Malaria Epidemiology In Southeast Asia: Intra- and Inter-Country Dynamics

项目1总结 尽管最近全球疟疾发病率和死亡率有所下降，但大湄公河地区的疟疾 东南亚次区域(GMS)仍然是最重要的公共卫生问题之一。当国家 在这一区域正在走向消灭疟疾之际，他们面临着一系列艰巨的挑战，包括 疟疾在国际边界的持续传播、多种药物的引进和传播 来自邻国的人类迁徙产生的抗药性疟疾寄生虫，以及持久的疟疾原虫 间日疟。因此，我们战略性地选择了泰国中国国际边境的学习地点 疟疾流行程度差异很大的国家和缅甸，以解决这些问题。最重要的是 本项目的目标是获得有关导致疟疾的因素的关键流行病学信息。 在大湄公河次区域持续存在边境疟疾，以便能够制定更有效的疟疾控制战略。在……里面 这个项目，我们的目标是(1)进行疟疾监测，并使用高度敏感的分子诊断工具 确定疟疾感染的传播热点和危险因素；(2)确定和监测 年边境地区寄生虫种群多样性变化的防治方案和寄生虫引种 使用种群基因组和景观遗传工具的空间和时间；以及3)评估 氯喹-伯氨喹方案根治高发边境地区间日疟 葡萄糖-6-磷酸脱氢酶缺乏症的患病率。该项目为以下项目奠定了重要基础 ICEMR方案的其他项目，并将为制定和评估提供关键知识 疟疾综合管理战略。

PROJECT 1 SUMMARY Despite the recent global reduction in malaria morbidity and mortality, malaria in the Greater Mekong Subregion (GMS) of Southeast Asia remains one of the most important public health problems. While nations in this region are moving towards malaria elimination, they face a daunting array of challenges, including continuous transmission of malaria along the international borders, introduction and spread of multidrug resistant malaria parasites by human migrants from neighboring countries, and the persistent Plasmodium vivax malaria. Accordingly, we strategically select study sites at the international borders of China, Thailand and Myanmar, which vary significantly in malaria endemicity, to address these problems. The overarching objective of this project is to gain critical epidemiological information about factors contributing to the persistence of border malaria in the GMS so that more effective malaria control strategies can be developed. In this project, we aim to (1) conduct malaria surveillance and use highly sensitive molecular diagnostic tools to identify transmission hotspots and risk factors for malaria infection; (2) determine and monitor the impact of control programs and parasite introduction in the border regions on changes in parasite population diversity in space and time using population genomic and landscape genetic tools; and 3) evaluate the effectiveness of the chloroquine-primaquine treatment regimen as a radical cure of vivax malaria in border areas with high prevalence of glucose-6-phosphate dehydrogenase deficiency. This project lays important foundations for other projects of the ICEMR program, and will provide critical knowledge for developing and evaluating integrated malaria management strategies.