Epidemiology

流行病学

• 批准号: 8009114
• 负责人: WILLIAM J MOSS
• 金额: $ 34.27万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 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/8009114
• 关键词: 10 year old; Address; Africa South of the Sahara; Age; Algorithms; Antigens; Area; Artemisinins; Behavior; Belief; Biology; Child; Clinics and Hospitals; Combined Modality Therapy; Communities; Community Participation; Complex; Country; Culicidae; Data; Development; Disease Progression; Ecological Change; Epidemiology; Etiology; Face; Foundations; Functional disorder; Goals; Household; Incidence; Individual; Intervention; Kenya; Knowledge; Link; Malaria; Measures; Mosses; Parasitemia; Parasites; Pattern; Perception; Plasmodium; Plasmodium falciparum; Population; Prevalence; Prevention; Prevention strategy; Recording of previous events; Research; Research Institute; Residual state; Risk; Risk Factors; Rural; Seasons; Seroprevalences; Site; Southern Africa; Staging; Structure; Surveys; Sustainable Development; Time; Transgenic Organisms; Vaccines; Zambia; Zimbabwe; artemisinine; base; cost; evidence base; health belief; indexing; mathematical model; novel; prospective; response; surveillance data; transmission process; vector

The long-term project goal is to provide the evidence-base for the development of sustainable strategies to further reduce malaria transmission in southern Africa and assess the feasibility of malaria elimination through an integrated understanding of local malaria epidemiology, vector biology, parasite populafion structure and community and household-level beliefs and actions. Building upon the Johns Hopkins Malaria Research Institute field site in Choma District in rural southern Zambia as a regional center of excellence in malaria research, we propose to invesfigate the changing epidemiology of malaria in three disfinct transmission settings in southern Africa reflecting different stages of malaria control (successful - Choma, ineffective - Nchelenge, resurgent - Mutasa) through prospective hospital, clinic and community-based studies to address the following: Aim 1) Measure changes in spafio-temporal patterns of malaria parasitemia in three disfinct epidemiological settings in southern Africa and identify individual, household and ecological risk factors for symptomafic and asymptomatic parasitemia in each setting; Aim 2) Identify individual, household and ecological risk factors for gametocyte carriage during high and low transmission seasons in three disfinct epidemiological settings in southern Africa; Aim 3) Measure spatio-temporal changes in agespecific anfibody responses to Plasmodium falciparium anfigens using sero-epidemiological surveys in the three regions of southern Africa; Aim 4) Idenfify targeted, risk-based combinations of malaria control strategies that are cost-effective and acceptable to the community using mathematical modeling approaches to optimize decision algorithms based on locally available survey and surveillance data. Detailed understanding of malaria transmission dynamics in three different epidemiological settings will thus inform the development of locally-adapted, cost-effective and community-supported strategies for malaria control. These epidemiological invesfigafions will be closely linked with studies of spafio-temporal changes in the anopheline vector and Plasmodium populafion structure in response to ecological changes and malaria control efforts. This integrated, evidence-based approach to malaria control will form the foundation for a regional center of excellence for malaria research in southern Africa and the foundation for regional malaria eliminafion.

长期项目的目标是为制定可持续战略提供证据基础，以进一步减少南部非洲的疟疾传播，并通过综合了解当地疟疾流行病学、病媒生物学、寄生虫种群结构以及社区和家庭一级的信念和行动，评估消灭疟疾的可行性。在赞比亚南部农村Choma区的约翰霍普金斯疟疾研究所现场作为疟疾研究的区域卓越中心的基础上，我们建议调查南部非洲三个不同传播环境中疟疾流行病学的变化，反映疟疾控制的不同阶段（成功- Choma，无效- Nchelenge，复苏- Mutasa）通过前瞻性医院，诊所和社区研究，以解决以下问题：目标1）衡量南部非洲三个不同流行病环境中疟疾寄生虫血症时空模式的变化，并确定每种环境中寄生虫血症和无症状寄生虫血症的个人、家庭和生态风险因素;目标2）在南部非洲三个不同的流行病背景下，确定在传播高峰和低谷季节配子体携带的个人、家庭和生态风险因素;目标3）在南部非洲三个区域利用血清流行病学调查测量年龄特异性抗疟抗体对恶性疟原虫的应答的时空变化;目标4）确定目标，基于风险的疟疾控制战略组合，使用数学模型方法，根据本地现有的调查和监测数据优化决策算法，以提高效率，并为社会所接受。因此，详细了解三种不同流行病背景下的疟疾传播动态将为制定适合当地情况、具有成本效益和社区支持的疟疾控制战略提供信息。 这些流行病学调查将与按蚊媒介和疟原虫种群结构的时空变化研究密切相关，以应对生态变化和疟疾控制工作。这种综合的、以证据为基础的疟疾控制方法将为南部非洲疟疾研究区域英才中心和区域消除疟疾基金会奠定基础。