Malaria still causes about 400,000 deaths each year, mostly in young children in Africa. Efforts to reduce the burden of malaria have been hampered by emerging resistance of the parasites to all available anti-malaria drugs, and the mosquitoes to insecticides. High level of lactic acid in the blood (hyperlactatemia) is one of the strongest independent predictors of death in both children and adults. However, no one has defined where this excessive lactate comes from, why it accumulates and how is this linked to death. My aim is to identify the physiological and molecular mechanisms leading to hyperlactatemia and establish whether hyperlactatemia is simply a consequence of severe disease or the cause of death. Understanding malarial hyperlactatemia could lead to targeted therapies for this high-risk group and inform understanding of hyperlactatemia in other fatal diseases such as sepsis and cancer.
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