'Dedication to The World Malaria Day 2016' or 'One-cell parasite outsmarts the humanity'.

 Malaria is a life-threatening but  preventable and curable disease. Despite the wide palette of global efforts, every minute a child dies from malaria. Mostly in Sub-Saharan Africa. Every fourteenth person on Earth carries the evidence of an evolutionary change due to malaria in their genes. Not only has the disease influenced our biology, but also the political map of the world: malaria was piling up colonialists and missioners when they were stepping on new lands without bringing along their immunity against malaria. An illustrative example of how the disease ruined the dreams of Scotts for becoming a strong independent country is given in the book of Sonia Shah "The Fever", which I highly recommend to curious minds.

Malaria is a parasitic vector-borne disease caused by the plasmodium parasite. It is transmitted to humans via the bites of infected female mosquitoes. One of the parasite’s human species, plasmodium falciparum, is listed among the most severe causes of morbidity and mortality in Africa.

At the beginning of the 20th century very few countries on the planet were malaria free. The burden of the disease has not been monotone through the last century world-wide, but particularly in Sub-Saharan Africa: after the Second World War it experienced a substantial decline, which continued for about four decades, until, in the late 1980s it returned to the pre-1940s level. Since 2000, due to multiple undertaken measures, malaria incidence shows declining trends in many areas again.

Anyhow, nowadays nearly half of the global population is at risk of malaria and the challenges are many. They include complexity of the parasite’s life cycle, its genetic diversity and acquisition of immunity, sensitivity of diagnostics methods, movements of the population including importation and displacement, leading, in some cases, to resurgence of the disease.

Here is a selection of facts that I recently learnt through books, courses and conversations, summarised in a naive but hopefully clear way.

1). Little but fierce: are we blaming the right killer?
According to the data of the Bill Gates Foundation, the deadiest animal in the World in terms of killing humans is not a scary crocodile or even a human himself. But a mosquito! Still, it is not the final truth. The truth is that mosquitos do not murder themselves, but only serve as transport to real killers - viruses and parasites such as malaria, yellow fever, dengue, zika, etc.

2). Up to a holiday romance with a parasite? It may last longer than you wish.
Dependence of the transmission on mosquitos makes malaria an environmental disease. Mosquitos like it in warm moist regions - precisely where people from the upper half of the northern hemisphere love going on vacation. Beware of the sneaky admirer - this one may take your sleep away for too long.

3). All cats are black at night: what may fever be a sign of?
Malaria becomes symptomatic with a delay: it takes from 10 to 15 days after a mosquito bite for the symptoms such as fever, headache, muscular aching, vomiting, cough and diarrhea, to appear. As an ensemble, they indicate a malaria case. But it is not rare, that an infected person only has fever and no other symptoms. High temperature may be caused by any other infection or inflammation. What a puzzle for a clinician!

4). Professional hide-and-seeker: losing the game may cost a life.
There are several malaria diagnostic tools available such as microscopy, rapid diagnostic test and PCR (polymerase chain reaction). These methods differ in sensitivity and cost and are also related to further obstacles for precise diagnosis. For instance,  the quality of microscopy highly depends on the experience of a person performing it. However, if the microscope is old and rusty, which is frequently the case in poor countries, no proficiency can compensate it. Another ill luck is that plasmodium is a professional hide-and-seeker: its concentration in human blood drastically varies over time having peaks around 15th, 25th, 50th days after infection and almost vanishes in-between. This means, that if a blood smear was taken in the low-concentration phase, results of the diagnostics may be false.

6). A one-cell parasite outsmarts the humanity: resistance detected.
There is a series of interventions that we invented to protect ourselves from the devastating disease. The strongest among them are ITNs (insecticide-treated mosquito nets), indoor residual spraying (IRS) with insecticide and antimalarial drugs. This natural-history-quest would be too easy if those measures solved the problem.

As a lyrical and personal remark I would like to say, that the more I learn about malaria, the more I think, that the mutual agreement on  what intelligence is, should be reconsidered. That is why: plasmodium is a single-celled eukaryotic parasite; it does not have limbs to move around by itself, but found a way to travel with mosquitos; it does not have a brain, but outsmarted the entire humanity and developed resistance against both insecticides and antimalarials.

