Epidemiology of Malaria Transmission in Low to Moderate Settings of Latin America

拉丁美洲中低度地区疟疾传播的流行病学

• 批准号: 8319228
• 负责人: Socrates Herrera Valencia
• 金额: $ 34.46万
• 依托单位: CAUCASECO SCIENTIFIC RESEARCH CENTER
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-07-01 至 2017-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8319228
• 关键词: Address; Adherence; Affect; Africa; American; Antigens; Antimalarials; Area; Behavior; Biology; Bionomics; Caring; Censuses; Characteristics; Chloroquine; Clinical; Cohort Studies; Colombia; Communities; Country; Cross-Sectional Studies; Data; Development; Diagnosis; Disease; Drug usage; Ecology; Effectiveness; Environmental Risk Factor; Epidemiologic Studies; Epidemiology; Exposure to; Failure; Frequencies; Genetic Anticipation; Genetic Variation; Goals; Guatemala; Health; Hospitals; Household; Housing; Immune response; Incidence; Individual; Infection; Institution; Intervention; Investigation; Latin America; Life; Location; Longitudinal Studies; Malaria; Maps; Measures; Modeling; Molecular; Morbidity - disease rate; Panama; Parasites; Pattern; Peru; Phase; Plasmodium; Plasmodium falciparum; Population; Prevalence; Primaquine; Prophylactic treatment; Prospective Studies; Pyrimethamine; Questionnaires; Relapse; Research; Resistance; Risk; Risk Factors; Sampling; Self Medication; Sentinel; Site; System; Thick; base; case control; clinical epidemiology; epidemiology study; follow-up; improved; multilevel analysis; programs; prospective; surveillance study; tool; transmission process; vector; vector control

The main objective of project 1 is to evaluate the diversity of the ecology and parasite populations related to the epidemiology and clinical findings in order to establish a scientific framework that supports the development of new intervention strategies for malaria elimination in non-Amazonian areas of LA. This goal will be approached through the following specific aims: 1) Study the epidemiology of seasonal malaria and their relationship with parasite population diversity and 2) Identification risk factors associated with malaria transmission in non-Amazonian areas of LA countries. We hypothesize that circulating Plasmodium populations and their dynamics modulate the clinical manifestations and immune responses in the affected populations and that vector bionomics, parasite population diversity, host biology and behavior, household conditions, and local environmental conditions, act simultaneously to determine malaria transmission and risk of infection. The studies proposed for aim 1 are directed to determine the real prevalence and incidence of malaria by considering both symptomatic and asymptomatic individuals living in seasonal areas in LA. This investigation includes community based cohort studies (prospective studies), active surveillance using temporal cross-sectional studies, and hospital based passive surveillance studies. The studies will be carried out in 7 endemic areas of Colombia, Peru, Panama and Guatemala, where a total of 21 sentinel sites will be studied. Studies will be carried out in three phases: 1) Our own census of the selected population from sentinel sites where inhabitants will be registered using a demographic questionnaire and houses coordinates using a GPS system; 2) thick smear and PCR for malaria diagnose in selected sentinels sites and random sampling in order to determine asymptomatic gametocytes carriers; 3) clinical follow-up and thick smear of asymptomatic at two sentinel sites (one in Colombia (Tierralta) and one in Peru (Sulluna). For aim 2 we will a) assess the conditions of antimalarial use in communities where malaria is endemic, including adherence, self-medication and prophylaxis; and (b) study the conditions of use of antimalarials in the public and private health institutions including the availability and suitability to care guides. In this ICEMR program, we will establish a network of sentinel sites that will be selected integrating bio-geographic criteria (vector and ecological conditions) and epidemiological information. Sentinel sites will provide baseline information on malaria ecology and epidemiology with the goal of characterizing parasite and vector populations resilient to control interventions. Such network will allow supporting current efforts directed to develop population models to quantify disease dynamics and malaria risk-maps to support MOH elimination activities.

项目1的主要目的是评估与流行病学和临床发现相关的生态学和寄生虫种群的多样性，以建立一个科学框架，以支持洛杉矶非阿马佐尼亚地区的疟疾消除新干预策略的发展。该目标将通过以下特定目的实现：1）研究季节性疟疾的流行病学及其与寄生虫种群多样性的关系以及2）识别洛杉矶国家非阿马佐尼亚地区疟疾传播相关的识别危险因素。 我们假设循环质量种群及其动力学调节临床 受影响人群中的表现和免疫反应以及载体的寄生虫种群多样性，宿主生物学和行为，家庭状况以及当地环境状况，同时采取行动以确定疟疾传播和感染风险。针对AIM 1提出的研究是指导旨在通过考虑居住​​在洛杉矶季节性地区的有症状和无症状的个体来确定疟疾的实际患病率和发病率。 这项研究包括基于社区的队列研究（前瞻性研究），使用时间横断面研究的主动监视以及基于医院的被动监视研究。这些研究将在哥伦比亚，秘鲁，巴拿马和危地马拉的7个流行地区进行，其中总共将研究21个哨兵地点。研究将分为三个阶段：1）我们自己从哨兵地点进行的人口普查，其中将使用人群调查表注册居民，并使用GPS系统进行坐标； 2）在选定的哨兵部位和随机采样中诊断疟疾的厚实涂片和PCR，以确定无症状的子志载体； 3）临床随访和 在两个前哨部位（一个在哥伦比亚（tierralta）和秘鲁的一个（Sulluna）的厚度无症状。 （b）研究在公共和私人卫生机构中使用抗疟药的条件，包括可用性和适合护理指南。在此ICEMR计划中，我们将建立一个哨兵网站网络，该网络将被选为整合生物地理标准（向量和生态条件）和流行病学信息。 Sentinel站点将提供有关疟疾生态和流行病学的基线信息，以表征寄生虫和矢量种群有弹性地控制干预措施。这种网络将允许当前的当前努力发展人口 量化疾病动态和疟疾风险图以支持MOH消除活动的模型。