Malaria Transmission and the Impact of Control Efforts in Southern Africa

描述（由申请人提供）：拟建的疟疾研究卓越中心将重点研究非洲南部大部分地区典型条件下疟疾寄生虫的流行病学、媒介生物学和遗传多样性。这项研究将在疟疾传播程度和控制阶段不同的三个流行地区进行。主要研究地点将设在赞比亚南部省Choma区的Macha疟疾研究所（MIAM）。这是一个半干旱地区，有季节性疟疾严重传播的历史。虽然减少疟疾死亡的化疗已经实施了20多年，但直到2007年才实施病媒控制干预措施。第二个实地站点将设在赞比亚北部卢阿普拉省Nchelenge区的热带病研究中心（TDRC），位于Mweru湖周边。这是疟疾从高度流行到全面流行的高传播地区。第三个实地地点将设在津巴布韦马尼卡兰省穆塔萨区的生物医学研究培训研究所（BRTI）。该地区实施了大约50年的有效疟疾控制计划，但该计划于20世纪90年代末终止。因此，疟疾又死灰复燃。这些研究领域之间的生态、地理和人口差异为调查南部非洲疟疾传播和控制提供了一系列流行病学条件，特别是传播的时空模式、媒介生物学和寄生虫多样性。疟疾流行病学研究将侧重于医院、诊所和社区前瞻性研究，以跟踪传播的时空变化。对病媒和寄生虫进行群体遗传研究将有助于确定与自然和强加的瓶颈以及杀虫剂抗性和抗疟疾抗性突变频率变化有关的遗传异质性特征。由环境监测、基因组学和数据管理/生物统计学组成的项目核心提供了这三个研究领域之间的联系。一个集成的关系数据库将跨越空间和时间连接信息。培训/职业发展项目将在赞比亚大学和约翰霍普金斯大学公共卫生学院协调，并将利用当地的能力加强其培训项目，以确保疟疾研究卓越中心在项目完成后得以维持。

DESCRIPTION (provided by applicant): The proposed Center of Excellence for Malaria Research will focus on the epidemiology, vector biology and genetic diversity of malaria parasites under conditions typical of much of southern Africa. The research will be conducted in three endemic areas with different levels of malaria transmission and stages of control. The main research site will be located at the Malaria Institute at Macha (MIAM) in the Choma District of the Southern Province of Zambia. This is a semi-arid region that has a history of intense seasonal malaria transmission. While chemotherapy to reduce deaths from malaria has been in effect for over 20 years, no vector control interventions were implemented until 2007. The second field site will be at the Tropical Disease Research Centre (TDRC) in the Nchelenge District in the Luapula Province in northern Zambia, in the environs of Lake Mweru. This is a high transmission area with hyper- to holo-endemic malaria. The third field site will be at the Biomedical Research Training Institute (BRTI) in Mutasa District in Manicaland Province, Zimbabwe. This region was under an effective malaria control program for about 50 years but the program was terminated in the late 1990's. Consequently, there has been a resurgence of malaria. The ecological, geographical and demographic differences between these research areas provide a range of epidemiological conditions to investigate malaria transmission and control in southern Africa, specifically spatio-temporal patterns of transmission, vector biology and parasite diversity. Studies of malaria epidemiology will focus on hospital, clinic and community-based prospective studies to track spatial and temporal changes in transmission. Population genetic studies of the vector and parasite will allow characterization of the genetic heterogeneity associated with natural and imposed bottle necks and the changing frequency of insecticide resistance and antimalarial resistance mutations. The project Cores, consisting of Environmental Surveillance, Genomics and Data Management/Biostatistics provide links between the three research areas. An integrated relational data base will link information across space and time. The Training/Career Development Program will be coordinated at the University of Zambia and the Johns Hopkins School of Public Health and will take advantage of local capacity to strengthen their training programs to ensure the Center of Excellence for Malaria Research is sustained after the completion of this program.