Ross Boyce team receives $4.4M for malaria work

The epidemiologist will lead a project in Uganda on using drugs to prevent outbreaks after flooding.

Dr. Ross Boyce smiling and posing for a photo with his arms folded.
“The impact of global climate change, including the increased frequency of weather extremes such as flooding, on the incidence of malaria and other vector-borne diseases, is an issue of great public health importance,” Dr. Ross Boyce said.

A multidisciplinary team led by Dr. Ross Boyce will use a $4.4 million, five-year National Institutes of Health to evaluate the effectiveness of a chemoprevention effort designed to prevent malaria outbreaks after flooding.

Boyce is a member of the Institute for Global Health and Infectious Diseases, an assistant professor in the UNC School of Medicine’s division of infectious diseases and a faculty fellow in the Carolina Population Center.

The project builds on findings from a proof-of-concept pilot study, one aspect of which was recently published in the Journal of Infectious Diseases. In addition to collaborators from the Mbarara University of Science and Technology in Uganda, key investigators include Dr. Jonathan Juliano, also from IGHID; Dr. Raquel Reyes, UNC School of Medicine; Elizabeth Frankenberg, College of Arts and Sciences; Sean Sylvia and Bonnie Shook-Sa, both of Gillings School of Global Public Health; and Michael Reiskind, NC State department of entomology.

Disease outbreaks and climate-related health emergencies have reportedly reached their highest levels ever in the greater Horn of Africa. This includes western Uganda, where an increase in the frequency of extreme precipitation events, likely exacerbated by changes in land use, is believed to have resulted in seasonal surges of malaria transmission. Children under 5 years of age are particularly vulnerable, accounting for an estimated 70% of all malaria deaths.

Recently published in the Journal of Infectious Diseases, the pilot study recognizes the spatial and temporal distribution of the vector-borne disease, including hotspots and target areas for interventions amidst a rapidly evolving environment.

Boyce says the research, when combined with rapid household surveys, can be used to guide an ongoing humanitarian response, highlighting areas that may require additional interventions to control malaria outbreaks as conditions evolve. Local adaptation and mitigation strategies — like infrastructure improvements to better manage floodwaters and relocating residents from the highest risk areas — are essential to preventing excess morbidity and mortality.

“In many ways, these are the same types of issues facing coastal areas of North Carolina that are increasingly affected by hurricanes and sea rise,” Boyce said. “The impact of global climate change, including the increased frequency of weather extremes such as flooding, on the incidence of malaria and other vector-borne diseases, is an issue of great public health importance. While the long-term solution involves reducing global carbon emissions, it’s imperative that we develop interventions to mitigate morbidity and mortality in the near term.”

Logistically, studying the health impacts of extreme climate can be very challenging as events are unpredictable. However, severe flooding has become increasingly predictable in western Uganda, which makes the site ideally suited for this type of research, Boyce said.

“I greatly appreciate the willingness of the NIH to invest in this type of work, which involves some degree of uncertainty and a higher tolerance for risk than research conducted in the laboratory or more established clinical sites. I’m optimistic that we can successfully demonstrate how to mitigate the risk of malaria and other vector-borne diseases in a rapidly changing climate.”

UNC’s Uganda partnership has a number of ongoing malaria studies targeting the most vulnerable populations in western Uganda. Carolina’s partners in Uganda are the People’s Health & Economic Development organization and the Mbarara University of Science and Technology.

Read more about the research project.