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Mission Man

David Colwell

Mission Man (continued)

Some of the most important translational research in Macha didn’t happen in the lab, or the creeks and huts that dot the countryside, but rather on Philip Thuma’s veranda. It’s there at the end of a hard day’s work that some of the numerous JHMRI researchers and their Zambian counterparts gather. Ostensibly they come to eat—half of Thuma’s house is the communal kitchen for the compound (“My wife is chief cook and I’m head bottle washer,” he laughs)—but a few stragglers usually make their way to the porch as the sun goes down and the enemy, those damned mosquitoes, start pinging off the veranda’s enclosing screens. That’s the kind of omnipresent buzz that can turn thought into action. 

And so it has. Over the past six years, JHMRI researchers and postdocs have made numerous trips to Macha. By studying both Thuma’s work and greater Macha, they’re hoping to develop a transferrable one-two punch: Prove that there’s a way to knock down seasonal malaria to just a few cases, and then track those cases back to the homes where the disease was initially transmitted to treat asymptomatic patients who are parasite carriers. In and around this, investigate the effectiveness of control efforts such as insecticide-treated bed nets and mosquito larvae eradication programs.

Thuma says the largest body of publications in the 2004–2007 period came from mosquito vector expert Douglas Norris’s team, including then doctoral student Rebekah J. Kent. Kent collected 31 different mosquito species in Macha, discovering that one, Anopheles arabiensis, was the primary vector for transmission. “No one had studied mosquitoes in that part of Africa for many years,” says Thuma.

Thuma and his JHMRI colleagues understand the irony of what’s going on in Macha now. With malaria cases at an all-time low, some researchers and funders might be tempted to shift attention to other diseases. Clive Shiff, an MMI associate professor, says that would be a mistake on several fronts, noting that another mosquito malaria vector, An. funestus, was wiped out in the Macha area during the 2003 drought but could return in any given rainy season. On a more practical level, cash-strapped African governments could spend far fewer dollars if they attacked malaria when it was relatively quiescent—if they only knew where to look.

“None of the African countries where malaria is endemic can afford these long-term, high-cost control programs,” says Shiff, of the massive mosquito spraying and drug distribution efforts some health ministries have used in the past when malaria cases soared out of control. Moreover, he notes, “this is not a good time for donor countries to reach into their pockets and come up with another billion dollars.” Shiff’s goal? “[Find ways] of reducing the costs by about 80 percent, so you can focus at specific times of the year on critical parts of the population.”

Working with Thuma and parasitologist Mharakurwa, JHMRI’s faculty and several young Zambian scientists have made significant potential inroads to creating such efficiencies in Macha in just a few short years. Their efforts combine fieldwork with the latest communication and satellite technologies. Amplifying on the work of Doug Norris’ team, Greg Glass and Clive Shiff determined that An. arabiensis was particularly fond of breeding in clean streams of slow running water. They also learned An. arabiensis could only travel 450 meters from its birthplace to feed, an important factor in targeting control efforts aimed at humans.

Glass took the finding one important step further: He used satellite imaging and modeled the hydrology to elegantly map likely breeding sites (see sidebar). Armed with knowledge of the mosquito’s flying range, Glass drew concentric circles around these bodies of water to come up with a relative bull’s-eye of those most likely affected: people who lived or worked inside the ring. Shiff is pulling the treatment net even tighter: He and team members Aniset Kamanga and Gillian Stressman are finding and treating asymptomatic adults.

Comments

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  • Kathleen Stuebing

    Ndola, Zambia 01/13/2011 01:32:27 AM

    This is an excellent article that accurately presents Macha and the incredible ways through which Dr. Phil Thuma has brought relief from malaria. Both of our children were born at Macha by Caesarean section, and I had no complications or infection, attesting to the quality of the medical care in the middle of the African bush. Now Dr. Thuma has added his malaria triumph, which your article describes so well. We eagerly await the time when malaria is controlled to such a degree where we live in urban Zambia. Our students and their children regularly suffer from malaria. This is a wonderful story of hope for all malaria ridden places, and it rightly honors the man who has given his life to pursuing this goal--Dr. Philip Thuma. Thank you.

  • Lee Nell

    Florida, USA 11/14/2012 12:14:32 PM

    Great article about a great man. Phil is a genius, in my opinion, the most unassuming person I've ever known considering the miracles he's accomplished so far, and, I'm proud to say, my brother-in-law. As the article notes, he is totally committed to the people in and around Macha and to eradicating this dread disease. As I've always said, my money is on the tenacious Phil Thuma to win that battle. Maybe then, and I'm sure only then, would he even consider accepting some credit for his success in the remarkable life's work he has undertaken. Maybe.

  • Juliet Laverley

    Sierra Leone 07/13/2013 11:52:01 AM

    This is great work it takes a special person to make this happen, I wish we can clone Dr. Thuma for other areas in west Africa. Is there opportunity for adoption of best practice and protocols from his experience and success for other African countries with similar challenges?

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Macha Slideshow

Fighting Malaria in Macha

Photographer David Colwell journeyed to Macha, Zambia and returned with images and sounds of malaria research and prevention.

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