Immunologist Neelika Malavige’s study of a massive dengue fever outbreak is hampered by fuel shortages and power cuts, according to a report in the journal Nature. He said: Sri Lanka is in a state of crisis. With the country heavily indebted and inflation skyrocketing, the government does not have enough money to import fuel, worsening food shortages. Last weekend, protesters marched through the official residence of President Gotabaya Rajapaksa, demanding his immediate resignation. He has since fled the country.
More than six million Sri Lankans – three in ten households – don’t know where to find their next meal, according to the World Food Programme. And after wave after wave of COVID-19, Sri Lanka is now experiencing a massive dengue fever outbreak. Neelika Malavige is an immunologist at the University of Sri Jayewardenepura in Colombo who has studied dengue fever for over a decade. She spoke to Nature about the situation in Sri Lanka and how it affects her work.
Asked to explain the current situation in Sri Lanka, Professor Malavige said: Sri Lanka does not have sufficient foreign exchange reserves to import fuel, which has affected all sectors. Schools are closed indefinitely. The government has declared Friday a public holiday for all public institutions except essential services. Patients cannot go to hospitals, nor can doctors, nurses and other medical staff. On top of that, we lack essential medicines and have daily power cuts of more than three hours.
There is also not enough food, partly due to the government’s decision in May 2021 to impose a nationwide ban on chemical fertilizers, which has drastically reduced agricultural production and driven up the price of staple foods. such as rice and vegetables. Fishing boats have no diesel or kerosene to catch fish, an important source of protein. Inflation exceeds 50%, pushing many people into a situation where they cannot afford to eat three meals a day.
We also have nearly 41,000 confirmed cases of dengue fever this year, which exceeds the number we had for all of last year. fever, which causes severe bleeding and can be fatal. There is no way to predict in the early stages of an infection whether someone will develop severe dengue, which means people have to go to hospital daily for blood tests and monitoring to detect the signs as soon as possible. It’s a huge strain on the health care system.
We are trying to identify biomarkers that can help determine if someone is going to develop severe dengue. We are also trying to determine the immune response associated with protection against severe disease, which is still unknown for dengue fever. Additionally, my lab is researching drugs that can be repurposed to treat dengue – for which there is no safe and effective vaccine – and has completed several clinical trials. We are recruiting and collecting samples for a study with a group in Latin America to compare the epidemiology and pathogenesis of dengue fever in the two regions. At the same time, we are trying to sequence and isolate the dengue virus to understand what is causing the current outbreak.
Professor Malavige said his work had been affected by the current crisis. “There are a lot of things that we are not doing that we could have done last year. Recruiting participants and collecting samples at the hospital, located 16 kilometers from our laboratory, is particularly difficult in this time due to lack of fuel. Lots of people started biking, including me, but biking between 8am and 4pm in temperatures above 33°C, with 80-90% humidity, under a scorching sun, is a nightmare.
Power outages and lack of fuel for emergency power generators mean we cannot use equipment such as our Illumina genome sequencing machine, which must run continuously for at least 24 hours. Instead, we rely on nanopore sequencing, which can run on a powerful battery. Nanopore sequencing is easier and cheaper and provides better coverage, but has slightly lower accuracy rates. Last week we managed to sequence a few samples of SARS-CoV-2, as cases slowly started to increase this month.
Due to the foreign supply crisis, we cannot purchase reagents for some of our dengue experiments, so we are freezing many samples for when we can get the reagents. But in March we had power cuts lasting up to 1pm, so we lost samples stored in some of our freezers. Some procedures, such as flow cytometry, need to be performed on fresh samples, so we have to work around the timelines. power outages and restricted opening hours at the university to conduct these experiments. It’s very difficult. I spend most of my time troubleshooting.
Inflation has driven up the price of many essential laboratory items. For example, a bottle of the cell culture medium we use cost 4,000 Sri Lankan rupees ($11 at the current conversion rate) in 2021, and is now 36,000 rupees. I’m still scratching my head trying to figure out how to fix this. Can we get support cheaper from manufacturers in China? Immune cells are very sensitive, so they may not grow as well in the new environment. Our staff are also seriously affected by rising food prices. An egg now costs 50 rupees, up from 17 in 2020. The price of rice, lentils and coconut oil has also skyrocketed. My research assistants and PhD students are really struggling to make ends meet.