Spatio-Temporal Patterns of Drug-Resistant Malaria

这个项目研究疟疾是如何在空间和时间上传播的。研究人员将测量遗传标记(基因流)的移动，以了解防止传播(障碍)或促进疾病(走廊)的因素。障碍可能是人为造成的，比如疟疾控制项目，也可能是自然的，比如由于气温较低而限制蚊子媒介栖息地的山脉。走廊也可以是人类创造的，比如道路，也可以是自然的，比如引导蚊子流动的河流。为了实现这项提议的目标，研究人员将使用来自刚果民主共和国(DRC)的数据和标本，刚果民主共和国是一个疟疾流行率高但空间可变的国家。调查人员将根据从2007年和2013年基于人口的大型人口和健康调查收集的干血迹中提取的DNA来分析信息。这些数据是在地理编码调查集群中收集的。研究人员将测量该国不同地区恶性疟疾寄生虫的遗传和地理距离之间的关系。他们还将确定防止或促进药物敏感和抗药性疟疾寄生虫扩散的因素。他们假设疟疾控制项目、运输路线和人类迁徙模式影响抗药性疟疾的传播。这一提议具有重大的智力价值，因为它结合了空间理论和方法、景观遗传学和高通量分子工具，提供了关于抗药性如何在空间和时间上传播的信息。该项目的成果将在刚果民主共和国和其他疟疾流行国家产生更广泛的积极影响，因为它们将有助于确定目标和评估干预措施。疟疾是一个巨大的公共卫生问题，特别是在刚果民主共和国，在2007年的全国调查中，那里几乎三分之一的成年人被感染。确定刚果民主共和国疟疾传播的人口和生态驱动因素可能会影响整个发展中世界的疟疾控制工作。该项目将作为其他疟疾流行国家的原型，这些国家可以以类似的方式使用他们的人口和健康调查干血点。该项目将为学生提供医学地理、空间和分子流行病学方面的教育和培训机会。

This project examines how malaria spreads over space and through time. The investigators will measure the movement of genetic markers (gene flow) to understand the factors that prevent transmission (barriers) or promote the disease (corridors). Barriers can be caused by humans, such as malaria-control programs, or they can be natural, such as mountains that restrict mosquito vector habitat because of cool temperatures. Corridors can also be created by humans, such as roads, or they can be natural, such as rivers that channel the movement of mosquitoes. To achieve the goals of this proposal, the researchers will use data and specimens from the Democratic Republic of Congo (DRC), a country with high but spatially variable malaria endemicity. The investigators will analyze information based on DNA extracted from dried blood spots collected through large population-based demographic and health surveys in 2007 and 2013. These data were collected in geocoded survey clusters. The researchers will measure relationships between genetic and geographic distance of Plasmodium falciparum malaria parasites in different areas of the country. They also will identify factors that prevent or promote diffusion of drug-sensitive and drug-resistant malaria parasites. They hypothesize that malaria control programs, transportation routes, and human migration patterns affect diffusion of drug-resistant malaria.This proposal has significant intellectual merit because it combines spatial theory and methods, landscape genetics, and high-throughput molecular tools to provide information about how drug resistance diffuses over space and time. The results of this project will have positive broader impacts in the DRC and in other malaria-endemic countries because they will help target and evaluate interventions. Malaria represents a massive public health problem, especially in the DRC, where almost one-third of all adults were found to be infected in the 2007 national survey. The identification of population and ecological drivers of malaria diffusion in the DRC could impact malaria-control efforts throughout the developing world. The project will serve as a prototype for other malaria-endemic countries, which could use their demographic and health survey dried blood spots in similar ways. The project will provide education and training opportunities for students in medical geography and spatial and molecular epidemiology.