AUSTRALIA–INDONESIA JOINT SYMPOSIUM IN SCIENCE AND TECHNOLOGY
Jakarta, 13-17 September 2006
Molecular diagnosis and detection of drug resistant markers in malaria and TB
Dr Ric Price, Senior Researcher, Menzies School of Health Research, Darwin
The emergence and spread of multi drug resistant (mdr) strains of plasmodia and mycobacteria pose a significant threat to endemic communities. To combat this, active surveillance programmes have been set up to track the prevalence and burden of disease, in the hope that rationalising therapeutic protocols will help retard the spread of untreatable infection. Conventional methods of surveillance have adopted in vivo and in vitro studies, however these are often difficult to maintain and, in the case of in vitro data, hard to interpret. Over the last decade significant progress has been made in identifying important genetic factors that underlie mdr in plasmodia and mycobacteria, which has been facilitated by the completion of the genome projects for both of these pathogens. Putative molecular markers of drug resistance have been correlated with both the in vitro and in vivo phenotype. It is clear that a complex array of factors are involved in determining clinical outcome following treatment. The interplay between parasite biomass, parasite genotype, pharmacokinetics and dynamics, host immunity and exposure to re-infection ensure that a wide array of parameters need to be accounted for in order to determine the attributable contribution of each factor. In this talk, the molecular mechanisms underlying drug resistance in TB and malaria will be reviewed and the utility of molecular diagnostic techniques to guide therapeutic practice at a population and individual level will be discussed.
Ric Price is a clinical specialist in infectious diseases, a Senior Researcher at the Menzies School of Health Research in Darwin, Australia and a lecturer at the Centre of Tropical Medicine, Oxford, UK. Over the last decade he has established an international reputation in the application of molecular markers of malaria drug resistance to public health and clinical outcomes. This work is aimed at developing and validating novel in vitro and molecular assays to correlate the parasite genotype with the host therapeutic response. The success of these studies has depended upon an appreciation of the multitude of parameters that determine clinical drug efficacy and an ability to define precisely the parasite phenotype. In his presentation Dr Price will discuss the role of molecular techniques in defining the epidemiology of malaria and TB in endemic settings.
