Pregnant women as a sentinel group for malaria surveillance in an era of changing malaria transmission (MiPMoz)

在疟疾传播不断变化的时代，孕妇作为疟疾监测的哨兵群体 (MiPMoz)

• 批准号: 9923523
• 负责人: EUSEBIO MACETE
• 金额: $ 13.46万
• 依托单位: FUNDACAO MANHICA
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-05-01 至 2022-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9923523
• 关键词: Address; Admission activity; Anti-malarial drug resistance; Antibodies; Antigens; Antimalarials; Area; Artemisinins; Biomedical Research; Birth Weight; Blood specimen; Body Temperature; Child; Childhood; Chloroquine; Choices and Control; Clinic; Clinical; Communities; Country; Data; Detection; Developing Countries; Disease; Drug resistance; Epidemiology; Exposure to; Fingers; Future; General Population; Generations; Gestational Age; Goals; Health; Health care facility; Hemoglobin concentration result; Hospitals; Immunity; Immunoglobulin G; Immunologics; Infection; Interruption; Investigation; Knowledge; Location; Malaria; Mediating; Molecular; Molecular Biology; Molecular Immunology; Monitor; Mozambique; Mutation; National Health Policy; Newborn Infant; Observational Study; Outcome; Paper; Parasite resistance; Parasites; Pharmaceutical Preparations; Placenta; Plasma; Plasmodium falciparum; Predisposition; Pregnancy; Pregnant Women; Prevalence; Preventive; Province; Proxy; Research; Sampling; Scientist; Sentinel; Sentinel Surveillance; Serologic tests; Serological; Seroprevalences; Sulfadoxine-pyrimethamine resistance; Surveillance Methods; Suspensions; Technology; Time; Training; Translations; Visit; Woman; adverse outcome; antenatal; biobank; burden of illness; clinical practice; density; epidemiology study; evidence base; improved; innovation; insight; malaria infection; malaria transmission; molecular marker; prospective; public health relevance; repository; tool; transmission process; trend

 DESCRIPTION (provided by applicant): Continued monitoring of malaria in pregnancy is lacking in most endemic settings, in spite of its significant disease burden. Increases in malaria-related harmful effects observed among Mozambican pregnant women after drastic malaria declines during the last decade [2] suggest that closely monitoring of the transmission is needed to quickly identify rebounds in adverse outcomes, especially in areas embarking in malaria elimination activities. Moreover, several evidences point to IgGs against VAR2CSA (the parasite antigen that mediates sequestration of P. falciparum in the placenta) as a marker of cumulative exposure to P. falciparum during pregnancy that can provide estimates of malaria transmission. We hypothesize that dynamics of malaria in pregnancy and pregnancy-specific immunity reflect changes in the intensity of transmission through location and time, not only among pregnant women but also in the underlying community. The goal of this study is to provide epidemiological, molecular and immunological insights of the value of pregnant women attending health facilities to generate estimates of malaria burden and its adverse consequences in situation of varying levels of malaria transmission, with the ultimate hope of developing new tools for the monitoring of malaria in endemic countries. To address this, we will conduct a three-year p study at three health facilities with different levels of malaria transmissin in Maputo Province to determine the relationship between malaria transmission, parasitological outcomes and the clinical impact of malaria infection in pregnant women at their first antenatal visit, delivery and during sick visits (Aim 1.1). Moreover, we will create a sample repository biobank for future investigations on host and parasite factors influencing malaria disease during pregnancy (Aim 1.2). We will also determine the relationship between malaria estimates obtained from pregnant women, children at hospital visits, (Aim 2.1) and seroprevalences against VAR2CSA (Aim 2.2). The impact of interrupting malaria transmission on pregnancy-specific serology (Aim 2.3) will be assessed in pregnant women from Magude after mass drug administration in the community. Finally, scientific capacity in the Manhiça Health Research Center (Aim 3) will be developed through training on a) epidemiological research and management of malaria data; b) molecular tools for detection of malaria parasites and molecular markers of antimalarial resistance for rapid mapping of drug resistance; and c) pregnancy- specific immunity as an innovative tool to assess malaria transmission. This study will contribute to promote a pregnancy malaria research agenda by improving our scientific knowledge on determinants of malaria susceptibility during pregnancy and demonstrating the feasibility and value of an easy-to-implement new generation serological tool for malaria surveillance in malaria elimination contexts.

