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    Mosquitoes around the home can be reduced significantly by minimizing the amount of standing water available for mosquito breeding. Residents are urged to reduce standing water around the home in a variety of ways.


    The best way is to avoid being bitten by mosquitoes.This can be accomplished using personal protecting  while outdoors when mosquitoes are present. Treated bed nets should be used sleeping. Mosquito repellent should be used when outdoor.


    Nearly half of the world’s population is at risk of getting malaria. Pregnant women are particularly at risk of malaria. Children under 5 years are at high risk of malaria.


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Making Health Research Real

The International Network for the Demographic Evaluation of Populations and their Health (INDEPTH) has researched extensively into malaria and other tropical diseases. The Network makes malaria a priority due to the number of lives lost yearly to the disease. In the following interview with the African Media and Malaria Research Network (AMMREN), the Executive Director, Professor Osman Sankoh, explains the malaria-policy driven activities of his outfit and looks at the present and future of INDEPTH Network.

AMMREN: How has INDEPTH's work in malaria, generally impacted on rolling out policies in Africa?
A:The  data  generated  from  INDEPTH member  centres  have  been  used  to inform the registration and adoption of the  control  strategies  such  as  vector control (ITNs, indoor residual spray) and diagnosis and treatment (ACTs, RDTs.)

AMMREN: What is the Network's contributions  to  malaria  policy in Africa?
A: INDEPTH  member  centres  provide most of the in-country data that support the national malaria control programmes in countries like Ghana, Kenya, Mozambique  and  Burkina  Faso.  The Network provides  technical support to the centres for data analysis and report and  manuscript  writing.  The  Network also  pools  the  data  from  the  various centres, producing supplements, monographs and policy briefs.

INDEPTH has  the  most  formidable malaria  mortality  database  in  Africa, providing relevant information to organisations.

AMMREN: To what extent has INDEPTH's malaria research  activities helped in the uptake of malaria interventions in Africa?
A: INDEPTH's member centres are the ones that conducted bed net studies in Africa. The large body of data generated led to the adoption  of  the insecticide- treated nets (ITNs) as a malaria control strategy  globally. The centres continue to provide data on the performance of ITNs such as insecticide resistance and shelf life of ITNs.

AMMREN: What other malaria control research have you been  involved in?
A: Currently the largest phase III study is being conducted within the framework of INDEPTH.  The data from this study being generated by 11 member centres of INDEPTH may lead to the licensure of the first malaria vaccine. Currently  as these data are being rolled out, they are being fed back to the  community and policy makers to help them understand the role a  malaria vaccine will play in malaria control and elimination. This is increasing the community  understanding of the need for the vaccine to create the needed demand.

AMMREN: What would you  consider the  most  critical  issues  relevant  to malaria control efforts?
A:  They  include  financing  of  malaria control  and  elimination  interventions; Universal access to  diagnostic Kits and treatment  with  A C T,  reaching  and maintaining universal coverage of ITNs; ownership  and  financing  of  research activities  required  for  planning  and implementation of malaria intervention strategies.

AMMREN: What are your thoughts on malaria elimination and eradication?
A: With the increase in coverage of key interventions, research from  INDEPTH Centres in a few countries  (like Kenya) have shown significant  decline in malaria  transmission  risk. Consequently, there is growing need to revisit the  malaria  elimination  agenda.  The Malaria  Eradication  Research  Agenda (malERA) initiative convened in 2008 to define the  knowledge base, strategies, and tools required to eradicate malaria from the human population, highlighted key elements including vaccines, surveillance and socio-cultural, religious,  and  understanding  of  local politics context. INDEPTH is well placed to play a key role in all the  elements particularly regarding  surveillance and understanding of the context.

AMMREN: Any other areas of focus?
Our other areas includes maternal and neonatal health; vaccinations and child survival; reproductive Health  a n d healthy transitions of  adolescents into adulthood; non-communicable diseases. We research into other infectious diseases in addition to malaria; health system evaluation; new products development and  evaluation; global environmental  change ; genetic and environmental factors for cardiometabolic diseases. One can also include mental health – epilepsy; social determinants of health; universal health coverage ; antibiotics  resistance; adult health and aging; cause of death determination; and indoor air pollution.

AMMREN: Any  success  stories  to share?
A: INDEPTH member centres in Ghana, Tanzania,  Kenya,  Uganda  and  South Africa collaborated on the largest study to date of epilepsy in Africa. The study of more than half a million people was the first  to  reveal  the  true  extent  of  the problem, showing that adults who had suffered parasitic diseases were 1.5 to 3 times more likely than other  adults  to have  epilepsy,  and  that  complications during delivery were a major risk factor for  children.  The  study  authors  high- lighted  the  importance  of  parasitic disease control and improved antenatal and perinatal care in reducing epilepsy. The  findings  were  published  in  the Lancet  Neurology  journal  in  January 2013.

AMMREN: What other achievements is the Network proud of?
A:  Drug  trials  at  the  Manhiça  Demographic  Surveillance  System  site  in Mozambique helped the national government to replace chloroquine with amodiaquine and sulphadoxine - pyrimethamine as its  principal malaria treatment. The Manhiça site has helped develop a nationwide malaria risk map for the National Malaria Control Programme. A study by the Kilifi Health and Demographic Surveillance System in Kenya  found  that  the  Haemophilus influenzae  type  b  (Hib)  vaccine  was highly  effective  and  cost-effective  in reducing incidence of meningitis, pneumonia and sepsis in children. This finding  persuaded  the  government  of Kenya to reverse its decision to withdraw the vaccine.

The Africa Centre for Health  and Population Studies, based at Mtubatuba in South Africa, has conducted pioneering  studies in the field of HIV/AID S research. In February 2013 it published findings showing for the first time in real life (as opposed to in models) that when 30% or more of all HIV-infected adults in a community are on HIV treatment the incidence in that community  substantially  and  significantly  decreases.  A second paper published in Science in the same month shows the impact of antiretroviral treatment on mortality via a  considerable  increase  in  life  expectancy.

AMMREN:  Any  success  stories  from centres in Asia ?
A:  The Health and Demographic Surveillance System at Matlab in Bangladesh is one of the oldest in  the world. The Matlab rural intervention for vaccine trials yielded important findings on the  effectiveness of injectable and oral cholera vaccines. The World Health Organisation now recommends the oral cholera vaccine, which was tested by the Centre.  Family  planning  strategies tested  at  Matlab  have  been  adopted nationwide  and  led  to  Bangladesh's recognition at the landmark 1994 United Nations  Conference on Population and Development in Cairo as a family planning success story.

AMMREN: Any challenges ?
A:  We face the challenge of  resource mobilisation for both the Network and member centres.  Most funding is done by Western organisations.

AMMREN: Any  advice  for  African governments and scientists?
A: Malaria is our problem and we have to take  leadership  in  the  planning  and execution of the control and elimination strategies. It is time to invest in malaria to eliminate it in order to reap development in  return, as it is affordable and achievable.