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Personal Experience and a Love of His Homeland Lead Louis Nkrumah to Find New Approaches to Drug-Resistant Malaria

Sep 20, 2006 -- Growing up in Ghana, malaria was as common an occurrence as getting a cold is here in the northeastern United States, recalls Louis Nkrumah, an M.D.-Ph.D. student at the Albert Einstein College of Medicine of Yeshiva University. “Malaria is something you see all the time,” he says, describing the throbbing headache, fever, aches and pains that accompany each outbreak. “If you survive the first five years of life, then usually you become semi-immune to its worst effects.” Yet, this deadly disease continues to claim up to 3 million lives each year, mostly children. Having had the disease frequently from the time he was a small child, malaria was very much on his mind when it came time to select a Ph.D. research project. (He earned his Ph.D. earlier this year.) “I wanted to do research that would allow me to give something back,” he says. In August, Dr. Nkrumah had that opportunity, publishing the cover story in Nature Methods, about his findings concerning the use of a bacterial phage (virus that infects bacteria) to perform a genetic manipulation that could help develop therapeutic targets for treating drug-resistant malaria. The paper was part of his research thesis. In many ways, malaria is an inescapable topic for Dr. Nkrumah. When he arrived in the United States 10 years ago as a freshman at Yale University, he was sick with the disease. “I was shivering with fever and had blisters on my lips,” he recalls. “I arrived a month before classes started and stayed with a fellow countryman who was a senior. I used the time to take the medicine I had brought with me and get well.” At Yale, Dr. Nkrumah studied biology while fulfilling pre-med requirements, despite advice that it is difficult for foreign students to gain entry into American medical schools. During his four years there, with support from a full scholarship, he earned dual degrees (B.S. and M.S.) in molecular, cellular and developmental biology. He then applied to leading medical schools including Albert Einstein College of Medicine, Yale, Cornell, and Johns Hopkins, among others. “I came to the United States determined to become a doctor. In Ghana, I had been enrolled in the University of Ghana Medical School, but when the school closed for eight months because of a faculty strike, I knew I needed to explore other options,” he says. “My undergraduate education provided excellent opportunities in the laboratory and the classroom. As one of nine surviving children (there were originally 13) in his family, Dr. Nkrumah is the only among his siblings to get a college education, although the others have completed the equivalent of high school, and his only brother has completed training at a technical school. His parents recognized his brightness and ambition and encouraged him throughout his schooling. He did not learn English until he was 13, when his family moved from their rural village, Asankrangwa -– where there was no electricity or good drinking water –- to the capital city of Accra. At the same time, he prepared for the G.C.E. Common Entrance Examination and ultimately received the highest score of any student in all of Ghana – among some 10,000 students. As a result, he received a full scholarship to cover the remaining seven years of his secondary schooling. In August of 2000 Dr. Nkrumah started his M.D.-Ph.D.studies at Einstein. Two years later, when it came time to select the focus for his research, he knew he wanted to study malaria. “At first I began working in a laboratory studying epigenetics (identifying genetic abnormalities in cancer), but even though I loved what I was doing, I had this feeling that I should be doing something that connected more closely to my experiences back home,” he explains. So, he sought a placement in the laboratories of Dr. David Fidock and Dr. William Jacobs, Jr. Both Dr. Fidock, who is associate professor of microbiology & immunology at Einstein and a renowned malaria researcher, and Dr. Jacobs, a Howard Hughes investigator and professor of microbiology & immunology and of molecular genetics at Einstein, as well as a world-renowned tuberculosis researcher, had been among the faculty members who interviewed Dr. Nkrumah when he was applying to the medical school. Each had encouraged him to come to Albert Einstein College of Medicine and was influential in his decision to do so. They then served as co-mentors to Dr. Nkrumah as he conducted research for his thesis and wrote the article that would be featured as the cover story in the August 2006 issue of Nature Methods. Using the enzyme from a bacterial phage nicknamed the “Bronx Bomber” – which had been discovered by Dr. Jacobs from a soil sample in his Bronx backyard and been used with great success in his tuberculosis research –- Dr. Nkrumah introduced genes into P. falciparum, the most deadly strain of Plasmodium (malaria) that is proving increasingly resistant to treatment. The technique proved remarkably successful. “This method should significantly benefit genetic strategies for exploring the biology of this malarial parasite,” notes Dr. Fidock. “And it represents the first efficient technique for inserting any gene of interest into the P. falciparum genome to gain biological information that could lead to more effective treatments.” Having fulfilled the Ph.D. portion of his M.D.-Ph.D, Dr. Nkrumah is currently rotating through various clinical wards, completing his training as a physician. For now, he is keeping an open mind as to what his future holds. “Science has always excited me, particularly biological systems,” he says. “My research of infectious diseases certainly puts that field in the running, but surgery also is of interest so I’m going to keep an open mind and focus on the best way I can make an impact back home.”