Latin American Center for Malaria Research and Control

拉丁美洲疟疾研究与控制中心

• 批准号: 8319233
• 负责人: Socrates Herrera Valencia
• 金额: $ 177.07万
• 依托单位: CAUCASECO SCIENTIFIC RESEARCH CENTER
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-07-01 至 2013-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8319233
• 关键词: Address; Adherence; Affect; American; Anopheles Genus; Antimalarials; Area; Behavior; Biology; Bionomics; Brazil; Caribbean region; Caring; Censuses; Centers for Disease Control and Prevention (U.S.); Characteristics; Clinical; Cohort Studies; Colombia; Communities; Country; Cross-Sectional Studies; Data; Data Analyses; Development; Diagnosis; Diagnostic; Disease; Ecology; Ecuador; Environmental Risk Factor; Epidemiology; Europe; Evaluation; Goals; Government; Guatemala; Haiti; Health; Honduras; Hospitals; Hot Spot; Household; Housing; Immune response; Incidence; Individual; Infection; Institution; Intervention; Investigation; Knowledge; Latin America; Latino; Life; Malaria; Maps; Modeling; Organism; Outcome; Panama; Parasites; Participant; Pathogenesis; Pattern; Peru; Phase; Plasmodium; Population; Prevalence; Prophylactic treatment; Prospective Studies; Protocols documentation; Publications; Quality Control; Questionnaires; Research; Research Activity; Research Personnel; Risk; Risk Factors; Sampling; Scientist; Self Medication; Sentinel; Site; System; Thick; Training Activity; United States; Work; anthropogenesis; base; clinical epidemiology; community living; data management; design; epidemiology study; experience; follow-up; health care service organization; immunological status; improved; international center; multidisciplinary; operation; programs; quality assurance; surveillance study; transmission process; vector; vector management strategies

DESCRIPTION (provided by applicant): The overall goal of this proposal is the establishment the "Centro Latino Americano de investigacion en Malaria - CLAIM" as a non-Amazonian malaria research center that would generate knowledge and provide technical and scientific support to governments of the partner countries as well as to organizations and health care institutions to further contribute to malaria elimination programs in the regions. CLAIM would initially bring together field sites from Colombia, Peru, Panama and Guatemala, and has plans to further include sites from Ecuador and Honduras and possibly other endemic countries of the Latin American (LA) and the Caribbean such as Haiti. CLAIM will be composed of multiple public and private research centers from the original partner countries, including centers and organizations depending from or associated to the Ministries of Health (MOH) from all participant countries. CLAIM has also involved consultants/collaborators from the Andean Health Organism and/or the US Centers for Disease Control for this ICEMR program. In addition, to the scientists from the partner countries, CLAIM will have the participation of prominent and experienced scientists from other endemic countries such as Ecuador and Brazil, as well as from United State (USA) and Europe. The ICEMR research activities have been divided into three closely inter-related projects as follows: Project 1 on Epidemiology will determine the ecological and epidemiological features in non-Amazonian regions; Project 2 on malaria transmission will address major gaps in our understanding of the ecology, behavior, vector potential, and control of Anopheles malaria vectors to guide the development and implementation of more effective integrated Vector Management (IVM) strategies, and Project 3 on malaria pathogenesis, that it will determine the clinical outcome of malaria infections and its correlation with the immunological status in communities living under different intensifies of malaria transmission in the study region. CLAIM would involve its epidemiology team to closely work with the National Malaria Control Program (NMCP) of all partner countries, to locate and track the "hot spots" and to assess the changing epidemiological conditions, identifying the malaria patterns and establishing linkages with environmental and anthropogenic factors or other determinants of malaria transmission. The study team will provide technical assistance for helping NMCPs improve surveillance operations, including quality control and assurance of data with respect to diagnostics. This ICEMR proposal includes training activities for selected junior scientists and groups of researchers/technicians. Special projects will be initiated by Year 3 of the program and will profit to redirect the program and/or involve other countries. A Data Management (DM) Core will coordinate all research protocol, DM, data analyses and publications. All CLAIM activities will be coordinated by Core A under responsibility of Caucaseco SRC. CLAIM will combine the multidisciplinary and integrated approach to enhance the research underpinnings for effective malaria elimination and possibly eradication. Data and findings generated by this Center are expected to provide input critical to inform future research design and evaluation of new interventions and control strategies. RELEVANCE: This is a comprehensive project designed to establish an international Center of Excellence for Malaria Research in Latin America (CLAIM) composed of multiple public and private research centers from the endemic countries, the USA and Europe working jointly to find alternatives for malaria control. Results will facilitate malaria elimination in low malaria endemic settings. PROJECT 1: Title: Epidemiology of Malaria Transmission in Low to Moderate Settings of Latin America Project Leader: Herrera, S. PROJECT 1 DESCRIPTION (provided by applicant): 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 of 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. RELEVANCE: Identify the relationship between environmental factors, parasite characteristics, household conditions and the malaria prevalence related to the epidemiology and clinical findings.

