ENSURE: Enhanced surveillance for control and elimination of malaria in the Philippines

确保：加强监测以控制和消除菲律宾的疟疾

• 批准号: MR/N019199/1
• 负责人: Chris Drakeley
• 金额: $ 51.34万
• 依托单位: London School of Hygiene & Tropical Medicine
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2016
• 资助国家: 英国
• 起止时间: 2016 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=MR%2FN019199%2F1
• 关键词: ENSURE; Enhanced; surveillance; control; elimination

Malaria remains a problem in many parts of the world. Even in countries where the level of infection is low, malaria can still cause death and there is the constant threat that drug and insecticide resistance may undermine any ongoing control attempts such that malaria comes back. A major complication for control programmes when infections are rare is identifying where transmission is actually occurring. This is because the current methods used to diagnose malaria are not sensitive enough to detect all infections and miss a substantial proportion. Although these infections that are missed may not cause illness, they can still lead to infections in mosquitoes and therefore maintain malaria transmission in the area. It is an expensive process for many poorer countries to try and actively find all these cases, and so more flexible approaches need to be used to identify where infections are happening so that they can be targeted effectively. The Philippines is a prime example of a low transmission setting. The country has recently experienced a reduction in annual malaria cases (from over 36,000 local cases in 2000 to fewer than 5,000 in 2014), but despite this progress, 54 out of the 81 provinces remain endemic of malaria, putting 14 million people at risk of the disease. Novel approaches and more sensitive methods are needed to detect if and where any remaining transmission might occur. With drug resistant parasites circulating in some countries in South East Asia, targeting transmission in the Philippines through an integrated surveillance system is particularly important and probably the most effective approach to address this issue. In this project, we will combine existing systems that monitor malaria in people who attend local clinics in the Philippines with more sensitive diagnostic methods to see who is infected and who has recently been exposed to malaria. We will use the data from the clinics and cutting edge mapping techniques with tablet computers to identify where people live, so that we can see where infections are occurring. We will give this information to the Philippines National Malaria Control Programme so that they can target the area for control. We will perform these activities regularly at health facilities and continually update the maps. This will allow us to identify new areas of infection and check that targeted areas remain low. We will work closely and continually with the control programme and health facility staff to see if the approach we are promoting is acceptable and how it might be improved. The goal is to develop an approach that can be easily absorbed into the existing health system using more modern approaches, and ultimately to help the Philippines eliminate a deadly and costly disease - and potentially to help other countries and regions achieve the same. The project also aims to build human capacity in the Philippines in serological and molecular surveillance, data analysis, epidemiology, spatial studies and health systems research. The international collaboration provides a unique opportunity to develop and evaluate malaria burden measurement tools, allowing for novel strategies in a region of diverse and complex epidemiology, in which the rapid advances being made on elimination require great input in research and innovation.

