All of us, in our DNA, carry a rich record of our past – a fact that can be exploited to study human health and disease.
Despite recent declines in the number of cases worldwide, malaria remains a public health concern with 3.2 billion people still at risk of infection globally.  Fortunately, malaria is a treatable disease - artemisinin is an effective and potent drug recommended for treatment of uncomplicated malaria cases in most parts of the world. However, the success of this frontline drug is threatened by emerging resistance.
Despite huge efforts to treat and eradicate the disease, in 2015, 214 million people were infected with malaria. 438,000 died. More than 292,000 of those deaths were African children aged under five. Treatment is complicated by the fact the malaria parasite develops resistance to antimalarial drugs.
Despite huge efforts to treat and eradicate the disease, in 2015, more than 200 million people were infected with malaria. Nearly half a million people died. The current frontline treatment for malaria is a drug called artemisinin but treatment is complicated by the fact that the malaria-causing parasite Plasmodium falciparum is exceptionally good at developing resistance to antimalarial drugs.
Korogwe site is where we at the National Institute for Medical Research are undertaking one of our Consortial Project 2 studies. In 2003 two neighbouring villages (about 25km apart) located at different altitudes, and therefore with different malaria transmission intensities, agreed to participate in various studies of the epidemiology and immunity of malaria. In all these studies community involvement and joint ownership have been recognised as critical components of the projects. Since 2003 the study has expanded to include more villages.
Within the MalariaGEN Consortial Project 2 project at the Institut Pasteur de Dakar we are working in 2 villages in the south-east of Senegal: Dielmo and Ndiop. With Dr Adama Tall, the investigator of the project, in November 2006 we carried out the collection of informed consent forms of both populations. This process enabled two extremely important advances in our ethics review and informed consent processes.
In Blantyre, Malawi we have been collecting DNA samples from children with severe malaria admitted to the Malawi-Liverpool-Wellcome Trust and Blantyre Malaria Project research ward since 1997. These datasets were contributed to MalariaGEN's Consortial Project 1. One of the challenges we have had to overcome with the project is a lack of ethnicity data for some of these retrospective cases.
Field activities started at my site, the Navrongo Health Research Centre, in June 2007. We aimed to recruit 300 new cases and controls for Consortial Project 1 and 30 child-mother-father trios for Consortial Project 3. One important aspect of the project was to explain and discuss the study with all the relevant stakeholders especially community leaders and research participants.
Working with the Noguchi Memorial Institute for Medical Research and the Navrongo Health Research Centre we planned to recruit 200 cases of severe malaria during our high transmission season spanning Aug-Nov 2007. We based this on the numbers of cases we had experienced in previous seasons. However, for a number of reasons we struggled to recruit even 60 cases during the same period.