Terrie Taylor, DO, a Michigan State University Distinguished Professor of Internal Medicine, leads the Blantyre Malaria Project, Queen Elizabeth Central Hospital (QECH), in Malawi. She’s been conducting malaria research and treating patients there six month a year for the past twenty five years. In 2010, Malawi and Michigan State were named one of ten International Centers of Excellence in Malaria Research (ICEMR) by the U.S. National Institutes of Health.
To kick-off the discussion, she shared with me some highlights from her work. Here’s an excerpt. All are invited to join.
Please give us a brief introduction on the Blantyre Malaria Project at the Queen Elizabeth Central Hospital in Malawi, and how you came to work there.
The Blantyre Malaria Project began in 1987 when the Malawi Ministry of Health identified “severe malaria in children” as a research priority. A red carpet was rolled out by Dr. Ankie Borgstein, then principal pediatrician at the Queen Elizabeth Central Hospital (QECH), which was fortuitous because in 1991, QECH became the first teaching hospital for the new University of Malawi College of Medicine.
What are the main components and goals of BMP’s partnership with Malawi’s College of Medicine? What are the highlights so far, 9 years into the relationship?
BMP was integrated into the College of Medicine right from the beginning. As a research affiliate of the College, members of the BMP team have been involved in providing patient care, teaching medical students, identifying post-graduate training opportunities, and supporting new investigators. One highlight was being named as one of the ten International Centers of excellence in Malaria Research (ICEMR) by the U.S. National Institutes of Health. Another was receiving a new, 1.5 Tesla Magnetic Resonance Imaging (MRI) machine from General Electric Health care in 2008. Neither of these could have happened without strong partnerships within and outside of Malawi.
Can you talk about the work of BMP in severe malaria? What are the key lessons for other malaria professionals/programs out there?
BMP has been unraveling the pathogenesis of cerebral malaria since 1987. We developed the Blantyre Coma Score, which helps to standardize the assessment of comatose children. Our autopsy study revealed that 23% of children who appear to have cerebral malaria actually do not; they are infected with malaria but die for other reasons. Concomitantly, we identified a characteristic retinopathy, evident on funduscopic examination of the eye – and it turns out that the cerebral malaria patients who have this retinopathy are the ones who truly have cerebral malaria. If a child appears to have cerebral malaria (i.e., they are infected with malaria, they are comatose, they are not post-ictal and they don’t have hypoglycemia or meningitis) but s/he doesn’t have any evidence of malaria retinopathy, the clinician should search for other causes of coma. We are currently working with the MRI findings to identify the actual cause of death in children with true cerebral malaria, in hopes of introducing an intervention which could save lives.