Does treating low density malaria infections reduce malaria transmission?
治疗低密度疟疾感染是否可以减少疟疾传播?
基本信息
- 批准号:10574796
- 负责人:
- 金额:$ 7.78万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2023
- 资助国家:美国
- 起止时间:2023-04-06 至 2025-03-31
- 项目状态:未结题
- 来源:
- 关键词:AcuteAdultAfrica South of the SaharaAfricanAgeAnopheles gambiaeAntimalarialsAreaArea Under CurveBiological AssayBiteCaliforniaChildChronicClinicalComparison armConsensusCosts and BenefitsCulicidaeDataDetectionDiagnosticDiseaseDrynessFeverFundingHealthHumanIndividualInfectionInterruptionInterventionMalariaMalaria DiagnosticMeasuresModelingMolecularMonoclonal AntibodiesParasitesParticipantPeriodicalsPharmaceutical PreparationsPoliciesPolicy MakerPrevalencePreventive treatmentPrimaquineRandomizedResidual stateRoleRuralSamplingSan FranciscoSchool-Age PopulationSchoolsScienceSeasonsSkinSymptomsTanzaniaTarget PopulationsTestingTimeTranslatingUnited States National Institutes of HealthUniversitiesWorkage grouparmartemetherbenflumetolcohortdensityfeedinghuman old age (65+)infection ratemalaria infectionmalaria transmissionmolecular diagnosticspoint of carerapid testsuccesstransmission processtreatment armvaccine distribution
项目摘要
ABSTRACT
Evidence is now robust that asymptomatic carriers contribute to the bulk of malaria transmission in Sub-
Saharan Africa, where 95% of the global malaria burden resides. This is true in both high and low transmission
settings. In areas where malaria control efforts have achieved some success and transmission has declined, it
may be hard to make further progress without interventions targeting the asymptomatic infectious reservoir.
We have worked in rural Bagamoyo district in coastal Tanzania since 2018, characterizing the asymptomatic
reservoir and performing mosquito feeding studies to better understand human-to-mosquito transmission from
low density malaria infections (LMI). This work has involved direct skin feeding assays to measure the
infectivity of > 500 children and adults to Anopheles gambiae, with ongoing analyses examining the
relationship of gametocytemia and other covariates to the likelihood of transmission (infectiousness) and
mosquito infection rates. Now, in conjunction with the University of California San Francisco and the Ifakara
Health Institute, we have the opportunity to leverage this data to understand how treatment of LMI through
periodic active case detection in children can lead to a reduction in gametocyte carriage and the infectious
reservoir. The “Low-density malaria infection (LMI) trial among children in Tanzania” (U01AI155315, PI: Hsiang
and Olotu) will assess whether treating LMI in children results in clinical benefits on long-term health. Over two
years, 200 children in Bagamoyo district randomized to undergo malaria active case detection with molecular
testing (ACDm) will be screened 3 times each year (during biannual transmission peaks and at end of second
peak) using an ultrasensitive PCR, and receive antimalarial therapy if positive. They will also be followed
monthly and treated if they present with fever and are positive on a rapid test, as per standard passive case
detection (PCD). In the comparator arm, 200 children will receive PCD only. In this proposed project, we will
measure gametocytemia from monthly surveillance samples to determine the effects of proactive treatment of
LMI on gametocyte prevalence and gametocyte AUC (area under the curve) in each study arm (Aim 1). Since
reductions in gametocyte carriage will variably translate into reduced transmissibility across individuals based
on factors such as age, symptom status, and seasonality, we will use data from our Bagamoyo skin feed
cohort to model how reductions in gametocytemia translates to a reduction in human-to-mosquito transmission
in both study arms (Aim 2). We hypothesize that active case detection of LMI will reduce gametocyte carriage
and days of infectiousness in children to a greater extent than that achieved by PCD alone. The proposed work
will quantify the potential transmission-reducing benefit of using ultrasensitive diagnostics to actively detect and
treat LMI in African children. Findings will be important to policymakers and advance the science behind efforts
to interrupt transmission and achieve malaria elimination.
