Genomics and sero-epidemiology of Plasmodium falciparum malaria in a pre-elimination setting

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PROJECT SUMMARY/ABSTRACT Malaria continues to severely impact public health in countries around the world. Some countries like Ecuador made impressive progress in the first 10-15 years of this century. Nevertheless, recent years have seen stagnation and malaria cases are increasing again. While most cases of Plasmodium falciparum in Northwest Ecuador appear to originate in the Pacific coast of Colombia, asymptomatic reservoirs of this parasite are common and may be important in maintaining transmission within Ecuador. One of the main problems for malaria elimination is the presence of asymptomatic reservoirs. To better understand the malaria transmission dynamics in this pre-eliminating region, we will characterize the genetics of the parasites circulating in northwest Ecuador (symptomatic and asymptomatic), identify serological biosignatures of infection and define the relationships between the clinical outcome of the infection, parasite genetics and serological markers. Lastly, we will validate the role of acquired immunity in disease severity, clonal persistence, and outbreak emergence through innovative in vitro assays. This project will inform local control decisions in Ecuador, and, most importantly, provide a model for understanding disease persistence in other pre-elimination settings around the world.