Innovation at Wits: A Master's Student's Push to Save Lives from Cerebral Malaria

In the bustling labs of the University of the Witwatersrand's Advanced Drug Delivery Platform, Taznita Kista is pioneering a potentially game-changing solution to one of Africa's deadliest diseases. As a master's student, her research into a nano-enabled nasal spray aims to deliver life-saving antimalarial drugs directly to the brain, offering hope for rapid treatment of cerebral malaria in remote and resource-limited settings. This development highlights the critical role South African universities play in addressing global health challenges through innovative higher education research.

Cerebral malaria, the most severe neurological complication of Plasmodium falciparum infection, strikes swiftly and fatally. It occurs when infected red blood cells adhere to the endothelium of small brain blood vessels, obstructing blood flow and depriving brain tissue of oxygen. Symptoms escalate from high fever and headaches to seizures, coma, and death, often within hours. In South Africa, while malaria incidence is low—around 10,000 cases annually, mostly imported—the country remains vigilant, with institutions like Wits leading continent-wide efforts.

The Devastating Toll of Cerebral Malaria in Africa

Africa bears 95% of the world's malaria burden, with the World Health Organization reporting over 250 million cases and nearly 600,000 deaths in 2024 alone, predominantly among children under five—who account for about 80% of fatalities. Cerebral malaria contributes significantly to this toll, with mortality rates of 15-25% even under optimal care, and up to 40% in untreated cases. Survivors often face long-term neurological deficits, including cognitive impairment and epilepsy, straining healthcare systems.

In South Africa, concerted elimination efforts have reduced local transmission, but cross-border influxes from Mozambique and neighboring countries pose ongoing risks. The Wits Research Institute for Malaria monitors these threats, emphasizing the need for accessible treatments. Pregnant women face compounded dangers: infection risks miscarriage, stillbirth, and maternal anemia, underscoring the urgency for innovations like Kista's.

Limitations of Current Cerebral Malaria Treatments

Standard therapy relies on intravenous artesunate or quinine, which clears parasites effectively but requires clinical facilities. In rural Africa, where clinics may lack IV expertise—especially for wriggling children—delays prove fatal. The blood-brain barrier further complicates delivery, as drugs struggle to reach sequestered parasites in cerebral vessels. Emerging artemisinin resistance in Southeast Asia threatens efficacy, demanding novel delivery strategies.

Pre-referral options like rectal artesunate exist but fall short for brain-targeted action. Research into intranasal routes, such as artesunate powder in mouse models, shows promise—reducing parasitemia by up to 88% within 24 hours and reversing symptoms. Kista's work builds on this, adapting nanotechnology for precision.

Nose-to-Brain Delivery: The Science Behind the Nasal Spray

Kista's innovation leverages the olfactory and trigeminal nerve pathways for direct nose-to-brain transport, circumventing the blood-brain barrier. Niosomes—vesicular structures from non-ionic surfactants like Span and Tween—encapsulate antimalarials, protecting them from degradation, enhancing solubility, and enabling controlled release.

• Step 1: Drug loading into niosomes via thin-film hydration or ethanol injection.
• Step 2: Nasal administration sprays vesicles into the olfactory epithelium.
• Step 3: Vesicles diffuse along axons to brain parenchyma.
• Step 4: Targeted release disrupts infected red blood cell cytoadherence.

Niosomes offer advantages over liposomes: cost-effective (using cheap surfactants), stable without cholesterol, and customizable for targeting via ligands. Early formulations show rapid brain uptake, vital for cerebral malaria's minutes-long window.

Taznita Kista: From Aspiring Pharmacist to Research Pioneer

A Johannesburg native with a passion for pharmaceutical sciences, Kista joined Wits after a BSc in Pharmacy. Motivated by malaria's grip on African communities, she chose WADDP for its translational focus. “I saw the need for treatments that don't rely on hospitals,” she notes, highlighting her drive to make science accessible.

Her project exemplifies how master's programs at South African universities foster real-world problem-solving, blending coursework with hands-on lab work under expert guidance.

Wits Advanced Drug Delivery Platform: A Hub of Excellence

Established in 2007, WADDP—directed by Professor Yahya E. Choonara—pioneers patient-centric solutions for infectious diseases. With over 300 publications and patents, the platform trains postgraduate students in nanotechnology, from polymeric nanoparticles to 3D-printed implants. Kista's work aligns with its mission: affordable, deployable therapies for Africa. Learn more about WADDP's groundbreaking research.

Guidance from Visionary Supervisors

Professor Choonara praises Kista's ingenuity: “Her work brings treatment closer to patients, addressing Africa's healthcare realities.” Co-supervisor Professor Pradeep Kumar adds a playful nod to World Malaria Day: “Driven to deliver to the brain: nose first, cure next.” Their mentorship underscores Wits' strength in nurturing talent through collaborative supervision.

Wits' Broader Commitment to Malaria Eradication

The Wits Research Institute for Malaria (WRIM) complements Kista's efforts, studying vector biology and urban malaria risks like Anopheles stephensi. South Africa's near-elimination—99% case reduction—relies on such university-led surveillance and innovation. Collaborative trials with global partners advance vaccines and diagnostics.

WHO's 2025 Malaria Report highlights stalled progress, positioning Wits' contributions as pivotal.

Challenges in Translating Research to Clinics

While promising, hurdles remain: optimizing niosome stability, ensuring mucosal permeation in diverse populations, and navigating regulatory approvals. Clinical trials in malaria-endemic KwaZulu-Natal or Mpumalanga will test efficacy. Drug resistance demands multi-pronged approaches, including vector control.

• Scalability: Low-cost production for mass deployment.
• Safety: Minimal nasal irritation for children.
• Equity: Distribution to underserved areas.

Implications for South African Higher Education and Global Health

Kista's project showcases how Wits integrates research into curricula, producing graduates ready for industry and academia. South African universities, amid funding pressures, excel in health sciences, attracting NRF grants and international collaborations. This innovation could reduce cerebral malaria mortality, easing SA's healthcare burden and positioning Wits as a leader.

Prospective researchers: Explore opportunities at Wits through master's programs in pharmaceutics. For faculty roles, South Africa's higher ed sector offers dynamic positions in drug delivery and infectious diseases.

Looking Ahead: A Nose-First Path to Ending Malaria

As Kista nears thesis completion, her nasal spray embodies hope: quick, cheap, brain-targeted treatment. Aligned with WHO's “Driven to end malaria,” it could save thousands. Wits' legacy in malaria research continues, training the next generation to turn lab breakthroughs into lives saved. In South Africa's universities, such stories affirm higher education's transformative power.

For insights into intranasal therapies, see this study on artesunate powder, validating the route's potential.

Photo by Boitshoko Morobeng on Unsplash