Changing Epidemiology of South Asian Malaria

项目1总结： 南亚的东北走廊有恶性疟原虫高水平的地区，发病率高， 和高水平的药物失败。与此形成鲜明对比的是，印度南部地区仍然主要携带P。 间日疟原虫在这些地区，疟疾的表现似乎比较温和。有趣的是， 印度中部正在迅速变化，因此提供了一个非凡的机会来研究可能发生变化的因素。 推动了疟疾的进化。 对印度中部恶性疟原虫水平较高的最明显的解释是， 寄生虫株正在从“源”点（涉及高毒力）转移到新的“汇”点， 在历史上表现出更良性的间日疟原虫感染。另一个更有趣的解释是， “寄生虫”不需要移动;由特定基因编码的特定毒力性状可以通过 跨区域重组。获得了新的毒力特性的本地寄生虫可能会更多地竞争 有效地对抗当地间日疟原虫寄生虫种群。为了研究这一点，项目1的一个总体目标是 目的是系统、仔细地确定南亚地区恶性疟原虫和间日疟原虫的种群结构。一 第二个总体目标是确定寄生虫的详细基因型分析是否允许我们将寄生虫 基因型与特定疾病结果的关系。

PROJECT 1 SUMMARY: The north-east corridor of South Asia has regions with high level of P. falciparum, high levels of pathogenesis, and high levels of drug failures. In complete contrast, southern regions of India still carry predominantly P. vivax. In these regions malaria presentations appear more benign. Interestingly, profiles of malaria cases in central India are changing rapidly thus providing an extraordinary opportunity to study the factors that may be driving the evolution of malaria. The most obvious explanation for higher levels of P. falciparum in central India is that specific parasite strains are moving from "source" sites (involving high levels of virulence) to new "sink" sites, which historically presented more benign P. vivax infections. Another, more intriguing explanation is that the "whole parasite" does not need to move; specific virulence traits, coded by specific genes, may propagate by recombination across regions. Local parasites that have acquired new virulence traits may compete more effectively against local P. vivax parasite populations. In order to investigate this, one general goal of Project 1 is to systematically and carefully define the population structures of P. falciparum and P. vivax in South Asia. A second general goal is to determine if detailed genotypic analysis of parasites allow us to correlate parasite genotypes to specific disease outcomes.