Ecology of African Highland Malaria

项目总结 标题：非洲高原疟疾的生态学 在过去的十年中，杀虫剂处理蚊帐(ITN)和室内残留的大规模扩大 喷洒(IRS)以及青蒿素联合治疗的引入导致了 非洲高原疟疾流行率和发病率的大幅下降。然而， 杀虫剂抗药性的上升和户外传播的增加极大地阻碍了 ITN和IRS的有效性，因为目前的室内干预没有针对 在户外叮咬的蚊子。因此，大多数高原地区都保持了持续的低海拔。 疟疾的传播水平有所下降，而其他一些国家的疟疾发病率最近出现了回升。 因此，新的补充干预措施可以应对室外传播和 人们迫切需要拟除虫菊酯类杀虫剂的抗性。这样做的中心目标是 竞争续期申请是为了确定以下各项的效果和成本效益 美国环保署批准的长效微生物杀幼虫剂，用于减少疟疾传播和 肯尼亚西部高地的临床疟疾发病率。三个具体目标是：1) 研究调节幼虫栖息地生产力的机制，2)确定 长效微生物杀幼虫在减少疟疾传播和临床疟疾中的作用 使用整群随机研究的发病率，以及3)确定 长效微生物杀幼虫计划与其他疟疾控制措施的比较 并评估其对非目标生物的影响。通过综合评估 潜在具有成本效益的长效微生物杀幼虫剂，该项目将提供关键的 关于长效微生物杀幼虫剂是否可以作为补充剂扩大规模的需要数据 进一步减少非洲高原疟疾发病率的疟疾控制工具。户外疟疾 传播控制目前是疟疾中一个非常重要和紧迫的问题。 控制整个非洲，因此，我们的结果将对疟疾产生广泛影响 非洲疫区和疫区的防控。

PROJECT SUMMARY Title: Ecology of African Highland Malaria In the past decade, massive scale-up of insecticide-treated nets (ITN) and indoor residual spraying (IRS), together with the introduction of artemisinin-combination treatments, have led to substantial reductions in malaria prevalence and incidence in African highlands. However, rising insecticide resistance and increased outdoor transmission have greatly hampered the effectiveness of ITN and IRS because the current indoor-based interventions do not target the outdoor-biting mosquitoes. Consequently, most highland sites maintain sustained low- level transmission while some others have recently experienced resurgence in malaria rates. Therefore, new supplemental interventions that can tackle outdoor transmission and pyrethroid insecticide resistance are urgently needed. The central objective of this competing renewal application is to determine the efficacy and cost-effectiveness of EPA-approved long-lasting microbial larvicides in reducing malaria transmission and clinical malaria incidence in western Kenya highlands. The three specific aims are: 1) to examine mechanisms regulating larval habitat productivity, 2) to determine the efficacy of long-lasting microbial larvicides on the reduction of malaria transmission and clinical malaria incidence using a cluster randomized study, and 3) to determine the cost-effectiveness of the long-lasting microbial larviciding program as compared to other malaria control interventions and evaluate its impact on non-target organisms. Through comprehensive evaluation of potentially cost-effective long-lasting microbial larvicides, this project will provide critically needed data on whether long-lasting microbial larvicides can be scaled up as a supplemental malaria control tool to further reduce malaria incidence in African highlands. Malaria outdoor transmission control is presently a highly significant and urgent issue in malaria control across Africa, and thus, our results will have broad implications on malaria prevention and control in endemic and epidemic regions of Africa.