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Annual Report 2003/2004 Menzies School of Health Research



Annual Report 2003/2004 Menzies School of Health Research

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Tabled Papers for 9th Assembly 2001 - 2005; Tabled papers for 9th Assembly 2001 - 2005; Tabled Papers; ParliamentNT






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Menzies School of Health Research 2003 Annual Report | Infectious Diseases Division | 11 Renewal of our Memorandum of Understanding (MOU) with our principal partner in international health research, Indonesias National Institute of Health Research and Development (NIHRD) in Jakarta. The Director and the Secretary of NIHRD signed the five-year MOU during a visit to Darwin in June 2003. This will enable collaborative malaria and tuberculosis health research and training to continue in Eastern Indonesia. Award of a major five-year grant to MSHR, NIHRD and University of PNG from the Wellcome Trust and NHMRC to undertake research and training to reduce morbidity and mortality from malaria in Papua (Indonesia) and PNG. MSHRs International Health team, as part of a collaboration with the University of Utah and Duke University in the USA, and Herbert Kariuki University in Tanzania, discovered that a natural substance may help fight the most severe forms of malaria. It is believed arginine, a simple amino acid found in the body and in some foods, may have potential as a new treatment for malaria by increasing the amount of a protective molecule, nitric oxide. Trials of arginine as an adjunctive treatment of malaria are planned to commence in 2004. Assembled a collaborative network in a new study to evaluate the extent of antimalarial drug resistance and its impact on malaria morbidity and mortality in the Timika region of Papua. Preparation of studies to evaluate whether widespread deployment of artemisinin-combination therapies can reduce the rate of incidence and death from multidrug resistant malaria in Eastern Indonesia. Patient enrolment commenced in a multicentre trial coordinated by the Wellcome Unit in Thailand to discover if artesunate treatment can reduce mortality from severe malaria. Artesunate is known to kill malaria parasites faster than quinine (the traditional treatment for malaria), but it is not yet known if it can reduce the risk of death from severe malaria. The trial is expected to enrol 2000 patients at sites in South and South-East Asia, making it the largest severe malaria trial ever performed. A study investigating how malaria affects the lungs has shown that gas transfer in the lungs of patients with severe malaria is lower than that in uncomplicated malaria, due to reduced lung blood flow and reduced gas transfer across the air sac membranes. Tens of thousands of adults with severe malaria die as a result of malaria making their lungs leaky causing them to fill with fluid. Knowledge gained from this study will better inform attempts to design specific treatments for this grave complication of severe malaria. Work in a study that aims to investigate the genetic mechanisms in the malaria parasite that are assumed to result in drug resistance, has found that the Pfmdr1 gene is the most important determinant of response to selected antimalarial drugs. Studies are now investigating the relevance of this gene to resistance of other antimalarial drugs, and seek to determine factors that facilitate and prevent the emergence of resistance. This work is of particular importance as the formidable rise of multidrug resistant strains of malaria pose a major threat to tropical countries, with some of the worst multidrug resistance found in South-East Asia. Significant progress in a new project aiming to determine if tuberculosis (TB) contributes to permanent lung damage in patients in countries with a high rate of TB and a lack of healthcare resources. Both TB patients and a control group of patients from the Mimika district in PNG have been enrolled in the study with examinations to occur over 12 months. Drug resistance is one of the major threats of TB globally, with multipledrug-resistant TB practically incurable in poorly resourced countries due to the cost of alternative treatments. Studies of drug resistance in our region aim to assist public health authorities to better plan and manage TB treatment. MSHR 2003 Research & Education Report provides detail on all research projects and is available online at www.menzies.edu.au Key achievements