Epidemiology and Transmission

流行病学项目的总体目标是进一步了解持续、强化的公共卫生干预措施如何减少疟疾传播，包括普遍部署长效驱虫蚊帐和青蒿素复方治疗，改变了疟原虫属之间的复杂关系。疟疾防治工作的重点是监测、评估和指导区域和国家疟疾控制方案。 该项目的主要特点包括：i）三个研究地点，表明恶性疟原虫和间日疟原虫在东南亚/太平洋地区的广泛流行和传播潜力，从完全流行到流行，（北海岸大陆巴布亚新几内亚[PNG]），中度/高度流行（东新不列颠巴布亚新几内亚），和低地方病（所罗门群岛西部省），ii）在所有三个研究中心执行类似的研究设计（纵向年龄分层儿童队列研究和社区感染和发病率监测），iii）有机会直接比较干预措施对控制和消除恶性疟原虫与间日疟原虫的影响，iv）与该地区国家疟疾控制计划的密切联系。具体目标是： 1)确定持续控制对疟原虫感染模式的影响及其对生活在3个不同疟疾流行地区的1-5岁儿童疟疾发病率的影响 2)评估持续控制对疟疾感染的强度、复杂性和动态的影响， 6-12岁儿童 3)确定特定年龄感染率和疟疾所致疾病的变化 4)恶性疟原虫和间日疟原虫感染的配子体动力学研究 5)监测疟原虫遗传多样性的变化。在艾滋病毒/艾滋病加剧的背景下， 控制活动 项目1是ICEMR协同作用的核心，因为研究项目2（传播）和3（发病机制/免疫）将在相同的地方病流行地点进行，由核心B（数据库）和核心C（分子诊断）共享数据并进行实验室检测。

The overall goal ofthe Epidemiology Project is to advance understanding of how reductions in malaria transmission mediated by sustained, intensified public health interventions that include universal deployment of long lasfing insecficide treated bed nets (LLINs) and artemisin combination treatment (ACT) alter the complex relationship between Plasmodium spp. parasites, malaria vectors and the human host in ways that can be translated to monitoring, evaluating and guiding regional and national malaria control programs. Major features of the project include i) three study sites that signify the breadth of P. falciparum and P. vivax endemicity and transmission potential in the SE Asia/Pacific region, ranging from holoendemic (north coast mainland Papua New Guinea [PNG]), meso/hyperendemic (East New Britain PNG), and hypoendemic (Western Province, Solomon Islands), ii) the execution of similar study designs in all three sites (longitudinal age-stratified childhood cohort studies and community surveillance for infection and morbidity), iii) the opportunity to compare directly the impact of interventions on control and elimination of P. falciparum versus P. vivax and, iv) close ties with national malaria control programs in the region. The specific aims are to; 1) Determine the effect of sustained control on patterns of Plasmodium spp infections and their contribution to malarial morbidity in children 1-5 years of age living in 3 areas with differing malaria endemicity 2) Assess effect of sustained control on force, complexity and dynamics of Plasmodium infections in children 6-12 years of age 3) Determine changes in the age-specific prevalence of infection and malaria-attributable illness 4) Study the gametocyte dynamics in P. falciparum and P. vivax infections 5) Monitor the changes in genetic diversity of Plasmodium spp. infections in the context of intensifying control activities Project 1 is central to the synergy of the ICEMR since Research Projects 2 (transmission) and 3 (Pathogenesis/immunity) will be done in the same endemic sites, with data shared and laboratory tests conducted by Core B (Database) and Core C (Molecular Diagnosfics).