Steve M Taylor, MD

Associate Professor of Medicine
Assistant Research Professor of Global Health
Campus mail 303 Research Drive, Sands Building #301, Durham, NC 27710
Phone (919) 684-8111
Email address steve.taylor@duke.edu

My lab website has a fuller description of my research activities: https://sites.duke.edu/taylorlab/.

I am principally interested in field and translational studies of falciparum malaria. These interests fall along several lines:

1) Epidemiology. Falciparum malaria is an immense problem whose contours are difficult to discern in hyperendemic regions like much of sub-Saharan Africa. I am involved in field applications of molecular genetic techniques to better define the burden of parasitemia in endemic areas and the partitioning and flux of parasite populations. We are working on techniques to generate and parse high-dimensional genomic data to better understand the structure of these parasite populations. Ultimately the goal of these investigations is to inform measures to control malaria and contain distinct parasite populations.

2) Pathogenesis. Severe malaria is a lethal disease; it is the cause of most of the 400,000 malaria deaths annually in African children. In these children, sickle-trait hemoglobin confers >90% protection from severe, life-threatening malaria. Several lines of evidence support the hypothesis that this dramatic protection results from the inability of the parasite to export parasite-derived proteins to the surface of the infected human red blood cell. We are investigating the molecular genetic correlates of this phenomenon in in vitro and ex vivo systems in order to identify mechanisms by which sickle-trait neutralizes the parasite. By leveraging this naturally-occurring model of malaria protection we hope to ultimately identify druggable targets for future antiparasitic or adjunctive therapies.

3) Diagnostics. In the field, clinical practice guidelines now recommend parasitologic diagnosis of malaria prior to treatment. Parasite detection can be confirmed by traditional microscopy or by rapid immunochromatographic tests, but each of these approaches is potentially undermined by limits of detection, operator error, and the monoplex nature of parasite testing in settings with complex pathogen epidemiology. With collaborators in Biomedical Engineering at the Pratt School of Engineering, we are developing PCR-free multiplex detection assays that utilize robust, rapid, and scalable nanoengineered platforms that target multiple bloodborne tropical pathogens in a single assay. The ultimate goal of this project is to enhance the clinical management of febrile illness in the tropics.

4) Prevention. In malaria-endemic Africa, high-risk groups that suffer disproportionate malaria morbidity clearly benefit from antimalarial chemoprevention; these groups include pregnant women across Africa and children under 5 in West Africa. African children with sickle-cell anemia also suffer significant malaria morbidity, but chemoprevention regimens that are recommended for them lack a compelling evidence base. With partners in Malawi and Kenya, we are testing new approaches to malaria chemoprevention in both pregnant women and in children with sickle-cell anemia. The goal of these projects is to enhance public health guidelines for the routine care of these high-risk groups and reduce the burden of malaria in African children.

The ultimate goals of these translational studies of falciparum malaria in children and pregnant women is to integrate epidemiologic, clinical, and molecular genetic models of disease in order to inform the rational design of medical and public health interventions to reduce the awful burden of malaria.

Education and Training

  • Gillings School of Global Public Health - Postdoctoral Fellow, Department Of Epidemiology, University of North Carolina at Chapel Hill, 2008 - 2012
  • Fellowship, Infectious Diseases & International Health, Duke University School of Medicine, 2007 - 2012
  • Internship/Residency, Medicine, Yale University School of Medicine, 2004 - 2007
  • M.D., Duke University School of Medicine, 2004
  • M.P.H., University of North Carolina at Chapel Hill, 2003
  • B.S., Duke University, 1998

Publications

Lin, JT, Mbewe, B, Taylor, SM, Luntamo, M, Meshnick, SR, and Ashorn, P. "Increased prevalence of dhfr and dhps mutants at delivery in Malawian pregnant women receiving intermittent preventive treatment for malaria." Tropical Medicine and International Health (2012).

PMID
23198734
Full Text

Taylor, SM, van Eijk, AM, Hand, CC, Mwandagalirwa, K, Messina, JP, Tshefu, AK, Atua, B, Emch, M, Muwonga, J, Meshnick, SR, and Ter Kuile, FO. "Quantification of the burden and consequences of pregnancy-associated malaria in the Democratic Republic of the Congo." J Infect Dis 204, no. 11 (December 1, 2011): 1762-1771.

PMID
21990422
Full Text

Messina, JP, Taylor, SM, Meshnick, SR, Linke, AM, Tshefu, AK, Atua, B, Mwandagalirwa, K, and Emch, M. "Population, behavioural and environmental drivers of malaria prevalence in the Democratic Republic of Congo. (Published online)" Malar J 10 (June 9, 2011): 161-.

PMID
21658268
Full Text

Taylor, SM, Messina, JP, Hand, CC, Juliano, JJ, Muwonga, J, Tshefu, AK, Atua, B, Emch, M, and Meshnick, SR. "Molecular malaria epidemiology: mapping and burden estimates for the Democratic Republic of the Congo, 2007. (Published online)" PLoS One 6, no. 1 (January 31, 2011): e16420-.

PMID
21305011
Full Text

Mumba, D, Bohorquez, E, Messina, J, Kande, V, Taylor, SM, Tshefu, AK, Muwonga, J, Kashamuka, MM, Emch, M, Tidwell, R, Büscher, P, and Meshnick, SR. "Prevalence of human African trypanosomiasis in the democratic republic of the Congo." PLoS Neglected Tropical Diseases 5, no. 8 (2011).

PMID
21829736
Full Text

Taylor, SM, and Meshnick, SR. "Molecular Detection of Human Fungal Pathogens." In Molecular Detection of Human Fungal Pathogens,edited by D Liu. CRC Press, 2011.

Scholars@Duke

Taylor, SM, Molyneux, ME, Simel, DL, Meshnick, SR, and Juliano, JJ. "Does this patient have malaria?." JAMA 304, no. 18 (November 10, 2010): 2048-2056. (Review)

PMID
21057136
Full Text

Taylor, SM, Molyneux, ME, Meshnick, SR, and Juliano, JJ. "DOES THIS PATIENT HAVE MALARIA? A META-ANALYSIS OF THE DIAGNOSTIC UTILITY OF CLINICAL FACTORS FOR ENDEMIC AND IMPORTED MALARIA." November 2010.

Scholars@Duke

Rantala, A-M, Taylor, SM, Trottman, PA, Luntamo, M, Mbewe, B, Maleta, K, Kulmala, T, Ashorn, P, and Meshnick, SR. "Comparison of real-time PCR and microscopy for malaria parasite detection in Malawian pregnant women. (Published online)" Malar J 9 (October 6, 2010): 269-.

PMID
20925928
Full Text

Taylor, SM, Wolfe, CR, Dixon, TC, Ruch, DS, and Cox, GM. "Wound botulism complicating internal fixation of a complex radial fracture." J Clin Microbiol 48, no. 2 (February 2010): 650-653.

PMID
20007390
Full Text

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