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Professor Umberto Dalessandro

MD MSc PhD

Professor
Director of the MRC Unit The Gambia

Room
NA

MRC Unit The Gambia
Fajara
Gambia

Tel.
+2204495917

Prof. Umberto D'Alessandro (MD, MSc, PhD) has a long working experience in Africa, first as a clinician (Benin and Kenya) and later as a clinical epidemiologist (The Gambia). He has been involved in malaria research since 1990 when he carried out the evaluation of the Gambian National programme on insecticide-treated bed nets. He joined the Department of Parasitology at the Institute of Tropical Medicine, Antwerp, Belgium in 1996 where he was, until the end of 2010, was the head of the Epidemiology Unit. There, he developed a research program around three themes: antimalarial treatment, including drug resistance, malaria prevention, and the P. vivax in vitro cycle, implemented in several malaria endemic countries, e.g. Uganda, Burkina Faso, Benin, Vietnam, Peru, etc.

 In 2011, Professor D’Alessandro joined the Medical Research Council Unit The Gambia (MRCG) as theme leader of disease control and elimination. In January 2014, he was appointed director of the MRCG. His research program on malaria at the MRCG is built around questions related to malaria elimination/eradication.

Affiliations

Department of Disease Control
Faculty of Infectious and Tropical Diseases

Centres

Malaria Centre
Centre on Climate Change and Planetary Health

Teaching

Prof D'Alessandro has supervised 24 PhD students. He is currently supervising 2 PhD students. 

Recently completed doctoral students:

  1. Mwesigwa J. Spatial and Temporal Dynamics of Malaria before and after Mass Drug Administration at the Community Level in The Gambia. Faculty of Medical Sciences, June 2020. UA promoter JP Van geertruyden, Co-promoter U. D'Alessandro
  2. Nambozi M. Antimalarial Treatement Safety and Efficacy in Pregnant Women. Faculty of Medical Sciences, December 2019. UA promoter JP Van geertruyden, Co-promoter U. D'Alessandro
  3. Okebe J. Identifying residual foci of malaria infection in a context of decreasing transmission. From control to elimination: reducing residual malaria transmission in The Gambia. Faculty of Medical Sciences, May 2017. UA promoter JP Van geertruyden, Co-promoters U. D'Alessandro.
  4. Tahita M. Case management and control of Malaria in Pregnancy: Case of Burkina Faso. University of Antwerp, Faculty of Medical Sciences, May 2017. UA promoter JP Van geertruyden , Co-promoters U. D'Alessandro; Halidou Tinto.
  5. Opondo K. Roles of biting preference and insecticide resistance in determining malaria transmission heterogeneity in The Gambia. University of Liverpool, June 2016. UL promoter M Donnelly, Co-Promoter U D’Alessandro 
  6. Kajungu D. Data mining methods for pharmacovigilance in Africa. Catholic University of Leuven, December 2015. UCL promoter N Speybroeck, Co-promoter U. D’Alessandro
  7. Oriero CE. Field implementation and evaluation of novel isothermal, nucleic acid -based diagnostic tools for malaria elimination in sub-Saharan Africa. University of Antwerp, Faculty of Medical Sciences, October 2015. UA promoter JP Van geertruyden , Co-promoters U. D'Alessandro; Jan Jacobs; Davis Nwakanma.
  8. Manyando C. Options for Treatment and Control of Malaria in Pregnancy in Zambia.  University of Antwerp, Faculty of Medical Sciences, 2014. UA promoter JP Van geertruyden , ITM promoter U. D'Alessandro.

Currently supervised PhD students: 

Expected completion: Spring 2021

Abdullahi Ahmad (Nigeria) - "The importance of asymptomatic malaria carriers in maintaining transmission"

Research

I have started my research career with the evaluation of the impact of the Gambian National insecticide-treated bed nets (ITNs) on childhood morbidity and mortality and on malaria in pregnancy. ITNs reduced mortality in children <10 years of age by 25%. It also showed that ITNs could prevent malaria in pregnancy and this resulted in a higher mean birth weight in intervention villages. This is one of the projects on which the recommendation by the World Health Organization of implementing ITNs for the prevention of malaria is based.

I also carried out, about around the same period, one of the first phase 3 malaria vaccine trials in sub-Saharan Africa, namely SPf66. Unfortunately, the vaccine was not efficacious, but the trial provided important information on how to conduct a malaria vaccine trial.

Antimalarial drug resistance and efficacy of new treatments has been for long time a major subject in my research portfolio. I have contributed assessing the magnitude of the resistance to chloroquine and sulfadoxine-pyrimethamine, both in West and Eastern Africa, and investigated how the intensity of malaria transmission influenced the spread of drug resistant parasites. I have also evaluated the safety and efficacy of artemisinin-based combination treatments in Africa and in other continents, including in high risk groups such as children <5 years old and pregnant women.  For the latter, I reported that dihydroartemisinin-piperaquine is the treatment with the highest efficacy and acceptable safety, while artemether-lumefantrine has excellent safety but lower efficacy.