疟疾仍然是世界许多地区的一个问题。即使在感染率较低的国家，疟疾仍可能造成死亡，而且药物和杀虫剂的抗药性可能破坏任何正在进行的控制努力，从而使疟疾卷土重来，这是一个持续的威胁。 当感染罕见时，控制方案的一个主要复杂问题是确定实际发生传播的地方。这是因为目前用于诊断疟疾的方法不够敏感，无法检测到所有感染，而且错过了很大一部分。虽然这些被遗漏的感染可能不会导致疾病，但它们仍然会导致蚊子感染，从而维持该地区的疟疾传播。对于许多较贫穷的国家来说，尝试并积极发现所有这些病例是一个昂贵的过程，因此需要使用更灵活的方法来确定感染发生的地方，以便有效地针对它们。 菲律宾是低传播环境的一个主要例子。该国最近经历了年度疟疾病例的减少（从2000年的36 000多个当地病例减少到2014年的不到5 000个），但尽管取得了这一进展，81个省中仍有54个省疟疾流行，使1 400万人面临感染这种疾病的风险。需要新的办法和更敏感的方法来检测是否以及在何处可能发生任何剩余的传播。由于抗药性寄生虫在东南亚一些国家流行，通过综合监测系统在菲律宾瞄准传播尤为重要，可能是解决这一问题的最有效方法。 在这个项目中，我们将联合收割机结合监测菲律宾当地诊所就诊者疟疾的现有系统和更敏感的诊断方法，以了解谁感染了疟疾，谁最近接触过疟疾。我们将使用诊所的数据和平板电脑的尖端绘图技术来识别人们的居住地，这样我们就可以看到感染发生的地方。我们将把这一信息提供给菲律宾国家疟疾控制方案，以便他们能够针对该地区进行控制。我们将定期在卫生设施开展这些活动，并不断更新地图。这将使我们能够确定新的感染区域，并检查目标区域是否保持低水平。 我们将继续与控制方案和卫生设施工作人员密切合作，以确定我们正在推广的方法是否可以接受，以及如何改进。其目标是开发一种可以使用更现代的方法轻松融入现有卫生系统的方法，并最终帮助菲律宾消除一种致命且代价高昂的疾病-并有可能帮助其他国家和地区实现同样的目标。 该项目还旨在建设菲律宾在血清学和分子监测、数据分析、流行病学、空间研究和卫生系统研究方面的人力。国际合作为开发和评估疟疾负担衡量工具提供了一个独特的机会，从而可以在流行病学多样和复杂的地区制定新的战略，在这个地区，消灭疟疾的迅速进展需要在研究和创新方面投入大量资金。

项目成果

MOESM1 of Use of mobile technology-based participatory mapping approaches to geolocate health facility attendees for disease surveillance in low resource settings

MOESM1 使用基于移动技术的参与式绘图方法对医疗机构参与者进行地理定位，以在资源匮乏的环境中进行疾病监测

• DOI: 10.6084/m9.figshare.6600584
• 发表时间: 2018
• 作者: Fornace K

Prevalence and temporal changes of mutations linked to antimalarial drug resistance in Plasmodium falciparum and Plasmodium vivax in Palawan, Philippines.

• DOI: 10.1016/j.ijid.2021.12.318
• 发表时间: 2022-03
• 期刊: International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases
• 作者: Bareng APN;Grignard L;Reyes R;Fornace K;Spencer F;Macalinao ML;Luchavez J;Espino FE;Drakeley C;Hafalla JCR
• 通讯作者: Hafalla JCR

Analytical approaches for antimalarial antibody responses to confirm historical and recent malaria transmission: an example from the Philippines

用于确认历史和近期疟疾传播的抗疟抗体反应的分析方法：来自菲律宾的例子

• DOI: 10.1101/2022.06.16.22276488
• 发表时间: 2022
• 作者: Macalinao M

Enhanced Health Facility Surveys to Support Malaria Control and Elimination across Different Transmission Settings in the Philippines.

• DOI: 10.4269/ajtmh.20-0814
• 发表时间: 2021-01-18
• 期刊: The American journal of tropical medicine and hygiene
• 作者: Reyes RA;Fornace KM;Macalinao MLM;Boncayao BL;De La Fuente ES;Sabanal HM;Bareng APN;Medado IAP;Mercado ES;Baquilod MS;Luchavez JS;Hafalla JCR;Drakeley CJ;Espino FEJ
• 通讯作者: Espino FEJ

Use of mobile technology-based participatory mapping approaches to geolocate health facility attendees for disease surveillance in low resource settings.

• DOI: 10.1186/s12942-018-0141-0
• 发表时间: 2018-06-18
• 期刊: International journal of health geographics
• 影响因子: 4.9
• 作者: Fornace KM;Surendra H;Abidin TR;Reyes R;Macalinao MLM;Stresman G;Luchavez J;Ahmad RA;Supargiyono S;Espino F;Drakeley CJ;Cook J
• 通讯作者: Cook J