Project A: Epidemiology

摘要 尽管在包括赞比亚在内的南部非洲大部分地区在降低疟疾发病率和死亡率方面取得了进展， 津巴布韦，挑战依然存在。在赞比亚北方的Nchelenge区等一些地区， 尽管实施了标准病例管理和病媒控制， 措施在边境另一边的刚果民主共和国，只有有限的病媒控制干预措施 已经实施。再往南，在津巴布韦东部的穆塔萨地区， 新出现的杀虫剂抗药性和跨境疟疾传播威胁着消除疟疾的工作。的 出现抗药性的潜在风险是对区域疟疾控制的威胁。重要的是，增加 将分配资源和努力，以减少疟疾在高传播环境中的传播， 赞比亚北方的卢阿普拉省和毗邻的刚果民主共和国加丹加省 (DRC)，并在季节性传播地区（如东部）防止疟疾死灰复燃和消除疟疾 辛巴威.南部和中部非洲ICEMR将解决三个关键的研究问题， 在这些流行病背景下控制疟疾的重要性：1）中度至高度疟疾的模式和驱动因素 疟疾传播水平; 2）控制方面的具体障碍，包括杀虫剂抗药性、抗疟药物 耐药性和跨境疟疾传播; 3）疟疾控制的最佳组合 干预措施。

Abstract Despite progress in reducing malaria morbidity and mortality in much of southern Africa, including Zambia and Zimbabwe, challenges persist. In some regions, such as Nchelenge District in northern Zambia, malaria transmission remains high despite implementation of standard case management and vector control measures. Across the border in the Democratic Republic of Congo, only limited vector control interventions have been implemented. Further south, in Mutasa District in eastern Zimbabwe, recent gains in malaria control and elimination are threatened by emerging insecticide resistance and cross-border malaria transmission. The potential risk of emergent drug resistance is a threat to regional malaria control. Importantly, increased resources and efforts will be allocated to reduce malaria transmission in high transmission settings such as Luapula Province in northern Zambia and the adjacent Katanga Province in the Democratic Republic of Congo (DRC), and to prevent resurgence and eliminate malaria in areas with seasonal transmission such as eastern Zimbabwe. The Southern and Central Africa ICEMR will address three research questions of critical importance to malaria control in these epidemiological settings: 1) patterns and drivers of moderate to high level malaria transmission; 2) specific barriers to control, including insecticide resistance, antimalarial drug resistance and cross-border malaria transmission; and 3) the optimal combination of malaria control interventions.