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的运动（基因流），以了解阻止传播（屏障）或促进疾病（通道）的因素。障碍可以是人为造成的，例如疟疾控制计划，也可以是自然造成的，例如由于温度较低而限制蚊子媒介栖息地的山脉。走廊也可以是人为创造的，比如道路，也可以是自然形成的，比如引导蚊子运动的河流。为了实现这一提议的目标，研究人员将使用来自刚果民主共和国（DRC）的数据和标本，这是一个疟疾流行率高但空间可变的国家。调查人员将根据2007年和2013年通过大规模人口和健康调查收集的干血点提取的DNA分析信息。这些数据是在地理编码调查集群中收集的。这组科学家将测量该国不同地区恶性疟原虫的遗传距离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耐药疟疾寄生虫扩散的因素。他们假设疟疾控制计划、运输路线和人类迁移模式影响了耐药疟疾的扩散。该建议具有重要的智力价值，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来提供关于耐药性如何在空间和时间上扩散的信息。该项目的成果将对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年的全国调查中发现，该国近三分之一的成年人受到感染。确定刚果民主共和国疟疾扩散的人口和生态驱动因素可能影响整个发展中国家的疟疾控制工作。该项目将成为其他疟疾流行国家的一个原型，这些国家可以以类似的方式利用他们的人口和健康调查来干燥血迹。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.