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

项目1 项目摘要 环境改变对恶性疟原虫的影响 疟疾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 这些国家依赖雨水灌溉的农业，使这些人口容易受到干旱的影响， 饥荒建造水坝和启动农村灌溉计划已得到广泛的重视， 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，撒哈拉以南非洲国家经历了一个新的大坝时代 建设和扩大灌溉农业农场。这些环境变化 可能会产生不可预见的生态后果，对人类健康产生不利影响。到目前为止， 评估环境影响的基础或转化研究有限， 对疟疾流行病学的修改。该项目的总体目标是 评估水资源开发造成的环境变化的影响 项目和改变农业做法， 分子、个体、场和群体水平。核心假设是， 大坝引起的生态变化和大规模人口迁移 大坝的建设、大坝集水区的洪水和农业做法的转变将 改变该地区疟疾的传播和风险。我们将通过以下方式检验这一假设： 监测生态变化，进行重复的横截面调查和纵向调查， 在社区进行队列研究，在卫生中心进行疟疾被动监测， 医院的三个具体目标是：1）比较症状性疟疾负担， 不同生态流行病学环境中疾病严重程度的谱 环境的改变和疟原虫物种的不同流行，2）检查 与建造水坝和灌溉农业有关的人口迁移对 疟疾寄生虫的景观遗传学，以及3）评估最近的有效性 引入伯氨喹治疗策略，降低间日疟原虫复发的风险， P.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站大坝的数量 预计在未来十年将大幅增加，了解水的影响， 制定疟疾流行病学发展项目，并随后制定战略， 减少传播和发病率至关重要。虽然这项研究是 仅在肯尼亚和埃塞俄比亚人口稠密地区进行，我们预计， 研究结果和工具将对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问题， 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.