描述（由申请人提供）：该提案的总体目标是建立“拉丁美洲疟疾研究中心 - CLAIM”作为非亚马逊疟疾研究中心，该中心将产生知识并向伙伴国家政府以及组织和卫生保健机构提供技术和科学支持，以进一步为该地区的疟疾消除计划做出贡献。 CLAIM 最初将汇集来自哥伦比亚、秘鲁、巴拿马和危地马拉的实地站点，并计划进一步包括来自厄瓜多尔和洪都拉斯以及可能的拉丁美洲 (LA) 和加勒比地区其他流行国家（如海地）的站点。 CLAIM 将由来自原始合作伙伴国家的多个公共和私人研究中心组成，包括所有参与国家卫生部 (MOH) 的附属中心和组织或与之相关的中心和组织。 CLAIM 还邀请了来自 Andean Health Organism 和/或美国疾病控制中心的顾问/合作者参与此 ICEMR 计划。此外，对于来自伙伴国家的科学家，CLAIM还将有来自厄瓜多尔和巴西等其他流行国家以及美国和欧洲的著名且经验丰富的科学家参与。 ICEMR的研究活动分为三个密切相关的项目，如下：项目1流行病学将确定非亚马逊地区的生态和流行病学特征；关于疟疾传播的项目 2 将解决我们对按蚊疟疾媒介的生态、行为、媒介潜力和控制的理解方面的重大差距，以指导制定和实施更有效的综合媒介管理 (IVM) 策略；关于疟疾发病机制的项目 3 将确定疟疾感染的临床结果及其与研究中生活在不同疟疾传播强度下的社区的免疫状态的相关性 地区。 CLAIM将让其流行病学团队与所有伙伴国家的国家疟疾控制计划（NMCP）密切合作，定位和跟踪“热点”并评估不断变化的流行病学状况，确定疟疾模式并与环境和人为因素或疟疾传播的其他决定因素建立联系。研究小组将提供技术援助，帮助 NMCP 改进监测操作，包括诊断方面的质量控制和数据保证。该 ICEMR 提案包括针对选定的初级科学家和研究人员/技术人员小组的培训活动。特别项目将在该计划的第三年启动，并将受益于调整该计划和/或让其他国家参与其中。数据管理 (DM) 核心将协调所有研究方案、DM、数据分析和出版物。所有 CLAIM 活动将由 Caucaseco SRC 负责的核心 A 进行协调。 CLAIM 将结合多学科和综合方法，加强有效消除和可能根除疟疾的研究基础。该中心产生的数据和研究结果预计将为未来的研究设计和新干预措施和控制策略的评估提供至关重要的输入。 相关性：这是一个综合项目，旨在建立拉丁美洲疟疾研究国际卓越中心 (CLAIM)，该中心由来自流行国家、美国和欧洲的多个公共和私人研究中心组成，共同努力寻找疟疾控制的替代方案。结果将有助于在疟疾低流行地区消除疟疾。 项目1： 标题：拉丁美洲低至中等环境中疟疾传播的流行病学 项目负责人：埃雷拉，S. 项目 1 描述（由申请人提供）：项目 1 的主要目标是评估与流行病学和临床发现相关的生态和寄生虫种群的多样性，以建立一个科学框架，支持在洛杉矶非亚马逊地区制定消除疟疾的新干预策略。该目标将通过以下具体目标来实现：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；2）确定与洛杉矶国家非亚马逊地区疟疾传播相关的风险因素。 我们假设循环的疟原虫种群及其动态调节受影响人群的临床表现和免疫反应，并且媒介生物学、寄生虫种群多样性、宿主生物学和行为、家庭条件和当地环境条件同时起作用，以确定疟疾传播和感染风险。为目标 1 提出的研究旨在通过考虑居住​​在洛杉矶季节性地区的有症状和无症状个体来确定疟疾的真实患病率和发病率。 该调查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测以及基于医院的被动监测研究。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，共研究21个哨点。研究将分三个阶段进行：1）我们自己对哨点选定的人口进行人口普查，其中居民将使用人口调查问卷进行登记，并使用 GPS 系统进行房屋坐标； 2）在选定的哨点进行厚涂片和PCR诊断疟疾，并随机抽样以确定无症状配子体携带者； 3) 在两个哨点（一处位于哥伦比亚（提拉尔塔），一处位于秘鲁（苏卢纳）进行临床随访和无症状厚涂片。对于目标 2，我们将 a) 评估疟疾流行社区的抗疟药物使用情况，包括依从性、自我药疗和预防； (b) 研究公立和私立卫生机构抗疟药物的使用情况，包括护理指南的可用性和适用性。在这个 ICEMR 计划中，我们将建立一个哨点网络，将根据生物地​​理标准（媒介和生态条件）和流行病学信息来选择哨点网络。哨点将提供疟疾生态学和流行病学的基线信息，目的是描述对控制干预措施有抵抗力的寄生虫和病媒种群。该网络将支持当前旨在开发人口模型以量化疾病动态和疟疾风险图以支持卫生部消除活动的努力。 相关性：确定环境因素、寄生虫特征、家庭条件和与流行病学和临床发现相关的疟疾患病率之间的关系。