摘要
现在有充分的证据表明,无症状的携带者促成了亚热带地区大部分的疟疾传播。
撒哈拉非洲占全球疟疾负担的95%。在高、低传输中均是如此
设置.在疟疾控制工作取得一些成功和传播下降的地区,
如果不针对无症状感染宿主进行干预,可能很难取得进一步进展。
自2018年以来,我们一直在坦桑尼亚沿海的巴加莫约农村地区工作,
水库和进行蚊子喂养研究,以更好地了解人与蚊子的传播,
低密度疟疾感染(LMI)。这项工作涉及直接皮肤喂养测定,以测量
> 500名儿童和成人对冈比亚按蚊的感染性,正在进行的分析
配子细胞血症和其他协变量与传播可能性(传染性)的关系,以及
蚊子感染率。现在,与加州大学旧金山弗朗西斯科和伊法卡拉大学合作,
卫生研究所,我们有机会利用这些数据来了解如何治疗LMI,
儿童定期发现活动性病例可导致配子体携带和传染性减少
水库“坦桑尼亚儿童低密度疟疾感染(LMI)试验”(U 01 AI 155315,PI:Hsiang
和Olotu)将评估治疗儿童LMI是否会对长期健康产生临床益处。两个多
2000年,巴加莫约区的200名儿童随机接受分子标记的疟疾活动病例检测,
将每年筛查3次(在一年两次的传播高峰期间和第二次结束时)
峰值),并接受抗疟治疗,如果阳性。他们也将遵循
每月一次,如果他们出现发烧,并在快速测试中呈阳性,则按照标准被动病例进行治疗
检测(PCD)。在对照组中,200名儿童将仅接受PCD。在这个项目中,我们将
从每月监测样本中测量配子体血症,以确定积极治疗的效果。
每个研究组中配子体患病率和配子体AUC(曲线下面积)的LMI(目标1)。以来
配子体携带的减少将不可避免地转化为个体间传递性的降低,
根据年龄、症状状态和季节性等因素,我们将使用来自巴加莫约皮肤饲料的数据
一个队列来模拟配子体血症的减少如何转化为人-蚊传播的减少
在两个研究组中(目标2)。我们假设,主动检测LMI病例将减少配子体携带
和儿童的传染性天数比单独PCD更大程度地减少。拟议工作
将量化使用超灵敏诊断积极检测和
治疗非洲儿童的LMI。研究结果对政策制定者来说很重要,并推动了努力背后的科学
以阻断传播并实现消灭疟疾。
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
数据更新时间:{{ journalArticles.updateTime }}
{{
item.title }}
{{ item.translation_title }}
- DOI:
{{ item.doi }} - 发表时间:
{{ item.publish_year }} - 期刊:
- 影响因子:{{ item.factor }}
- 作者:
{{ item.authors }} - 通讯作者:
{{ item.author }}
数据更新时间:{{ journalArticles.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ monograph.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ sciAawards.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ conferencePapers.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ patent.updateTime }}
Jessica Lin其他文献
Jessica Lin的其他文献
{{
item.title }}
{{ item.translation_title }}
- DOI:
{{ item.doi }} - 发表时间:
{{ item.publish_year }} - 期刊:
- 影响因子:{{ item.factor }}
- 作者:
{{ item.authors }} - 通讯作者:
{{ item.author }}
{{ truncateString('Jessica Lin', 18)}}的其他基金
Development of novel diagnostics for African non-falciparum malaria
非洲非恶性疟疾新型诊断方法的开发
- 批准号:
10206017 - 财政年份:2020
- 资助金额:
$ 7.78万 - 项目类别:
Development of novel diagnostics for African non-falciparum malaria
非洲非恶性疟疾新型诊断方法的开发
- 批准号:
10057106 - 财政年份:2020
- 资助金额:
$ 7.78万 - 项目类别:
Determinants of malaria transmission by submicroscopic gametocytemia
亚显微配子体血症传播疟疾的决定因素
- 批准号:
9926215 - 财政年份:2018
- 资助金额:
$ 7.78万 - 项目类别:
Determinants of malaria transmission by submicroscopic gametocytemia
亚显微配子体血症传播疟疾的决定因素
- 批准号:
10400098 - 财政年份:2018
- 资助金额:
$ 7.78万 - 项目类别:
Determinants of malaria transmission by submicroscopic gametocytemia
亚显微配子体血症传播疟疾的决定因素
- 批准号:
10189493 - 财政年份:2018
- 资助金额:
