Malaria and the Russian salad of genetics, epidemiology and anthropology

The more I explore the public health problem of malaria, the more I am aware of how many pieces are they to the puzzle. Experimentally, I am confronted with studies on Plasmodium parasites where genetics feature prominently, such molecular evolution at the apical membrane antigen 1 (AMA1) of the parasite itself or issues concerning the host, such as a paper on how people negative for the Duffy blood group are now susceptible to the P.vivax malaria parasite, a finding that breaks the protection that Duffy negative individuals were thought to have against this type of malaria. The aim of the researchers has been to link their findings with issues of malaria infection on the ground in both endemic and epidemic settings (epidemiology), but this is apparently a formidable task. The line between genetic dimensions of the parasite and the epidemiological dimension is nonlinear. I wonder whether pursuing a standard epidemiology and statistics program would be adequate to even begin to unravel the problems of malaria. Perhaps I need to look at a program with a genetic focus. Would I be capable of integrating this genetic focus into my standard epidemiology, as a molecular biology graduate? Is my interest strong enough to do this? I have been admitted in Epidemiology of infectious disease program at WITS and if I end up going there, I will certainly have to wield my molecular biology knowledge. That was the whole point, was it not? The level of genetics required goes well beyond what I studied as an undergrad, so I will need to do more courses. Then my aim is to ultimately enter the medical anthropology aspect of it, but it seems that if enter the molecular biological part, there is no coming out. No, there is, there always is. Pancho

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About writinghealth

Wannabe Epidemiologist? Wannabe med anthro person? I guess. Christian, scientist (not Christian scientist), i mean like I studied molecular biology. I am doing a Masters of Public Health, at the University of Cape Town.
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One Response to Malaria and the Russian salad of genetics, epidemiology and anthropology

  1. Pancho says:

    Right now I realize that I want to do a malaria program – as part of a larger epidemiology program. Honestly, I entered this direction because the ministry of health is offering funding – specifically through the malaria control program, for epidemiology. And so I jumped onto the bandwagon. So far, I understand that studies looking into specific parasite genes – such as AMA1 locus – and linkage disequilibrium to determine the extent of genetic variation in a popilation and the time from when a strain of Plasmodium entered a human population. I wonder whether I will get a chance to look at the linkage disequilbrium in a quantitative way at WITS (I am admitted there! Now I have to go for the interview).
    Basically, what I expect to gain over the course of 18 months is good grounding in statistical methods and how to apply those to epidemiological studies. I am really interested in the way human behavior affects their health, so in the case of malaria there is alot I could look at. Since there are many variables one has to take into account when looking at behavior, I would do well to learn statistical methods that allow me to tease apart variables and how to avoid pitfalls of confounding them. If I had access to genetic data – such as Duffy blood group (but Vivax is not in Namibia, is it? – no because it would not survive as most are Duffy negative, but then there is new strain that infects Duffy Positive) then that would be cool.
    So I should perhaps chose an example – like the Duffy one – and illustrate it for them – the interview pannel.
    Explain the problem of Duffy and the Madagascar findings
    How do you find out the proportions of the blood groups in a population?
    How do you find that “representative” sample?
    How quickly can the Duffy infection P.vivax spread within a population?

    It sounds simple – but it needs to be done professionally and accurately, because lives depend upon it.
    I need to contact Professor Davis, molecularepidemiologist and ask him about this.

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