Southeast Asia Malaria Research Center

东南亚疟疾研究中心

• 批准号: 9915839
• 负责人: LIWANG CUI
• 金额: $ 279.59万
• 依托单位: UNIVERSITY OF SOUTH FLORIDA
• 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 2024-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9915839
• 关键词: Achievement; Address; Affect; Anti-malarial drug resistance; Antibodies; Artemisinins; Behavioral; Biological Assay; Biology; Biostatistics Core; Blood Circulation; Breeding; Cambodia; China; Chloroquine resistance; Collaborations; Combined Modality Therapy; Communities; Complex; Country; Culicidae; Detection; Development; Disease; Drug resistance; Ecology; Effectiveness; Epidemiological trend; Epidemiology; Face; Falciparum Malaria; Family; Fostering; Foundations; Genomics; Goals; Heterogeneity; Human; Immunoassay; Individual; Insecticide Resistance; Insecticides; International; Intervention; Knowledge; Laos; Malaria; Measures; Migrant; Molecular; Monitor; Monoclonal Antibodies; Multi-Drug Resistance; Myanmar; Parasite resistance; Parasites; Pharmaceutical Preparations; Phase; Plasmodium falciparum; Plasmodium vivax; Politics; Population; Population Biology; Province; Public Health; Pyrimethamine; Research; Resistance; Sampling; Scientist; Series; Site; Southeastern Asia; Structure; System; Thailand; United States; Ursidae Family; Vietnam; Vivax Malaria; base; data management; effectiveness evaluation; environmental change; human migration; improved; innovation; innovative technologies; interdisciplinary approach; malaria transmission; new combination therapies; point of care; programs; resistance mechanism; resistant Plasmodium falciparum; socioeconomics; southeast Asian; transmission process; vector; vector control; vector mosquito

OVERALL SUMMARY Malaria in the Greater Mekong Subregion (GMS) of Southeast Asia remains an important public health problem. There is immense spatial heterogeneity in malaria distribution, with Myanmar having the highest regional malaria burden. Highly mobile populations crossing porous international borders are a major contributor to parasite introduction and continued transmission. The recent emergence of resistance to the artemisinin (ART) family of drugs as well as to their partner drugs raised global concerns. The vectorial system is highly diverse, and increased outdoor biting and development of insecticide resistance have rendered the two core vector control interventions – insecticide-treated nets and indoor residue spray less effective. Furthermore, falsified and substandard ART-based combination therapies (ACTs) have become a global crisis. Therefore, the central goal of this program is to improve our understanding of how mobile human populations, parasite drug resistance, and mosquito biology contribute to continuous malaria transmission at international borders so that innovative control strategies can be developed to propel the course of regional malaria elimination. To achieve this overarching objective, we have selected study sites in the international border regions of three GMS countries, Myanmar, China, and Thailand, with drastically different malaria epidemiology to conduct comprehensive research on humans, vectors, and parasites in four interrelated projects. In Project 1, the foundation of the whole program, we will conduct malaria surveillance, monitor human migration and its impact on parasite introduction, and evaluate the effectiveness of the current treatment of the predominant P. vivax malaria. Project 2 will study how environmental changes affect mosquito community structures and malaria transmission, identify whether behavioral changes of major vectors are genetically determined, and determine the extent and mechanisms of insecticide resistance in malaria vectors. In Project 3, we will address the emerging problem of resistance of P. falciparum to both the ART family of drugs and partner drugs through molecular studies of resistance mechanisms and by tracking resistance spread in the GMS. Finally, we want to develop monoclonal antibody-based immunoassays to detect both active ingredients in an ACT, and use our newly developed point-of-care dipstick assays for large-scale assessment of the extent of problem of the falsified and substandard ACTs in the GMS countries using a stratified random sampling approach. This program, built on the scientific achievements of the current ICEMR program and the strong network of international collaborators, aims to dissect the complex interactions between migrant human populations, diverse mosquito vectors, MDR parasites, and falsified and substandard ACTs, which are responsible for continued malaria transmission along international borders. These scientific questions are not only pertinent to the GMS nations, but are also applicable to other malaria regions. Therefore, findings from these studies will bear far-reaching impacts on global malaria elimination.

总体汇总 东南亚大湄公河次区域（GMS）的疟疾仍然是一个重要的公共卫生问题， 问题.疟疾分布存在巨大的空间异质性，缅甸的疟疾发病率最高， 区域疟疾负担。高度移动的人口跨越漏洞百出的国际边界是一个主要的 寄生虫的引入和继续传播的贡献者。最近出现的抵制 青蒿素（ART）家族药物及其伙伴药物的滥用引起了全球关注。矢量系统 是高度多样化的，增加户外叮咬和杀虫剂抗性的发展，使 两种核心病媒控制措施-驱虫蚊帐和室内残留物喷洒效果较差。 此外，伪造和不合标准的以抗逆转录病毒疗法为基础的联合疗法已成为全球危机。 因此，该计划的中心目标是提高我们对移动的人口， 寄生虫抗药性和蚊子生物学有助于国际上疟疾的持续传播 因此，可以制定创新的控制战略，以推动区域疟疾的进程。 淘汰为了实现这一总体目标，我们在国际边界选择了研究地点， 缅甸、中国和泰国这三个GMS国家的地区，疟疾流行病学有很大不同， 在四个相互关联的项目中对人类、病媒和寄生虫进行综合研究。在项目 1，整个计划的基础，我们将进行疟疾监测，监测人类迁移及其 对寄生虫传入的影响，并评估目前治疗占主导地位的P。 间日疟项目2将研究环境变化如何影响蚊子群落结构， 疟疾传播，确定主要病媒的行为变化是否由基因决定， 确定疟疾病媒对杀虫剂抗药性的程度和机制。在项目3中，我们将解决 新出现的恶性疟原虫对ART家族药物和伙伴药物的耐药性问题， 抗性机制的分子研究和通过跟踪抗性在GMS中的传播。最后，我们希望 开发基于单克隆抗体的免疫测定法，以检测ACT中的两种活性成分，并使用我们的 新开发的即时检测试纸测定法，用于大规模评估 使用分层随机抽样方法，在GMS国家中对伪造和不合标准的青蒿素综合疗法进行调查。这 计划，建立在当前ICEMR计划的科学成就和强大的网络， 国际合作者，旨在剖析移民人口之间复杂的相互作用， 不同的蚊子媒介，耐多药寄生虫，以及伪造和不合标准的青蒿素综合疗法，这是造成 疟疾继续在沿着国际边界传播。这些科学问题不仅关系到 大湄公河次区域国家，但也适用于其他疟疾地区。因此，这些研究的结果将 对全球消灭疟疾产生深远影响。