Impact of Environmental Modifications on Plasmodium falciparum and P. vivax Malaria Epidemiology and Disease Burden

项目1 项目总结 环境改造对恶性疟原虫的影响 和间日疟原虫流行病学和疾病负担 几个世纪以来，严重的干旱一直困扰着非洲大陆。大多数非洲人 国家依赖雨水灌溉的农业，使这些人口容易受到干旱和 饥荒。修建大坝和启动农村灌溉计划得到了广泛的应用 被认为是干旱易发地区粮食安全和经济增长的关键解决办法。 在过去的十年里，撒哈拉以南的非洲国家经历了一个新的大坝时代 新建和扩建灌溉农业农场。这些环境变化 可能会产生不可预见的生态后果，对人类健康造成不利影响。到目前为止， 评估环境影响的基础或转化性研究有限 关于疟疾流行病学的修改。这个项目的总体目标是 评估水资源开发对环境变化的影响 关于疟疾流行病学变化的项目和转变的农业做法 分子水平、个体水平、领域水平和种群水平。中心假设是 大坝引发的生态变化与人口大规模迁移 建设、大坝集水区的洪水泛滥和农业做法的转变将 修改疟疾在该地区的传播和风险。我们将通过以下方式验证这一假设 监测生态变化，反复进行横断面调查和纵向调查 社区中的队列研究，以及卫生中心和 医院。这三个具体目标是：1)比较有症状的疟疾负担和 不同生态流行病学环境地区的疾病严重程度范围 环境变化和不同种类疟原虫的流行，2)检查 与修建水坝和灌溉农业相关的人类迁徙对 疟疾寄生虫的景观遗传学，以及3)评估最近 介绍了伯氨喹治疗间日疟原虫复发风险的策略和 恶性疟原虫在埃塞俄比亚不同环境条件下的传播。因为 撒哈拉以南非洲的灌溉面积和大型水电大坝的数量 预计在未来十年将大幅增加，了解水的影响 关于疟疾流行病学的发展项目，并随后制定战略以 减少传播和发病率将是至关重要的。尽管这项研究是 只在肯尼亚和埃塞俄比亚人口稠密的地区进行，我们预计我们的 研究结果和工具将对#年疟疾预防和控制产生广泛影响。 撒哈拉以南非洲的其他地区正在经历类似的环境 修改。

PROJECT 1 PROJECT SUMMARY Impact of Environmental Modifications on Plasmodium falciparum and P. vivax Malaria Epidemiology and Disease Burden Severe droughts have plagued the African continent for centuries. Most people in African countries depend on rain-fed agriculture, making these populations vulnerable to drought and famine. Construction of dams and initiating rural irrigation schemes has been widely recognized as key solutions to food security and economic growth in drought prone regions. In the past decade, sub-Saharan African countries have experienced a new era of large dam constructions and expansion of irrigated agricultural farms. These environmental changes may have unforeseen ecologic consequences that adversely affect human health. To date, there has been limited basic or translational research evaluating the impact of environmental modifications on the epidemiology of malaria. The overarching objective of this project is to assess the impact of environmental modifications from water resource development projects and shifting agricultural practices on the change of epidemiology of malaria at the molecular, individual, field and population levels. The central hypothesis is that ecological changes and large-scale human population movement resulting from dam construction, flooding of the dam catchment and shifting of agriculture practices will modify the transmission and risk of malaria in the area. We will test this hypothesis by monitoring ecological changes, conducting repeated cross-sectional surveys and longitudinal cohort studies in the community, and passive surveillance for malaria in health centers and hospitals. The three specific aims are to: 1) compare symptomatic malaria burden and spectrum of disease severity in areas of diverse eco-epidemiologic settings with drastic environmental modifications and differing prevalence of Plasmodium species, 2) examine the effect of human migration associated with construction of dams and irrigation farming on the landscape genetics of malaria parasites, and 3) assess the effectiveness of recently introduced primaquine treatment strategies on the risk of Plasmodium vivax recurrence and P. falciparum transmission under different environmental conditions in Ethiopia. Because the irrigated area of sub-Saharan Africa and the number of large hydropower dams are anticipated to increase dramatically in the next decade, understanding the impact of water development projects on malaria epidemiology and subsequently developing strategies to reduce transmission and morbidity will be of paramount importance. Although this study is conducted only in highly populated areas in Kenya and Ethiopia, we anticipate that our findings and tools will have broad implications for malaria prevention and control in other regions of sub-Saharan Africa that are undergoing similar environmental modifications.