7). Back to the future: genetically engineered mosquitos.
Modern history knows several success stories of defeating diseases by genetically modifying vectors. For dengue eradication, for instance, the genes of mosquitos were edited in such a way that the next generation would not have female progenies. Similarly, there has been created a mosquito that is incapable of transmitting malaria to humans with this trait being inherited by its offsprings. For the concept to work scientist also need to ensure, that wild female mosquitos will pick the genetically modified mates. Researchers from Perugia conjecture that the sound of the wings and the speed at which male mosquitos are moving defines female mosquitos' choices. This and other examples can be found in the book "The Deadly Air: Genetically modified mosquito" by Christian Jennings.

8). When networking becomes harmful: importation.
In the setting of low local transmission importation becomes the main threat.  Investigating local climatic conditions and focusing on vector control will not be fruitful. Instead, discovering social networks could be of great help. This can be done either through surveys or, as the world is becoming digitalized, through analysis of digital communication data.

There is much more to write and read and learn and question about malaria. But what is the conclusion so far? The war is far from over!

New global goals to achieve by 2030 have been recently determined and it is truly exciting to be working in a place with a lot of malaria research going on and espetially being part of it. On the 25th April, Swiss Tropical and Public Health Institute, member of the Swiss Malaria Group, takes us on a short trip to Bern for the Malaria Day 2016. 

Traditionally I close the post with a TED-talk. Sonia Shah, mentioned above, names 3 reasons we still haven't got rid of malaria. How can this be changed within the coming 14 years?

The leaking pipeline of the faultless gender

Once a year our university offers female PhD candidates and postdocs the opportunity to participate in a mentorship program called Antelope. It has two branches - Antelope at university and Antelope at Novartis, addressed to those willing to pursue academic and industrial paths respectively. The objective is to support young lady-scientists obtain a better picture of  their future career possibilities and help them shape a strategy towards the desired role through a series of workshops and mentor-mentee activities. Over-arched, this is the university's and corporation's infusion into the ongoing fight for gender equality.

The echo of this program reached me several times through female friends who took part in it in the past years. From their feedback I understood, that many of them could benefit from being mentored to different degrees while almost everyone was praising workshops where they met and mingled with other co-antelopes. Thinking of myself as someone with reduced social potential, never would I think of that second part as something attractive. My goal of joining the program was to use its means to learn more about the role of statistics and machine learning in the pharma industry, to ask to which extent they are able to use artificial intelligence and what is the prospective, how much impact can one have working in that field and whether some freedom is permitted or one becomes a prisoner of the golden cage... How big was the surprise, when after having applied and being accepted, I found myself on the first event engaged into the group work and attentively listening to other people's life stories!

After a formal introduction, we jumped directly into the career planning workshop. Since we had to present ourselves by outlining our backgrounds and previous paths, the conversation slipped into the personal plane pretty soon. The ambient created in the circle of humans with highly similar life situations was comforting: female, permeating scientific thinking, feeling being financially undervalued by society, experiencing obstacles in their programs - through mobbing, unsuccessful experiments, lack of materials or funding, difficult advisers, lack of future perspectives - all of that boiled up into the state where nearly everyone was upset about their projects for one or another reason and an overwhelming feeling of insecurity. Both in professional and personal lives. 

Still, at this point I kept questioning whether there was something special about the audience of the room compared to the rest of the PhD and postdoc population. The obvious answer was gender. But what does this unfold into?

For a long period in the past I stayed very skeptical towards all gender specific issues in the 'first world'. 'How are we going to achieve equality by keeping the frontier so sharp? How can we unite by underlying the separation?', - I was wondering. Somehow, over time this attitude ceased as I informed myself better about the so called 'leaking pipeline'.

'The leaking pipeline' is a phenomenon when high number of women leave academic careers after the PhD stage making the counts of male and female scientists on further levels uneven. The same applies to industrial leadership positions. At a first glance one may think that there are simply more women who prefer staying in the work force or being housewives compared to roles with power, social and business involvement. But we will never know the answer until the mentality of our society is such, that it allows us to run that experiment collectively. And count the numbers a posteriori. 