$ 7.78万 - 项目类别:
Genetic determinants of Plasmodium vivax relapse
间日疟原虫复发的遗传决定因素
- 批准号:
8679282 - 财政年份:2014
- 资助金额:
$ 7.78万 - 项目类别:
Genetic determinants of Plasmodium vivax relapse
间日疟原虫复发的遗传决定因素
- 批准号:
8991706 - 财政年份:2014
- 资助金额:
$ 7.78万 - 项目类别:
Genetic determinants of Plasmodium vivax relapse
间日疟原虫复发的遗传决定因素
- 批准号:
9222696 - 财政年份:2014
- 资助金额:
$ 7.78万 - 项目类别:
相似海外基金
Co-designing a lifestyle, stop-vaping intervention for ex-smoking, adult vapers (CLOVER study)
为戒烟的成年电子烟使用者共同设计生活方式、戒烟干预措施(CLOVER 研究)
- 批准号:
MR/Z503605/1 - 财政年份:2024
- 资助金额:
$ 7.78万 - 项目类别:
Research Grant
Early Life Antecedents Predicting Adult Daily Affective Reactivity to Stress
早期生活经历预测成人对压力的日常情感反应
- 批准号:
2336167 - 财政年份:2024
- 资助金额:
$ 7.78万 - 项目类别:
Standard Grant
RAPID: Affective Mechanisms of Adjustment in Diverse Emerging Adult Student Communities Before, During, and Beyond the COVID-19 Pandemic
RAPID:COVID-19 大流行之前、期间和之后不同新兴成人学生社区的情感调整机制
- 批准号:
2402691 - 财政年份:2024
- 资助金额:
$ 7.78万 - 项目类别:
Standard Grant
Elucidation of Adult Newt Cells Regulating the ZRS enhancer during Limb Regeneration
阐明成体蝾螈细胞在肢体再生过程中调节 ZRS 增强子
- 批准号:
24K12150 - 财政年份:2024
- 资助金额:
$ 7.78万 - 项目类别:
Grant-in-Aid for Scientific Research (C)
Migrant Youth and the Sociolegal Construction of Child and Adult Categories
流动青年与儿童和成人类别的社会法律建构
- 批准号:
2341428 - 财政年份:2024
- 资助金额:
$ 7.78万 - 项目类别:
Standard Grant
Understanding how platelets mediate new neuron formation in the adult brain
了解血小板如何介导成人大脑中新神经元的形成
- 批准号:
DE240100561 - 财政年份:2024
- 资助金额:
$ 7.78万 - 项目类别:
Discovery Early Career Researcher Award
Laboratory testing and development of a new adult ankle splint
新型成人踝关节夹板的实验室测试和开发
- 批准号:
10065645 - 财政年份:2023
- 资助金额:
$ 7.78万 - 项目类别:
Collaborative R&D
Usefulness of a question prompt sheet for onco-fertility in adolescent and young adult patients under 25 years old.
问题提示表对于 25 岁以下青少年和年轻成年患者的肿瘤生育力的有用性。
- 批准号:
23K09542 - 财政年份:2023
- 资助金额:
$ 7.78万 - 项目类别:
Grant-in-Aid for Scientific Research (C)
Identification of new specific molecules associated with right ventricular dysfunction in adult patients with congenital heart disease
鉴定与成年先天性心脏病患者右心室功能障碍相关的新特异性分子
- 批准号:
23K07552 - 财政年份:2023
- 资助金额:
$ 7.78万 - 项目类别:
Grant-in-Aid for Scientific Research (C)
Issue identifications and model developments in transitional care for patients with adult congenital heart disease.
成人先天性心脏病患者过渡护理的问题识别和模型开发。
- 批准号:
23K07559 - 财政年份:2023
- 资助金额:
$ 7.78万 - 项目类别:
Grant-in-Aid for Scientific Research (C)