Determinants of Malaria Disease in Malawi

成功的疟疾预防、控制和消除活动有赖于持续实施有效和有针对性的干预措施。开发创新方法和建立已有方法的新应用需要多学科研究。这项研究应该在跨越疟疾滋生的生态光谱的地点进行。与政策制定者的密切协调加强了从“数据”到政策的过渡。马拉维是南部非洲的一个内陆国家，是进行变革性疟疾研究的理想环境。马拉维境内几乎包含了与疟疾控制有关的所有生态地理环境。马拉维的疟疾研究已经进行了20多年，集中在马拉维大学医学院这一医学院。马拉维的相关决策机构--国家疟疾控制计划已经做出了一系列由数据驱动的决定，它与医学院的研究人员联系紧密。马拉维ICEMR将利用所有这些优势建立一个自给自足的研究实体，能够为设计、实施和评估疟疾控制和预防战略提供科学基础。核心活动(行政、数据管理和生物统计学以及分子和基因组)将设在医学院，研究活动将在3个流行病学不同的地点进行，所有地点都位于彼此相距50公里的范围内。这项研究的主要目标是确定、了解和评估针对疟疾决定因素的干预措施。我们将通过使用新开发的分子和基因组工具以及成熟的流行病学方法系统地调查病媒、宿主和寄生虫的种群来实现这些目标。描述了四个协同项目(两个在流行病学领域，两个在传播领域)。通过现有和新的沟通渠道，我们将确保将研究成果应用于政策制定。 在这项工作中建立的监测机制将为确定这些政策对疟疾感染和疾病的影响提供一种机制。

Successful malaria prevention, control and elimination activities depend on the sustained application of effective and well-targeted interventions. Developing innovative approaches and establishing novel applications of established approaches requires multi-disciplinary research. The research should be carried out in sites which span the ecological spectrum in which malaria thrives. Close coordination with policy makers enhances the transition from "data" to policy. Malawi, a landlocked country in southern Africa, is the ideal setting for transformative malaria research. Malawi contains within its boundaries nearly all of the eco-geographic settings relevant to malaria control. Malaria research in Malawi has been ongoing for over 20 years, and is concentrated in its one medical school, the University of Malawi College of Medicine. The National Malaria Control Program, the relevant policy-making body in Malawi, has made a series of data driven decisions, and its link with investigators in the College of Medicine is strong. The Malawi ICEMR will harness all of these advantages to establish a self-sustaining research entity capable of developing the scientific basis for designing, implementing, and evaluating malaria control and prevention strategies. Core activities (Administrative, Data Management and Biostatistics, and Molecular and Genomic) will be based in the College of Medicine, and research activities will take place in 3 epidemiologically diverse sites, all located within 50 kilometers of each other. The primary objectives of the research are to identify, understand and evaluate interventions that target the determinants of malaria disease. We will accomplish these objectives by systematically surveying populations of vectors, hosts and parasites using newly developed molecular and genomic tools in conjunction with well-established epidemiologic approaches. Four synergistic Projects (two in the area of epidemiology, and two in transmission) are described. Through existing and new communication channels we will ensure that research findings are brought to bear on policy development. The surveillance mechanisms established during this work will provide a mechanism for determining the impact of those policies on malaria infection and disease.