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Malaria and schistosomiasis, two of the most prevalent and deadly diseases in West Africa, are at the forefront of public health efforts in the region. Malaria, a preventable yet potentially fatal disease caused by parasites transmitted by mosquitoes, accounted for approximately 94% of global cases in the WHO African Region in 2022. Tragically, 78% of these deaths were children under the age of five. This dire situation has galvanized scientists and healthcare professionals to intensify their research and intervention strategies, with substantial support from the Special Programmed for Research and Training in Tropical Diseases (TDR).

One notable figure in this battle is Dr. Mamy Andrianirina Rakotondratsara, a medical doctor and research technician at Madagascar’s National Institute of Public and Community Health (INSPC). Rakotondratsara, hailing from an endemic region in eastern Madagascar, was personally affected by malaria, having lost his older brother to the disease. This personal loss fueled his dedication to combating malaria through rigorous research and practical interventions.

A Journey Fueled by Personal Loss and Academic Pursuits

Rakotondratsara pursued his master’s in public health at the Cheikh Anta Diop University of Dakar (UCAD), supported by a TDR fellowship. During his studies, he completed TDR’s Massive Open Online Course (MOOC) on implementation research, which equipped him with the skills to design and conduct effective health interventions. His research focuses on the correlation between the frequency of malaria episodes and mosquito bed net coverage in Madagascar’s rural Anosibe An’Ala district. Although the results are pending, this study aims to provide actionable insights for improving malaria prevention strategies.

Training the Next Generation of Public Health Professionals

The TDR global postgraduate training scheme plays a crucial role in building the capacity of public health professionals in West Africa. This program, co-sponsored by UNICEF, UNDP, WHO, and the World Bank, focuses on interdisciplinary research that addresses barriers and opportunities for better uptake of preventative and treatment methods. UCAD, along with the University of Sciences, Techniques and Technologies in Bamako, Mali, serves as a sub-regional training center for Francophone Africa, providing students with the skills needed to tackle infectious diseases.

Rakotondratsara reflects on the transformative impact of the TDR training: “The TDR training allowed us to have a new vision of the health system. It changed my way of asking questions when faced with poor health indicators. Regarding my Master’s thesis, it gave me an idea of issues to be explored in the mosquito net distribution process, starting with the quantification of needs to end point use.” His experience has empowered him to integrate these insights into his work at INSPC and pursue further specialization in implementation research.

Tackling Schistosomiasis: A Lesser-Known but Deadly Foe

Schistosomiasis, also known as bilharzia, is the second most prevalent disease after malaria in Senegal and much of sub-Saharan Africa. Urogenital schistosomiasis, the most common form, can cause significant damage to the bladder, urethra, and kidneys. This parasitic disease thrives in tropical and subtropical regions with limited access to clean water, such as the Senegal River Basin.

Dr. Oumy Kaltome Boh, a physician from Dakar, has dedicated her career to addressing the burden of neglected tropical diseases (NTDs) like schistosomiasis. Inspired by her desire to see these diseases eradicated by 2030, Boh pursued a Masters in Health Programme Management at UCAD and an International Inter-University Diploma in Emerging Infections. With a TDR grant, she conducted a study examining the lifestyle practices and environmental factors that facilitate schistosomiasis transmission in Senegal.

Her study, in collaboration with Senegal’s national bilharziasis program, involved 287 children and assessed the effectiveness of praziquantel, the only available treatment for schistosomiasis. The results showed a 98% reduction in parasite eggs by day 21, demonstrating the drug’s efficacy. Now serving as the deputy chief medical officer in Saint-Louis, Senegal, Boh applies the skills she acquired through the TDR program to manage public health challenges, particularly for people living with HIV or tuberculosis.

Embracing Innovative Approaches for Disease Control

TDR-supported training programs are instrumental in introducing new health research and management approaches to West African students. Among these is the One Health approach, which examines disease emergence from a holistic, ecosystem-oriented perspective, considering the interconnected roles of humans, animals, plants, and microorganisms. This comprehensive approach is critical for addressing the complex factors that contribute to the spread of infectious diseases.

By combining scientific rigor with strategic implementation training, TDR grants enable students to evaluate and enhance health interventions against poverty-related infectious diseases. These opportunities not only benefit the students but also contribute to the broader goal of achieving the Sustainable Development Goals (SDGs) by addressing the neglect of diseases that disproportionately affect vulnerable populations.

This article is part of a series on TDR’s research capacity strengthening program, which aims to build the skills of public health researchers, implementers, health practitioners, and policymakers in the rapidly evolving field of implementation research. Through this program, TDR continues to empower the next generation of public health leaders in French-speaking Africa to make a lasting impact on the health of their communities.