 描述（由申请人提供）：在大多数地方性环境中，尽管妊娠期疟疾的疾病负担很重，但仍缺乏对妊娠期疟疾的持续监测。在过去十年中疟疾急剧下降后，莫桑比克孕妇中观察到的与疟疾有关的有害影响增加[2]，这表明需要密切监测传播情况，以迅速发现不良后果的反弹，特别是在开展消除疟疾活动的地区。此外，一些证据指出抗VAR 2CSA（介导胎盘中的恶性疟原虫隔离的寄生虫抗原）的IgG作为妊娠期间累积暴露于恶性疟原虫的标志物，其可以提供疟疾传播的估计。我们假设，疟疾在怀孕和妊娠特异性免疫力的动态反映了传播强度的变化，通过位置和时间，不仅在孕妇，而且在潜在的社区。本研究的目的是提供流行病学、分子和免疫学方面的见解，了解孕妇到卫生设施就诊的价值，以估计疟疾负担及其在不同疟疾传播水平情况下的不良后果，最终希望开发新的工具，用于监测疟疾流行国家的疟疾。为解决这一问题，我们将在马普托省三个疟疾传播水平不同的卫生机构进行一项为期三年的研究，以确定疟疾传播、寄生虫学结果和疟疾感染对孕妇在首次产前检查、分娩和生病期间的临床影响之间的关系（目标1.1）。此外，我们将建立一个样本库，用于今后调查影响妊娠期疟疾疾病的宿主和寄生虫因素（目标1.2）。我们还将确定从孕妇和儿童医院就诊时获得的疟疾估计值（目标2.1）与VAR 2CSA血清阳性率（目标2.2）之间的关系。将在社区大规模给药后，评估马古德孕妇阻断疟疾传播对妊娠特异性血清学的影响（目标2.3）。最后，Manhiça卫生研究中心（目标3）的科学能力将通过以下方面的培训得到发展：a）流行病学研究和疟疾数据管理; B）检测疟疾寄生虫的分子工具和抗疟药抗药性的分子标记，用于快速绘制抗药性图谱;以及c）妊娠特异性免疫作为评估疟疾传播的创新工具。这项研究将通过提高我们对怀孕期间疟疾易感性决定因素的科学知识，并证明易于实施的新一代血清学工具在消除疟疾背景下进行疟疾监测的可行性和价值，有助于促进怀孕疟疾研究议程。

项目成果

Detecting temporal and spatial malaria patterns from first antenatal care visits.

从第一次产前保健就诊中检测疟疾的时间和空间模式。

• DOI: 10.21203/rs.3.rs-2592126/v1
• 发表时间: 2023
• 期刊: Research square
• 作者: Pujol,Arnau;Brokhattingen,Nanna;Matambisso,Gloria;Mbeve,Henriques;Cisteró,Pau;Escoda,Anna;Maculuve,Sonia;Cuna,Boaventura;Melembe,Cardoso;Ndimande,Nelo;Munguambe,Humberto;Lopez,JuliaMontana;Nhamussa,Lidia;Simone,Wilson;Tetteh,
• 通讯作者: Tetteh,

Gravidity and malaria trends interact to modify P. falciparum densities and detectability in pregnancy: a 3-year prospective multi-site observational study.

• DOI: 10.1186/s12916-022-02597-6
• 发表时间: 2022-11-15
• 期刊: BMC MEDICINE
• 影响因子: 9.3
• 作者: Matambisso, Gloria;Brokhattingen, Nanna;Maculuve, Sonia;Cistero, Pau;Mbeve, Henriques;Escoda, Anna;Miguel, Judice;Buetas, Elena;de Jong, Ianthe;Cuna, Boaventura;Melembe, Cardoso;Ndimande, Nelo;Porras, Gemma;Chen, Haily;Tetteh, Kevin K. A.;Drakeley, Chris;Gamain, Benoit;Chitnis, Chetan;Chauhan, Virander;Quinto, Llorenc;Galatas, Beatriz;Macete, Eusebio;Mayor, Alfredo
• 通讯作者: Mayor, Alfredo

Targeted and whole-genome sequencing reveal a north-south divide in P. falciparum drug resistance markers and genetic structure in Mozambique.

• DOI: 10.1038/s42003-023-04997-7
• 发表时间: 2023-06-08
• 期刊: COMMUNICATIONS BIOLOGY
• 影响因子: 5.9
• 作者: da Silva, Clemente;Boene, Simone;Datta, Debayan;Rovira-Vallbona, Eduard;Aranda-Diaz, Andres;Cistero, Pau;Hathaway, Nicholas;Tessema, Sofonias;Chidimatembue, Arlindo;Matambisso, Gloria;Nhama, Abel;Macete, Eusebio;Pujol, Arnau;Nhamussua, Lidia;Galatas, Beatriz;Guinovart, Caterina;Enosse, Sonia;De Carvalho, Eva;Rogier, Eric;Plucinski, Mateusz M.;Colborn, James;Zulliger, Rose;Saifodine, Abuchahama;Alonso, Pedro L.;Candrinho, Baltazar;Greenhouse, Bryan;Aide, Pedro;Saute, Francisco;Mayor, Alfredo
• 通讯作者: Mayor, Alfredo