Malaria Operations Research to Improve Malaria Control and Reduce Morbidity and Mortality in Western Kenya

疟疾行动研究旨在改善肯尼亚西部的疟疾控制并降低发病率和死亡率

• 批准号: 10242605
• 负责人: FEIKO OLAF TER KUILE
• 金额: $ 40万
• 依托单位: TMLIVERPOOL SCHOOL OF TROPICAL MEDICINE
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-01 至 2022-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10242605
• 关键词: Malaria; Operations; Research; Improve; Control

Project summary This application is for the fourth, 5-year CoAG between CDC’s Malaria Branch and the Liverpool School of Tropical Medicine (LSTM). Activities take place in western Kenya under the umbrella of the long-term collaboration between the Kenya Medical Research Institute (KEMRI), CDC, and LSTM and benefit from LSTM’s existing infrastructure in Kenya. The research strategy follows the 5 objectives of the NOFO. The first objective involves the expansion in 2020/21 of the epidemiological (1.1) and entomological surveillance (1.2) platform to track progress towards malaria transmission reduction targets following the introduction of population-wide interventions in 2021/22. To maintain low transmission status, this requires a shift from the existing periodic, district-level surveillance to systems where surveillance itself becomes an intervention and can detect individual geo-located cases near real-time for rapid notification and foci investigation. We will support the Kenyan Ministry of Health (MoH) with their goal to digitise the data collected on their paper-based health registers using software that makes them scannable (1.1.5). This will include registers that capture case-burden data used in out-patient departments (1.1.6) and by community health workers as part of integrated community case management (ICCM) (1.1.7), and antenatal clinic registers that capture malaria infection prevalence during first antenatal clinic visits. This is a novel method to track the asymptomatic parasite reservoir in populations (1.1.8). Combined, this allows, for the first time, sustainable, daily, near real-time surveillance to track progress towards malaria transmission reduction targets. We will also conduct continuous malaria indicator household surveys (cMIS) to track malaria prevalence and intervention coverage (1.1.9) and entomological monitoring (1.2), both using adaptive sampling frameworks that can respond to challenges related to rapid changes in malaria transmission. As part of the second objective, we will implement population-wide interventions targeting malaria transmission, starting in 2021/22. The optimal combination of novel or improved interventions will be developed in close collaboration with CDC in 2020/21. This is likely to include enhanced case- management using digitally supported quality improvement approaches of ICCM, enhanced vector control with larval source management and insecticide-treated piperonyl butoxide (PBO) nets, and mass drug administration with dihydroartemisinin-piperaquine and ivermectin targeting the asymptomatic parasite reservoir (2.1). The third objective involves assessing the safety effectiveness of currently deployed antimalarials for the prevention (3.2.1) and treatment (3.2 and 3.3) of malaria in the context of increasing antimalarial drug resistance. We will liaise with CDC’s laboratories in Atlanta for the molecular monitoring of drug resistance. The fourth objective aims to maximise the public health impact by supporting the creation of a knowledge centre at the KEMRI’s CGHR for evidence synthesis and information exchange to enhance the translation of global malaria control policies (4). Objective 5 involves the strengthening of research capacity of the partners in Kenya by the provision of internships (5.1) and MSc, PhD and post-doctoral studentships and research leadership mentoring (5.1).

项目摘要 本申请是CDC疟疾分支和利物浦热带学校之间的第四次5年CoAG 医学（LSTM）。在肯尼亚西部开展的活动是在下列机构长期合作的框架内进行的： 肯尼亚医学研究所（KEMRI），CDC和LSTM，并受益于LSTM现有的基础设施， 肯尼亚.研究战略遵循NOFO的5个目标。第一个目标是扩大 2020/21年流行病学（1.1）和昆虫学监测（1.2）平台，以跟踪疟疾防治进展 在2021/22年引入全民干预措施后实现减少传播的目标。保持 低传输状态，这需要从现有的定期，地区一级的监测系统， 监测本身成为一种干预措施，可以近实时地发现个别地理位置的病例， 通报和疫源地调查。我们将支持肯尼亚卫生部（MoH）实现数字化目标， 使用可扫描的软件在纸质健康登记册上收集数据（1.1.5）。这将 包括记录门诊部（1.1.6）和社区卫生部门使用病例负担数据的登记册 作为综合社区病例管理（ICCM）一部分的工作人员（1.1.7），产前诊所登记， 在首次产前门诊就诊时掌握疟疾感染率。这是一种新颖的方法来跟踪 无症状寄生虫宿主（1.1.8）。结合起来，这是第一次，可持续的，每天， 近实时监测，以跟踪减少疟疾传播目标的进展情况。我们还将进行 持续进行疟疾指标住户调查，以跟踪疟疾流行率和干预措施覆盖率（1.1.9） 和昆虫学监测（1.2），两者都使用能够应对挑战的适应性取样框架 与疟疾传播的快速变化有关。作为第二个目标的一部分，我们将在全国范围内实施 从2021/22年开始，采取针对疟疾传播的干预措施。新的或改进的组合物的最佳组合 在2020/21年度，将与CDC密切合作制定干预措施。这可能包括增强的情况下， 利用国际化学品管理大会的数字化支持质量改进方法进行管理， 幼虫来源管理和杀虫剂处理过的胡椒基丁醚（PBO）网， 针对无症状寄生虫宿主的双氢青蒿素-哌喹和伊维菌素（2.1）。第三 目的是评估目前部署的抗疟药物预防疟疾的安全有效性（3.2.1） 以及在抗疟药物抗药性增加的情况下治疗疟疾（3.2和3.3）。我们将与 疾病预防控制中心在亚特兰大的实验室进行耐药性的分子监测。第四个目标是最大限度地 通过支持在KEMRI的CGHR建立一个知识中心， 综合和信息交流，以加强全球疟疾控制政策的转化（4）。目标5 通过提供实习机会，加强肯尼亚合作伙伴的研究能力（5.1）， 硕士，博士和博士后研究生和研究领导指导（5.1）。