- Since 2007 Member Royal Society of Tropical Medicine and Hygiene (RSTMH), UK