Pathogen exchange at the human wildlife interface - a comprehensive molecular study on vector-borne disease in rural Sulawesi.

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The rural poor, the wildlife they encounter and the potential exchange of pathogens between humans and wildlife is not known in much of the world, including Sulawesi, yet emerging infections of zoonotic origin that become epidemic and pandemic are feared. The collaborative molecular study proposed here focuses on emerging mosquito-borne infections with the fundamental goal to discover pathogen exchange where humans and wild Sulawesi macaques share habitat. The UK PI has a strong track record in this field as co-investigator and investigator in ground breaking molecular research that lead to the discovery and characterization of zoonotic malaria in the human population in Malaysian Borneo. Plasmodium knowlesi, a malaria parasite of macaque monkeys, had entered the human population and as a result of that work is now recognised as the 5th type of malaria in humans. The Indonesian PI is a clinically qualified medical entomologist with special interest in mosquito vectors of disease. He has extensive field research experience and is based in Hasanuddin University, Sulawesi. By joining their expertise and that of key co-investigators and collaborators, with particular expertise in patient recruitment in remote rural Borneo (CJD) and wildlife veterinary research (DKS) they plan to investigate, for the first time, pathogen transmission, particularly malaria transmission, within and between the unique Sulawesi macaque species and remote rural populations. Clinical, pathogen, mosquito, and wildlife data will be generated from study sites where rural populations share habitat with the Sulawesi macaques. The expected primary outcomes are: 1) to describe the clinical impact and molecular fingerprint of vector-borne pathogens transmitted within remote rural populations in Sulawesi; 2) to identify mosquito vector species and the pathogen genotypes they transmit between humans at each location; 3) to catalogue mosquito vectors that feed on, and vector-borne pathogens harboured by macaque troops, that overlap with humans at each location; 4)compare pathogen genetic fingerprints generated from mosquito vectors, macaque and human hosts to determine pathogen crossover events between hosts, particularly zoonotic crossover from macaque monkeys to humans and 5) develop location-specific tools and strategies for the Indonesian department of health and local communities to use to pre-empt emerging vector-borne zoonoses. The information generated by this study will immediately inform measures to reduce vector-borne infections and improve health and wellbeing of the study populations, by definition the remote rural poor. The study protocol could be used as a template for similar study in the region. The approach is internationally competitive molecular research (genetics, genomics and bioinformatics) and the partnership will foster human resource and capacity strengthening in cutting-edge infectious disease research in Indonesia. Our ODA compliant study when viewed through the lens of the sustainable development goals (SDG's) will contribute to Goal 1 - Ending poverty that includes ensuring that the poor and vulnerable have access to basic services - including health. Goal 3 Health - that includes ending neglected tropical diseases and malaria. Goal 8 - decent job creation, in this case through building expertise in the bio-medical research sector in Sulawesi and Goal 17 Partnerships - achieving the SDG's through sustainable equal partnerships.