Epidemiology and Population Genetics of Malaria Parasites in Kenya

肯尼亚疟疾寄生虫的流行病学和群体遗传学

• 批准号: 10642702
• 负责人: Brook Jeang
• 金额: $ 4.32万
• 依托单位: UNIVERSITY OF CALIFORNIA-IRVINE
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-05-11 至 2025-04-10
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10642702
• 关键词: Africa; Africa South of the Sahara; African; Area; Bioinformatics; Blood; Cessation of life; Clinical; Communicable Diseases; Communities; Country; County; Data; Detection; Development; Diagnosis; Diagnostic Procedure; Disease; Disease Outbreaks; Dryness; Effectiveness of Interventions; Epidemiologic Monitoring; Epidemiologist; Epidemiology; Exhibits; Faculty; Genetic; Genotype; Geography; Goals; Health care facility; Hospitals; Household; Incidence; Infection; Infectious Disease Epidemiology; Infrastructure; Intervention; Kenya; Leadership; Malaria; Malaria Diagnostic; Maps; Measures; Mentorship; Microsatellite Repeats; Molecular; Molecular Epidemiology; Morbidity - disease rate; Nosocomial Infections; Outcome; Parasites; Pattern; Plasmodium; Population Genetics; Prevalence; Program Reviews; Public Health; Reporting; Research; Research Personnel; Residual state; Resolution; Risk; Sampling; Spatial Distribution; Spottings; Stratification; Surveillance Methods; System; Testing; Training; burden of illness; career; deep sequencing; design; detection method; effective therapy; effectiveness evaluation; epidemiologic data; experience; genetic epidemiology; genetic variant; global health; improved; indexing; international center; malaria infection; malaria transmission; member; mortality; multidisciplinary; novel strategies; programs; scale up; screening; skills; spatial epidemiology; stem; tool; transmission process; vector

Project Summary Scale-up of vector interventions, improved diagnosis, and effective treatment have collectively contributed to significant global reductions in malaria mortality and morbidity over the last 15 years. Nevertheless, malaria burden remains high in sub-Saharan Africa, which reported 215 million cases and 380,000 deaths in 2019. Malaria burden reduction is not uniform, with some countries or regions continuously exhibiting high incidence whereas others show drastic reductions. Consequently, many African countries have proposed sub-national stratification of malaria risk and have developed corresponding surveillance and intervention plans to target heterogeneous malaria burden. As the prevalence of clinical malaria cases decreases, transmission becomes more focal and the proportion of malaria infections that are asymptomatic increases. Asymptomatic cases typically go undetected and untreated. They constitute an obscure parasite reservoir, silently sustaining transmission and threatening malaria control and elimination efforts. Functional and responsive malaria surveillance systems are necessary for quantifying the true burden of disease, identifying residual transmission foci for targeted control, and evaluating the effectiveness of interventions. Enhanced surveillance methods and more sensitive malaria diagnostic methods are needed to detect symptomatic and asymptomatic infections in low-transmission settings. The central objective of this F31 application is to examine the spatial and genetic epidemiology of malaria parasites in low-transmission regions in Kenya in the context of rapidly declining transmission following the implementation of intensive control programs. I will examine the effectiveness of hospital-based clinical malaria cases and reactive case detection methods in transmission hotspot detection (Aim 1), and investigate the genetic connectivity and diversity of malaria infections within and among clusters of malaria cases using amplicon deep sequencing and microsatellite typing (Aim 2). Identification of transmission hotspots will inform malaria intervention strategies best suited to local epidemiological contexts. Patterns of genetic connectivity among parasite isolates will reveal the geographical spread and transmission network of malaria infections. These data will improve our understanding of malaria epidemiology in settings where transmission is rapidly declining, thus guiding decision-makers in tailoring optimal strategies to achieve local malaria control and elimination goals. This proposed research will have broad implications for malaria surveillance in other areas of Africa that are experiencing significant reductions in malaria transmission. Under the mentorship of a multidisciplinary team, I will gain skills in infectious disease epidemiology, spatial epidemiology, molecular population genetics, and bioinformatics while developing leadership and professional skills that are necessary to prepare me for a career as an independent global health researcher and infectious disease epidemiologist.

项目摘要 病媒干预措施的扩大、诊断的改进和有效的治疗共同促成了 在过去15年里，全球疟疾死亡率和发病率大幅下降。然而，疟疾 撒哈拉以南非洲的负担仍然很高，2019年报告了2.15亿例病例和38万例死亡。 疟疾负担的减轻并不统一，一些国家或地区的疟疾发病率持续高企 而其它的显示出急剧的减少。因此，许多非洲国家提出了国家以下一级的建议， 疟疾风险分层，并制定了相应的监测和干预计划， 不同疟疾负担。随着临床疟疾病例流行率的下降， 疟疾感染的病灶更大，无症状疟疾感染的比例增加。无症状病例 一般都不会被发现也不会被治疗它们构成了一个隐蔽的寄生虫库， 传播和威胁疟疾控制和消除工作。功能性和应对性疟疾 监测系统对于量化疾病的真实负担、识别残余传播、 有针对性的控制重点，并评估干预措施的有效性。加强监测方法， 需要更敏感的疟疾诊断方法来检测有症状和无症状的感染， 低传输设置。这个F31应用程序的中心目标是检查空间和 肯尼亚低传播地区疟疾寄生虫的遗传流行病学研究 实施强化控制计划后，传播率下降。我会检查 以医院为基础的疟疾临床病例和反应性病例检测方法在传播中的有效性 热点检测（目标1），并调查疟疾感染的遗传连通性和多样性， 使用扩增子深度测序和微卫星分型（Aim 2）在疟疾病例群中进行研究。识别 传播热点的信息将为最适合当地流行病学情况的疟疾干预战略提供信息。 寄生虫分离株之间的遗传连接模式将揭示寄生虫的地理传播和传播 疟疾感染网络。这些数据将提高我们对环境中疟疾流行病学的理解 传播迅速下降，从而指导决策者制定最佳战略， 地方疟疾控制和消除目标。这项拟议中的研究将对疟疾产生广泛的影响 在非洲其他疟疾传播显著减少的地区开展监测。下 一个多学科团队的指导，我将获得传染病流行病学，空间 流行病学，分子群体遗传学和生物信息学，同时发展领导和专业 这些技能是必要的准备我的职业生涯作为一个独立的全球卫生研究人员和传染病 疾病流行病学家