Epidemiology of Malaria in the Peruvian and Brazilian Amazon

秘鲁和巴西亚马逊地区疟疾的流行病学

• 批准号: 8005385
• 负责人: Marcelo Urbano Ferreira
• 金额: $ 38.86万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-07-01 至 2017-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8005385
• 关键词: Address; Advocate; Agriculture; Anopheles Genus; Area; Biological Assay; Biology; Brazil; Clinical; Cohort Studies; Communities; Complement; Country; Culicidae; Data; Diagnosis; Disease; Disease Outbreaks; Doctor of Medicine; Epidemic; Epidemiology; Future; Genetic; Genotype; Goals; Gold; Human; Incidence; Infection; Institution; Intervention; Laboratories; Life; Malaria; Malaria Vaccines; Measurement; Membrane; Microscopic; Mining; Molecular Diagnosis; Monitor; Parasites; Pathogenesis; Peru; Prevalence; Principal Investigator; Production; Protocols documentation; Public Health; Research; Research Infrastructure; Risk; Risk Factors; Rural; Site; Surveys; Testing; Time; Translating; Universities; Virulence; asexual; base; cohort; disorder risk; feeding; migration; multidisciplinary; population based; population survey; programs; transmission process; vector

Institutions based in two malaria-endemic countries, Brazil and Peru, are partnering with a leading research group in the USA with the long-term goal of providing scientific evidence that can be translated into effective public health interventions for malaria control in Amazonia. To determine whether asymptomatic parasite carriage is a major contributor to malaria transmission across the region, we aim: (a) to estimate the prevalence, incidence and risk factors for asymptomatic malaria parasite carriage in rural Amazonia; (b) to estimate the prevalence, incidence, average duration and risk factors for gametocyte carriage; (c) to compare the ability of symptomatic and asymptomatic carriers of gametocytes to experimentally infect wild caught local vectors; (d) to compare prospectively the risk of subsequent clinical malaria among asymptomatic parasite carriers and non-infected controls living in the same communities and to determine whether these episodes are due to persistent parasite lineages or to new infections; and (e) to test whether intra-host competition of genetically distinct parasite clones contributes to increased parasite virulence, greater risk of disease, and increased gametocyte production. These aims will be achieved with population based surveys, using uniformized clinical and laboratory protocols, in three epidemiologically diverse Amazonian settings: (a) a typical agricultural settlement with endemic malaria transmission in Brazil, (b) periurban villages in Peru that became recently exposed to epidemic malaria, and (c) gold-mining enclaves in Peru with explosive malaria outbreaks due to P. vivax. The field-based clinical and epidemiological analysis will be complemented with measurements of immunological parameters, extensive parasite genotyping and experimental infections of mosquitoes through membrane-feeding assays, providing a unique multidisciplinary perspective on the public health significance of asymptomatic parasite carriage in the Amazon Basin. Of crucial importance, the infrastructure and the data resulting of seven years of active malaria surveillance in the field sites will establish the bases for the vector biology and pathogenesis components ofthis proposal and for implementing future malaria vaccine trials in the Amazon region.

巴西和秘鲁这两个疟疾流行国家的机构正在与美国的一个领先研究小组合作，其长期目标是提供科学证据，这些证据可以转化为亚马逊流域疟疾控制的有效公共卫生干预措施。为了确定无症状疟疾寄生虫携带是否是该地区疟疾传播的主要原因，我们的目标是： (a) 估计亚马逊流域农村地区无症状疟疾寄生虫携带的患病率、发病率和风险因素； (b) 估计配子体携带的患病率、发生率、平均持续时间和风险因素； (c) 比较有症状和无症状的配子体携带者通过实验感染野生捕获的当地媒介的能力； (d) 前瞻性地比较生活在同一社区的无症状寄生虫携带者和未感染对照者随后患临床疟疾的风险，并确定这些事件是由于持续存在的寄生虫谱系还是新感染所致； (e) 测试遗传上不同的寄生虫克隆的宿主内竞争是否会导致寄生虫毒力增加、疾病风险增加以及配子体产生增加。这些目标将通过在三个流行病学不同的亚马逊环境中使用统一的临床和实验室方案进行基于人口的调查来实现：(a) 巴西发生地方性疟疾传播的典型农业定居点，(b) 最近暴露于流行性疟疾的秘鲁城郊村庄，以及 (c) 由于疟原虫引起的爆发性疟疾爆发的秘鲁金矿飞地。 间日疟原虫。基于现场的临床和流行病学分析将辅以免疫学参数测量、广泛的寄生虫基因分型和通过膜喂养测定对蚊子进行的实验感染，从而为亚马逊流域无症状寄生虫携带的公共卫生意义提供独特的多学科视角。至关重要的是，基础设施和七年实地疟疾主动监测所产生的数据将为该提案的媒介生物学和发病机制部分以及未来在亚马逊地区实施疟疾疫苗试验奠定基础。