I have worked extensively on malaria in pregnancy and produced data on the burden of infection and efficacy and effectiveness of control interventions. For example, I evaluated several approaches to increase the coverage of intermittent preventive treatment during pregnancy (IPTp), one of them combining IPTp with malaria screening and treatment between IPTp doses.

In the last 10 years, I investigated residual malaria transmission and factors maintaining it; and I have evaluated interventions with the potential of further reducing or interrupting residual malaria transmission. I have characterized malaria transmission across The Gambia and established the likely ‘parasite flow’ by genotyping and modelling, showing that transmission in western Gambia is partly maintained by parasites from eastern Gambia. We carried out several cluster randomized trials to evaluate the safety, efficacy and acceptability of different control interventions. For example, we recently evaluated the impact mass drug administration with ivermectin (endectocidal drug that may reduce vector survival after a blood meal) and dihydroartemisinin‐piperaquine on residual malaria transmission. The intervention decreased significantly malaria prevalence in intervention villages.  

We carried out the first Controlled Human Malaria Infection (CHMI) experiment in The Gambia and showed that individuals with serological evidence of higher malaria exposure were able to better control infection and had higher parasite growth inhibitory activity.

Finally, the MRC Unit The Gambia I am leading is fully involved in the national response to the covid-19 epidemic. Besides providing the diagnostic facilities and managing patients in our clinical services, we are starting several covid-19 related projects. We are validating a new antigen-based diagnostic test and setting up a cohort of covid-19 patients to determine their immune response over 6 months. We are about to start a treatment trial with 2 cohorts, one with mild disease patients and the other with severe disease patients.

Research Area
Child health
Clinical care
Clinical trials
Diagnostics
Drug resistance
Maternal health
Parasites
Perinatal health
Public health
Chemotherapy
Disease control
Global Health
Medicines
Neonatal health
Randomised controlled trials
Discipline
Genetic epidemiology
Immunoepidemiology
Molecular epidemiology
Demography
Epidemiology
Medicine
Parasitology
Entomology
Disease and Health Conditions
Cardiovascular disease
Infectious disease
Malaria
Hepatitis
Sepsis
Country
Benin
Burkina Faso
Guinea
The Gambia
Mali
Senegal
Region
Sub-Saharan Africa (developing only)

Selected Publications

Knowledge, attitude and practice towards tuberculosis in Gambia: a nation-wide cross-sectional survey.
Bashorun AO; Linda C; Omoleke S; Kendall L; Donkor SD; Kinteh M-A; Danso B; Leigh L; Kandeh S; D'Alessandro U
2020
BMC Public Health
Fetal biometry assessment with Intergrowth 21st's and Salomon's equations in rural Burkina Faso.
Bihoun B; Zango SH; Traoré-Coulibaly M; Valea I; Ravinetto R; Van Geertruyden J-P; D'Alessandro U; Tinto H; Robert A
2020
BMC pregnancy and childbirth
Insecticide resistance in indoor and outdoor-resting Anopheles gambiae in Northern Ghana.
Hamid-Adiamoh M; Amambua-Ngwa A; Nwakanma D; D'Alessandro U; Awandare GA; Afrane YA
2020
Malaria journal
Tolerance of Gambian Plasmodium falciparum to Dihydroartemisinin and Lumefantrine detected by Ex vivo Parasite Survival Rate Assay (PSRA).
Mbye H; Bojang F; Jawara AS; Njie B; Mohammed NI; Okebe J; D'Alessandro U; Amambua-Ngwa A
2020
Antimicrob Agents Chemother
Seroprevalence and Parasite Rates of Plasmodium malariae in a High Malaria Transmission Setting of Southern Nigeria.
Oriero EC; Olukosi AY; Oduwole OA; Djimde A; D'Alessandro U; Meremikwu MM; Amambua-Ngwa A
2020
The American journal of tropical medicine and hygiene
Adoption of evidence-based global policies at the national level: intermittent preventive treatment for malaria in pregnancy and first trimester treatment in Kenya, Malawi, Mali and The Gambia.
Webster J; Hoyt J; Diarra S; Manda-Taylor L; Okoth G; Achan J; Ghilardi L; D'Alessandro U; Madanista M; Kariuki S
2020
Health policy and planning
Sero-epidemiological evaluation of malaria transmission in The Gambia before and after mass drug administration.
Wu L; Mwesigwa J; Affara M; Bah M; Correa S; Hall T; Singh SK; Beeson JG; Tetteh KKA; Kleinschmidt I
2020
BMC medicine
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