Amazonian Center of Excellence in Malaria Research

亚马逊疟疾研究卓越中心

• 批准号: 9263618
• 负责人: Marcelo Urbano Ferreira
• 金额: $ 29.74万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至 2024-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9263618
• 关键词: Accounting; Address; Amino Acids; Anopheles Genus; Area; Behavior; Behavioral Genetics; Biological; Biology; Brazil; Characteristics; Clinical; Clinical Treatment; Communities; Complex; Culicidae; Data; Data Set; Early Diagnosis; Early treatment; Ecology; Effectiveness; Environment; Epidemiology; Falciparum Malaria; Genetic Polymorphism; Genome; Geography; Goals; Heterogeneity; Human; Immunity; Immunologics; Immunology; Incidence; Individual; Infection; Insecticides; Intervention; Lead; Longitudinal Studies; Longitudinal cohort study; Maintenance; Malaria; Measures; Microsatellite Repeats; Modeling; Molecular; Molecular Epidemiology; Morbidity - disease rate; Movement; Occupations; Outcome; Parasitemia; Parasites; Patients; Pattern; Periodicity; Peru; Peruvian; Phase; Plasmodium falciparum; Plasmodium vivax; Polymorphism Analysis; Population; Population Genetics; Population Replacements; Prevalence; Protein Microarray Assay; Proteins; Public Health; Research; Research Activity; Residual state; Serologic tests; Single Nucleotide Polymorphism; Site; Social Interaction; Testing; Time; Translating; Work; anthropogenesis; attributable mortality; base; demographics; epidemiologic data; experimental study; genome sequencing; improved; indexing; malaria transmission; mathematical model; novel strategies; population based; predictive modeling; programs; public health intervention; time use; tool; transmission process; urban area; vector; vector control; whole genome

The broad, long-term objective of this project is to guide malaria elimination strategies in Amazonia taking into account human, environmental, and biological features that combine to maintain hypoendemic malaria in the region. The complexity of Amazonian malaria is augmented by intense human movement related to work and social interactions, which combined with asymptomatic infections lead to “silent” reservoirs of malaria parasites moving across space and time. Over the past ICEMR project period, population-based longitudinal cohort studies in Brazil and Peru have demonstrated complex patterns of malaria transmission in epidemiologically contrasting sites (e.g., increasing transmission vs. disappearing malaria). This new Project will continue longitudinal studies to delineate a fine level of malaria transmission and endemicity complexity in these and new sites. This Project is based on the primary hypothesis (as is the entire Amazonia ICEMR program) that asymptomatic, subpatent parasitemia drive ongoing hypoendemic malaria. Residual malaria (due to outdoor-biting Anopheles darlingi mosquitoes potentially related to anthropogenically-driven changing vector behaviors and genetics, Project 2) and emerging, complex patterns of malaria reintroductions has made studying alternative approaches to malaria elimination a critical issue. In this project we seek to understand the patterns and determinants of two contrasting malaria epidemiological settings in the Amazon: residual malaria with continuing hypoendemicity, and foci of high transmission. These settings have different local ecologies (riverine, highway and urban areas) and human behavior (e.g., bednet use, occupation, mobility). In Aim 1, we will gather data to calculate and interpret local indices of transmission, and to comprehensively identify local determinants of malaria transmission. Aim 1 integrates all three Projects of the ICEMR by identifying and characterizing the context of malaria cases, and referring symptomatic and asymptomatic patients to Project 2 to guide mosquito population characterization and transmission biology studies, and to Project 3 for immunological experiments, respectively. In Aim 2 comprehensive molecular epidemiological approaches and population genetics will be used to identify temporal population changes in P. vivax and P. falciparum, to detect reintroductions and parasite population replacements, and to estimate parasite population complexity at baseline and potentially after interventions. Aim 3, also integrating all three ICEMR projects, will model the dynamics of malaria transmission, simulate the optimal intervention packages to reduce malaria in epidemiologically contrasting settings, explicitly accounting for ecological heterogeneity and differences in human socio-demographics. This Project will contribute new solutions to ongoing and emerging malaria challenges in Amazonia. The comprehensive molecular and epidemiological data sets from this Project, integrated with Project 2, studies of vector ecology and transmission biology, and with Project 3, immunology of asymptomatic malaria, will provide a roadmap for new approaches to malaria elimination.

该项目的广泛、长期目标是指导亚马逊地区的疟疾消除战略 考虑人类、环境和生物特征，这些特征结合起来维持低流行性疟疾 地区。与工作和工作相关的剧烈人类活动加剧了亚马逊疟疾的复杂性。 社会互动与无症状感染相结合，导致疟疾寄生虫的“沉默”储存库 跨越空间和时间。在过去的 ICEMR 项目期间，基于人群的纵向队列 巴西和秘鲁的研究表明，从流行病学角度来看，疟疾传播的复杂模式 对比地点（例如，传播增加与疟疾消失）。这个新项目将继续进行 纵向研究，以详细描述这些地区和地区的疟疾传播和流行病的复杂性 新网站。该项目基于主要假设（整个亚马逊 ICEMR 计划也是如此） 无症状、隐匿性寄生虫血症导致持续的低流行性疟疾。残留疟疾（由于 室外叮咬达林按蚊可能与人为驱动有关 改变媒介行为和遗传学，项目 2) 以及新出现的复杂疟疾模式 重新引入使得研究消除疟疾的替代方法成为一个关键问题。在这个 该项目旨在了解两种截然不同的疟疾流行病学的模式和决定因素 亚马逊地区的环境：残留疟疾持续低流行，以及高传播灶。这些 不同的环境具有不同的当地生态（河流、高速公路和城市地区）和人类行为（例如蚊帐） 使用、职业、流动性）。在目标 1 中，我们将收集数据来计算和解释本地传播指数， 并全面查明疟疾传播的当地决定因素。目标 1 整合了所有三个项目 ICEMR 的方法是识别和描述疟疾病例的背景，并参考有症状和 无症状患者参加项目 2，指导蚊子种群特征和传播生物学 研究，以及项目 3 分别进行免疫学实验。 In Aim 2 综合分子 流行病学方法和群体遗传学将用于识别 P. 间日疟原虫和恶性疟原虫，检测重新引入和寄生虫种群替代，并估计 基线时和干预后可能的寄生虫种群复杂性。目标 3，也整合这三个目标 ICEMR 项目将模拟疟疾传播的动态，模拟最佳干预方案 减少流行病学对比环境中的疟疾，明确考虑生态异质性 以及人类社会人口统计的差异。该项目将为正在进行的和 亚马逊流域新出现的疟疾挑战。全面的分子和流行病学数据集 该项目与项目 2（媒介生态学和传播生物学研究）以及项目 3 相结合， 无症状疟疾的免疫学将为消除疟疾的新方法提供路线图。