The Interview!

Interview on Malaria

We chose to interview Dr. Mary Haskins, a professor of biology at Rockhurst University.  Her expertise in malaria stems from her personal visits to countries in which malaria is prevalent, as well as the extensive amount of research she has done on the subject.  Thank you, Dr. Haskins!



How did you get into studying malaria?

Well, I teach a course in parasites, and I think parasites are very fascinating.  Also, malaria is one of the major parasitic issues affecting our world today.  I’ve also been to several countries where malaria is an issue and I have been on malaria meds four times in my life.  So, having gone to countries where malaria is an issue, I wanted to be educated about the risks and prevention techniques.

Why should a doctor/researcher studying malaria know about evolution?

One of the biggest problems with malaria, as with other diseases, is that once you develop a drug to treat the organism that is the problem, then you select against all of those that were weak.  Those that were not selected against survive, so over time you end up with a population of organisms that are not going to be susceptible to that drug treatment.  So you need to understand evolution to appreciate the evolutionary process that your organisms are undergoing and understand why drugs that work at time “A” may not work at another point in time.  Organisms can adapt and evolve resistance

We read about HIV, in which they often use a cocktail of drugs in an attempt to fight the disease.  Is the same thing done for malaria?

To my knowledge, they do not use a drug cocktail with malaria.  They use a specific drug, and there are several different drugs on the market.  Depending on where you go, you might take drug A or drug B.  If you go to one country you might take drug B, because the parasites in that country are resistant to the drugs used in another country.  So you have to know which form of plasmodium you are dealing with because there are different species, and you have to know which ones are resistant to which drugs.  There is a lot of background research that needs to be done by tourists, as well as the physicians that advise those tourists.

For our evolution project we are doing grid-computing that looks at protein folding.  How does finding certain ways that a protein folds help find a cure for malaria?

I would assume that if you could look at protein folding and maybe find a way in which you could interfere with the process, then that would be a useful mode of action for a pharmaceutical drug. 

Do you think it is possible for there to be a cure for malaria since it seems to mutate, or evolve, so much?

I don’t know.  There are a lot of reservoir hosts, which are animals where the parasite can “hang out”.  You could theoretically get rid of it from the human population, but if a mosquito were to then go bite a reservoir host, the disease could find its way right back into the human population.  There is a ton of money being dumped into medically combating this disease, and major foundations (including the Gates Foundation) have a goal of eradicating malaria.  Whether or not that will happen in the near future, that is anyone’s guess.

Do you think it is plausible to eradicate malaria by just putting money into the medical treatment of the disease?  Or do you think it would be better to improve the social environment (e.g. living conditions)?

I think we need a multipronged approach.  We have to have pure education in regards to how malaria is transmitted, how it can be prevented, and drug treatments.  I think one approach would be wrong.  You have to attack it from a broad spectrum to have a higher chance of success.  And there are some examples of things that have been wiped out, so it’s not unheard of, but when you think about all the reservoir hosts it seems like quite the challenge.

What are some common misconceptions about malaria that you encounter?

A lot of people do not understand where malaria actually comes from.  They know it’s associated with mosquitoes, but they don’t know that it’s a protozoan carried by mosquitoes.  Also, I think some people believe that if you get it you just go to the doctor and you’re cured, and that is not necessarily true.  Two of the four species (of malaria) may be capable of residing within an individual for their entire life.  The parasite can go into remission and you may not show any symptoms but, at some point in time, it will come out of remission and you will experience those symptoms.    

Can you give us an example of how the malaria parasite is treated?

Malaria is one of the easier parasites to treat in the sense that there is actually a treatment that has very minor side effects.  Basically, before you go to a country with malaria, while you are there, and a few weeks after you get back, you take oral tablets as a preventive measure.  The length of time you take the pill depends on the country and relative species of plasmodium, as well as which drug you are taking.  The pill that you are taking would have the chemical in it that is going to destroy the parasite, but there is some evidence that for at least 2 species the parasite can hide out in the liver.  As a result, the drugs cannot get to them and treat them effectively, leaving the door open for recurrent episodes. 

Have you had first-hand contact with malaria patients?

Not to my knowledge.  I have never been in an area where I felt like I was at risk.  A lot of communities spray their towns with chemicals that kill off the mosquitoes.  That breaks the transmission to people, but now you have all of these harmful chemicals in the air that you are breathing in.  Now, this isn’t just done in non-industrialized countries.  This has been done in the United States.  When I went to Belize last year I did not see a mosquito the whole time I was there, and I believe it was because they sprayed so much that they essentially knocked out the population.  Now what that means is if you ever got a malaria-carrying mosquito that evolved to be resistant to those chemicals, you just made it harder to knock that population, and disease, out. 

Are mosquitoes the only way malaria can be transmitted to humans?

Yes, they are the only vector.  And it is only the female mosquitoes.

Do malaria treatment drugs have side effects?

Yes, but I don’t remember the long list.  One of the drugs (mefloquine) I have been on, however, has the side effect of causing horrendous, HORRENDOUS nightmares.  Unfortunately, they do not tell you that side effect when they give you the drug.  It’s not a pleasant experience when you are in a new country, unfamiliar territory, possibly by yourself, and you go to bed and wake up in the middle of the night because of a traumatizing nightmare.  Now, this is only a supposed side effect.  I personally have never had this experience, but a former student of mine had a sister who went on a service trip (and was taking mefloquine) and experienced traumatizing nightmares almost every night she was there.

Does Rockhurst require you to be on anti-malarial drugs when you go on service trips?

No.  Basically, Rockhurst tells you to go to your physician and ask them what you should do.  Some physicians are good about getting you the right information and some physicians are not.  I had a young lady last year whose doctor told her that Belize did not have malaria.  That’s not true.  You can go to the CDC website and see that there are three districts in Belize which have cases of malaria.  Now, the odds of you getting it are still slim, but I think you should be allowed to make the educated choice: either choosing not to take the drugs because the risk is low or choosing to take them no matter what.  My guess is the doctor probably assumed that she was going to Belize City, which is in the northern part of the country and is a more touristy area (malaria is more prevalent in the southern part of the country, where we were going), thus advising her not to worry about it. 

In which country is malaria most prevalent?

It would be an African country, though I wouldn’t be able to pick out which one.  Interestingly, when I went to Cameroon and then came back to the U.S. and went to the Red Cross to donate blood, Cameroon was not listed under the “cannot donate” list for recent visitors.  This is odd because malaria is, in fact, present in Cameroon.  They did have Belize listed though.  That may have to do with the type of malaria present within each respective country, but I cannot say for sure.



Reflection

Our interview with Dr. Haskins was extremely informational. The interview gave us a lot of insight into the "real" part of our Evolution project, not simply the grid-computing/computer aspect. Dr. Haskins provided us with first hand knowledge on the topic of malaria which was very informative.  We covered many aspects of the topic and learned new and interesting things. It was beneficial for our group to listen to an expert speak regarding the topic of malaria and it was interesting to hear her personal views regarding the disease and potential for a cure.