The Senior Fellowship grant scheme supports the development of African scientific leadership and mentorship. It was instrumental in developing the careers of mid-level to senior African scientists and helping them to become more competitive internationally, to build research teams and to develop the scientific excellence and leadership required for larger grants from EDCTP and other funding sources. A number of Senior Fellows have received prestigious international awards.

The EDCTP Senior Fellow Professor Abdoulay Djimdé (Malaria Research & Training Center, Mali) conducted an assessment of the public health benefit of the use of artemisinin-based combinations in sub-Saharan Africa. Patients with uncomplicated malaria were randomised to receive artesunate + amodiaquine (AS+AQ; Arsucam^®, Sanofi Synthelabo), artesunate + sulfadoxine-pyrimethamine (AS+SP) or artemether-lumefantrine (AL; Coartem^®, Novartis). Once subjects had been assigned to a given group, subsequent malaria episodes were treated with the same treatment regimen. Patients were closely followed both clinically and biologically to record any adverse event.

Using this novel approach of repetitive treatment over two consecutive transmission seasons and three years, the study showed that in this setting of perennial transmission with seasonal peaks, the incidence density of malaria in the AS/SP and AS/AQ arms were reduced as compared to the AL arm. All artemisinin-based combinations maintained acceptable clinical and laboratory safety profiles despite their repetitive usage. Using direct feeding, it showed that all artemisinin-based combinations decreased gametocyte carriage, the impact on gametocyte infectivity to Anopheles mosquitoes varied from one artemisinin-based combination to the other.

Intensive training and capacity development activities were conducted in the context of these studies, leading to the development of an effective team of young scientists, ready to undertake clinical development of antimalarial drugs.

Furthermore, the EDCTP Senior Fellowship allowed Prof. Djimdé to remain in Mali and continue his work as a re-entry scientist. Through this experience and funding opportunity, he was able to build a strong team and lay the foundation for the infrastructure required for antimalarial drug trials. This attracted new clinical development activities sponsored by various pharmaceutical groups. Subsequently, Prof. Djimdé and his group received a larger grant from EDCTP for an integrated clinical trial project, the WANECAM project (www.wanecam.org). Recently in 2015 Prof. Djimde has been awarded another 5.5 million pounds grant from Wellcome Trust for Developing Excellence in Leadership and Genetic Training for Malaria Elimination in Sub-Saharan Africa (http://www.wellcome.ac.uk/Funding/Biomedical-science/Funded-projects/Major-initiatives/Developing-excellence-in-leadership-training-and-science-initiative/WTP059938.htm).

 

Relevant publications:

1. Zwang, JL; Dorsey, G; Djimde, A; Karema, C; Martensson, A; Ndiaye, JL; Sirima, SB; Olliaro, P. (2012) ‘Clinical tolerability of artesunate-amodiaquine versus comparator treatments for uncomplicated falciparum malaria: an individual-patient analysis of eight randomized controlled trials in sub-Saharan Africa’. Malaria Journal. 2(11):260
2. Djimde, A; Fofana, B; Sagara, I; Sidibe, B; Toure, S; Dembele, D; Togo, A; Sanogo, K; Dama, S; Dicko, A; Lameyre, V; Plowe, CV; Doumbo, OK. (2012) ‘Impact of repeated administration of acts on safety, efficacy and incidence of uncomplicated malaria in Mali’. American Journal of Tropical Medicine and Hygiene. 87(1):50-6
3. Tekete, M; Djimde, AA; Beavogui, AH; Maiga, H; Sagara, I; Fofana, B; Ouologuem, D; Dama, S; Kone, A; Dembele, D; Wele, M; Dicko, A; Doumbo, OK. (2009) ‘Efficacy of chloroquine, amodiaquine and sulphadoxinepyrimethamine for the treatment of uncomplicated falciparum malaria: revisiting molecular markers in an area of emerging AQ and SP resistance in Mali’. Malaria Journal. 26(8):34
4. Djimde, AA; Fofana, B; Sagara, I; Sidibe, B; Toure, S; Dembele, D; Dama, S; Ouologuem, D; Dicko, A; Doumbo, OK. (2008) ‘Efficacy, safety, and selection of molecular markers of drug resistance by two ACTs in Mali’. American Journal of Tropical Medicine and Hygiene. 78(3):455-61.