Dermot's diary #4
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Managing Director Dermot Cox talks about effective diagnostic pathways, the coming winter months and the malaria vaccine.
There's a good deal of positivity in the field regarding the efficacy and roll out of the malaria vaccine. What are the latest updates?
The malaria vaccine trials conducted over the last 20 years have yielded some very encouraging results. The R21/ Matrix M Vaccine, which is a recombinant subunit vaccine and is based on the Plasmodium falciparum circumsporozoite protein (CSP), showed 75-80% protection against clinical malaria in trials conducted in several African countries from 2021-2023.
Roll out of the R21 vaccine, together with the RTS,S/AS01 vaccine is being implemented in over 23 African countries, with the WHO aiming to vaccinate 10 million children per year.
And how will that affect the need for ongoing testing?
Vaccination is not a silver bullet. Malaria is a complex disease with regional variability, and vaccine efficacy, while significant, is not absolute. These vaccines are designed for Plasmodium falciparum, which tends to dominate both the clinical mindset and diagnostic strategies. However, the so-called “non-falciparum” specie, P. vivax, P. ovale, P. malariae, and P. knowlesi, carry very real implications for both treatment decisions and the design of effective diagnostic pathways.
P. vivax and P. ovale are particularly important because they form dormant liver stages (hypnozoites). These can reactivate weeks or months after the initial infection, causing relapse. If a patient is diagnosed but treated only for the blood-stage infection, without addressing the liver stage with drugs like primaquine or tafenoquine (and appropriate G6PD screening), the infection is not truly cleared. In practical terms, this means that accurate species identification directly determines whether a patient receives curative therapy or is left at risk of recurrence.
P. malariae, while often causing lower-level parasitaemia, is associated with chronic infections that can persist for years if untreated. It has also been linked to complications such as nephrotic syndrome. These infections are frequently missed because they present more subtly and at low parasite densities, yet they contribute to ongoing transmission.
P. knowlesi introduces a different kind of risk. As a zoonotic malaria species (originating in primates), it has a rapid replication cycle and can cause severe disease resembling that of P. falciparum. It is often misidentified under microscopy due to morphological similarities with other species. In regions where it is present, misdiagnosis can delay appropriate treatment and escalate clinical risk.
From a diagnostics perspective, Celtic, in partnership with Altona, offers a comprehensive solution. The RealStar® CE Malaria Screen & Type RT-PCR Kit 1.0 offers a qPCR assay that detects and differentiates all four species:
And another vaccination process - Foot & Mouth. Briefly, what's the situation this month?
The situation remains dynamic and, at times, concerning. This month has seen continued vigilance across several regions, with sporadic outbreaks reinforcing the importance of rapid detection and containment.
The economic implications for the livestock industry are substantial, and timely, accurate diagnostics are central to managing these risks. There is a growing emphasis on strengthening local testing capacity.
Staying with livestock and agriculture, mastitis is front of mind at the moment. We're sharing an extensive research article (below) on the misuse of antimicrobials in treatment. What is your take on the current situation and how is Celtic responding?
The industry is at something of a crossroads. The overuse and, in some cases, misuse of antibiotics in livestock management is well documented, and the downstream effects, particularly antimicrobial resistance, are a serious global concern. What is becoming increasingly clear is that blanket treatment approaches are neither sustainable nor scientifically justified. There is a strong movement toward more targeted, evidence-based interventions, underpinned by accurate pathogen identification.
Celtic Molecular Diagnostics is responding to this shift by prioritising diagnostic solutions that enable precision treatment. The Mastit4 test from DNA Diagnostic, allows the detection of 4 bacterial pathogens in less than 3 hours. There are a number of kits offering different combinations of bacteria, only testing for those which are prevalent in a specific region. By identifying causative organisms quickly and reliably, we can help veterinarians and producers move away from empirical antibiotic use toward more responsible stewardship. This not only supports animal health and productivity but also aligns with broader public health objectives:
https://dna-diagnostic.com/products/mastitis/
The second quarter is upon us – what is your focus as winter knocks on the door?
Respiratory pathogens and seasonal disease patterns, definitely, both in human and veterinary contexts. We remain focused on innovation and partnership, continuing to explore opportunities where our platforms and expertise can add meaningful value in both clinical and agricultural settings. These include our multi-plex and single-plex assays for respiratory pathogens.
Winter typically increases diagnostic demand, and preparedness is key to supply chain readiness. The ongoing conflict in the Middle East is placing pressure on key global shipping routes and air freight corridors, leading to longer lead times and higher transport costs. Celtic is working closely with our logistics and supply partners to minimise any risk to the supply of reagents.