Michaela Gross is like most young researchers at USF’s College of Public Health: She thinks big.
Big as in dreaming of a world free of many diseases, including the lethal and elusive scourge known as malaria. A PhD candidate focusing on epidemiology, Gross recently traveled to Africa, where she gave a talk at the Multilateral Initiative on Malaria Society Conference in Cameroon. Making the trip possible were funds from the college’s Student Honorary Award for Research.
Her presentation, “A systematic review of non-malarial effects of malaria chemoprevention programs,” reviewed the existing literature available on potential non-malarial effects of these programs.
“The conference was a fantastic opportunity for national malaria programs, researchers, and global stakeholders to meet and discuss both challenges and successes in the goal of eliminating malaria,’’ Gross said.
The trip allowed the 35-year-old to learn more about what’s happening through intervention programs, and to better understand their complexities and challenges.
“What I find fascinating about public health is that it’s not just any one thing, it’s all of them intertwined together into the greater ecology,’’ she said.
Malaria chemoprevention is recommended by the World Health Organization (WHO). It works by routinely giving medications to vulnerable groups − including pregnant women and young children – but also offers benefits beyond the disease, such as increasing infant birth weight.
Malaria is most feared in Africa, where more than 600,000 people die each year from Plasmodium falciparum, a protozoan parasite that lives in the Anopheles mosquito. About 95 percent of its victims are children under age 5.
“It’s a real tragedy and elusive is a great word to describe malaria eradication,’’ Gross added. “Part of the challenge is the complexity of the transmission system and tackling malaria really needs an interdisciplinary approach.’’
(Photo courtesy of Michaela Gross)
Conquering malaria has challenged scientists for decades, and it wasn’t until 2021 that WHO recommended the first vaccine − called Mosquirix − for global use. Although this vaccine has shown high public health impact and has greatly reduced cases, mortality, and hospitalizations for severe malaria, it only provides partial protection and the WHO recommends using a combination of different control strategies.
The parasite’s ability to adapt to its environment, as well as the variables of a person’s immune system, make it a challenging foe for health care officials. “It has a complex life cycle,’’ Gross said, “and genetically it’s a very diverse parasite.’’
Gross doesn’t specialize in vaccines but focuses on better understanding the malarial and non-malarial effects of chemoprevention and how it might lead to new avenues for research. Although scientists have a toolbox of control interventions, health systems tend to be weak where transmission is highest, and the data available to inform decision-making is often lacking.
“It’s a constant battle to stay ahead of the parasite to ensure that the tools we have in our arsenal are effective,’’ she said.
If health officials can find ways to better control malaria, or even to eradicate it as they did with polio, the impact would resonate beyond the remote hospitals and clinics where the disease is most deadly.
“Malaria exacerbates poverty and inequality,’’ Gross said of its economic effects. “Supporting control and prevention efforts directly supports the goal of global health equity, so there is a moral and ethical imperative … since malaria exacts a heavy economic cost, its prevention benefits the global economy.’’
Supporting her dissertation project has been Dr. Gillian Stresman, associate professor of epidemiology at USF who this year received COPH’s Excellence in Teaching Award for her contributions to student development and quality of education within their department.
“She’s been an incredible source of knowledge and a fantastic supervisor,’’ Gross said.