“We were just thinking that the burden of malaria is extremely high in Africa – in the sort of level that’s very difficult for people who haven’t lived in a malaria endemic country to understand. Children are getting sometimes, in highly endemic areas, more than one infective bite a day and many repeated infections. And we just wondered what that might do to children and their endothelium in the long term,” he said.

Moxon and his colleagues knew that mosquito control programs appeared to have effects far beyond reducing malaria cases.

He said, “There have been a number of studies that have shown in small areas if you reduce or eliminate malaria that the reduction in mortality is higher than you might expect from simply a reduction in the number of acute febrile illnesses. So we wondered whether there was another effect that malaria was having. Whether this might be that the endothelium remained activated for a longer period of time.”

By an activated endothelium, he means inflamed. There are blood tests to determine if that’s the case.

“The endothelial cells have proteins on the surface that give the endothelial cells a lot of their function. And these proteins are shed in healthy individuals, but when you get an illness and the endothelium changes they’re shed at higher levels. So you can measure these proteins in the blood and malaria changes the blood vessels. It sort of hijacks the endothelium to be able to stick to blood vessels. And that’s a sort of mechanism that the parasite uses to prevent going through the spleen and stop being cleared by our immune system,” he said.