Now back to the workshop room where we, confused girls, are putting bits and pieces together to understand how a perfect career for each of us looks like. One of the exercises we have to do is to select the values, that we prioritize at the moment. We are given a list of pairs like 'Influence-Justice' and from each pair we have to select just one. These preferences build new pairs, and so on until only three values are left. We write them on colorful cards and put them on the floor to have an overlook. Most frequent outcomes are Meaning, Challenge, Independence, Fun - very representative for our social group. 'No trace of power, status or relative features, like it often occurs in male and/or industrial groups. No harmony and aesthetics, that so many females would seek.' - our coach notices. I couldn't fully relate to the last assertion since I sometimes physically suffer when colors in a space or on a person opposing me don't feel harmonious. But overall, this is a very precise portrait of the material that is about to 'leak', including myself at some point in the future. It doesn't really sound that we carve for high positions, power and respect. Who cares for the outlook when it is only the content that matters - what do you really know? what are you able to do? how do you leverage hard tasks? If you perform well at those, all rewards are yours - one may think naively. Anyhow, there is one hidden obstacle in this story. It is called resources. Any task is performed better, or has potential to be performed better, when better resources are available. And most of those resources are concentrated in the hands of men, who, not because they are bad, but because they are different, may be overlooking some issues, crucial to the lives of women.

The day was closed by a talk of a female professor. She communicated a clear message about the currently existing inequality between genders at work. Her style, though, was witty but provoking. Some of her arguments sounded sexist. She proudly told us stories of how she made some men, whose ego she considered over-pumped, feel bad.

My eyes became big: oh really? Is this how we are approaching the problem? Putting someone else down won't help us rise! The saddest thing was that most of the girls kept knocking their heads in agreement or giggling. What an evil strategy she picked - playing on other people's insecurities and presenting women almost faultless compared to men. Trying to understand my feelings and reactions while listening to her, in defence of integrity, I hurried up to formulate my own position: 'Don't be faultless. Be conscious and proactive'.

At the end of the speech she mentioned a book, that was advised to me recently by Odette, whom I accidentally met through a friend and found very pleasant. That friend, Jenn, who is an amazing woman herself, dares to be all in one: passionate about her job, a caring mother and wife, a wise open person. Having those examples in front of my eyes substitutes all the talks of the world about how it may and should be... in theory.

The aforementioned book is 'Lean In' by Sheryl Sandberg - a curious reading-matter supported with facts and stories. The content of the book is summarized by Sheryl herself in the TED-talk posted below (even, the book is dated later than the video).

These were my reflections after just the first Antelope 2016 event. Looking forward for more.

Maps and mapping: then and now.

Geographical discoveries, finding the shortest route to the supermarket, navigating through traffic jams, heat maps of a tornado intensity, mining, military attacks  - all of that is barely possible without maps.

When I was little, maps were used instead of tapestry in my parents and grandparents homes - from modern political and geographical maps to the the map of ancient Russia with its trade trails and neighboring folks. It is hard to believe, how limited out ability to precisely document geographical locations was until recent. For instance, a book with historical maps of Switzerland that one of my friends owns, starts with an upside-down map (the north-south direction is inverted) where distances correspond to some severely skewed metric. The first adequate map of the country was made by a (bored?) Swiss army soldier quite late in the country's history.

Today, on the contrary, through a digital device anyone has access to abundant spatial information. The GPS (Global Positioning System) assigns precise coordinates to any point on Earth. This allows us to store raster images coming from satellites, air-borne devices, infra-red cameras and, lately, drones to later retrieve the data.

A funny fact is that for many people a map has become a synonym of the google maps product. Furthermore, with a bit understanding of HTML and JavaScript (can be substituted with the accurate copy-paste ability) such a map can be incorporated in any webpage. Technical details follow in the next post.

Due to advances of modern technology we don't even notice how we start co-creating maps by feeding bits of our private information into geographical information systems. We overlay our pictures, trajectories, life events. And so we moved from the static world of paper based maps to the dynamic world of synergetical co-mapping.

Another personal remark: maps and mapping is not just something that I find entertaining, but it is interweaved with  my PhD project. Isn't it a great application of the spatial science: risk mapping of infectious diseases? It constitutes an immanent part of the understanding of the phenomena. During a pandemic such as, for instance, the ongoing spread of the Zika virus, the first question to be addressed is 'Where?'. Followed by 'How many?' and 'What is next?'. 

Therefore, not unexpectedly, once this blog was called to life, I felt an urge of amending it with a map. Right at the top. And geo-tag along with the blogging process the places I am writing about.

If you own a webpage that needs a google map to be incorporated, you may find the next post useful. And if you don't, let me know which information is missing.

To wrap-up, here is another map in case you are curious about history: BBC: World War, Western Front.