The UKHSA Malaria Reference Laboratory is the national reference centre for malaria diagnosis in the UK and provides specialist diagnostics on malaria for NHS laboratories throughout the country. It is also the national centre for epidemiological monitoring and surveillance of malaria, conducts applied research relevant to UK malaria patients and is an advisory service for complex questions on malaria.

The MRL is contracted by UKHSA to provide a comprehensive reference diagnostic service for malaria parasitology, checking the diagnosis and species diagnosis on all suspected malaria blood films submitted following primary diagnosis, genetic typing of Plasmodium falciparum for drug resistance- associated alleles, strain typing as an aid to outbreak surveillance, and PCR for diagnosis of complex cases. We also collect and analyze all records of imported malaria into the UK by whatever route they may arrive, to seek to make reporting as complete as possible, to provide data to all levels of health authorities and trusts, to work with them on prevention as resources permit, and to liaise with the Centre for Infectious Disease Surveillance & Control (CIDSC).

Current active applied research activities include monitoring of HRP2 deletion mutants in UK P. falciparum infections (with Khalid Beshir), genetic analysis of recrudescent parasite isolates (with Lindsay Stewart) and genomic studies of non-falciparum malaria (with Susana Campino).

For more information, please contact:

• Peter Chiodini - Clinical Parasitologist; Director
• Colin Sutherland - Clinical Scientist, Deputy Director of Science
• Claire Rogers - Principal Biomedical Scientist; Head of Teaching & Diagnostic Unit
• Emma Victory - Lead BMS; Main Laboratory
• Debbie Nolder - Lead BMS; Molecular Laboratory
• Dawn Britten - Lead BMS; Quality Manager

The Hospital for Tropical Diseases is part of the University College London Hospitals NHS Foundation Trust (UCLH), and provides a walk-in service for the diagnosis of malaria for those recently returned from the tropics. Diagnosis and treatment of malaria is free for all, wherever they come from, since malaria in the UK is a notifiable disease.

In addition to malaria, the Hospital for Tropical Diseases has expertise across the range of infectious tropical diseases and has the UK’s only clinical parasitologist, clinical nephrologist, tropical ophthalmologist and specialists in a range of tropical diseases, many of which interact with malaria.

As well as out-patient and travel-health sections, there is an in-patient ward at UCLH for the treatment of severe malaria and other tropical diseases.

For further information relating to the HTD, please see http://www.thehtd.org/home.aspx

If you require travel or medical advice please contact the HTD clinic on 0207 388 9600

Service to measure the quality of antimalarial medicines and insecticides

The School’s bioanalytical laboratory currently conducts analyses of the quality and level of antimalarial medicines, and measures the amount of insecticide on fabrics as well as sprayed on walls using chromatographic techniques.

Substandard, degraded and falsified (including counterfeit) medicines are found in malaria-burdened countries. Therefore, there is a need to routinely determine the quality of available formulations.

Physicochemical assessment of medicines is highly informative and in vitro dissolution testing is carried out prior to the start of the clinical trials. This offers information of the in vivo bioavailability and bioequivalence of oral solid dosage forms.

Furthermore, the detection of antimalarial medicinesand their metabolites at the population level is invaluable when evaluating drug levels during clinical trials. This is also helpful in population-based epidemiological field studies.

We use high performance liquid chromatography (HPLC) coupled to a photodiode array (PDA) detector to quantitate most of the widely used antimalarial medicines. These include the artemisinin-based combination therapies (ACTs), some of the metabolites and four antibiotics on a single column. We also analyse insecticides by measuring the amounts of DDT, permethrin, deltamethrin, alpha-cypermethrin, Lambda-cyhalothrin & chlorfenapyr on filter paper, fabrics or mosquitoes utilising the HPLC-PDA based methodology.

We have developed non-laboratory based screening methods for use in the field, to check the quality of ACTs by specifically detecting the artemisinin component, as well as simple chemical analysis for the semi quantitative levels of type 2 pyrethroids on bed nets as well as mosquitoes.

Please direct all queries relating to the analytical service to Harparkash Kaur.

Please direct all queries relating to Insecticide & Repellent Testing at LSHTM to James Logan.

Malaria Centre entomologists collaborate with manufacturing industry to undertake testing of new candidate insecticide or repellent products for efficacy, iterative product improvement and registration purposes. We conduct testing for the World Health Organisation (WHO) Pesticide Evaluation Scheme to characterise or verify product performance.

The School also works with the WHO to improve or produce standardised testing guidelines, which we then use as the basis for our own formal testing. LSHTM operates state of the art controlled environment insectaries and insecticide/repellent testing suites in the Keppel Street building and undertakes more sophisticated smallscale field trials using semi field systems, suites of experimental huts, and ‘mosquito spheres’ in West and East Africa through the Pan African Malaria Vector Research Consortium and Ifakara Health Institute.