Identifying the Distribution, Origin, and Threat of Plasmodium vivax in the DRC

项目摘要 由间日疟原虫引起的疟疾每年在全球范围内造成严重的发病率甚至死亡。然而，它 长期以来一直被认为在撒哈拉以南非洲地区没有出现，因为一种突变的高度流行 赋予Duffy阴性表型，保护宿主免受感染。尽管达菲的负面言论 表型以前被证明是保护性的，最近来自撒哈拉以南非洲的报告发现 间日疟原虫在达菲阴性宿主中的活跃传播。这表明间日疟原虫可以感染达菲- 消极的宿主引发了几个问题，包括感染发生在哪里，谁被感染，哪里 这些感染是否来源于，最后是持续传播的历史和程度。这个 这项建议的目标是填补这一关键的知识空白，并为公共卫生官员提供 形成有针对性干预的战略所需的信息。 在这项提案中，我们将使用人口健康调查(DHS)在2013-2014年间收集的数据 刚果民主共和国国土安全部标准调查(研究ID：DRC DHS-II)。这在全国范围内 代表性调查包括刚果民主共和国约25,000名成年男子、妇女和儿童。从… 每个人，我们有超过500个人口和行为协变量，间日疟原虫疟疾状况，以及 地理信息。使用这个强大的数据集，这项提议的具体目标是：(1)地图间日疟原虫 在刚果民主共和国流行和确定与感染有关的风险因素 使用2013-2014年人口健康调查和(2)使用全基因组测序，确定 感染源，并确定在刚果民主共和国境内持续传播的程度 刚果间日疟原虫种群。 通过这个研究方案和相关的培训计划，我将获得一套独特的跨学科技能 它以一种创新的方式将流行病学和人口遗传学结合在一起，走在了 传染病流行病学。这次培训将为我提供技术、统计和专业知识 我需要的技能才能成为学术中心的领导者，并追求我的国际化实践目标 作为一名内科科学家从事医学和研究。

Project Abstract Malaria due to Plasmodium vivax causes significant global morbidity and even mortality each year. However, it has long been considered absent from Sub-Saharan Africa due to the high prevalence of a mutation that confers the Duffy-negative phenotype and protects the host from infection. Although the Duffy-negative phenotype has been previously shown to be protective, recent reports from Sub-Saharan Africa have identified active transmission of P. vivax among Duffy-negative hosts. This indication that P. vivax can infect Duffy- negative hosts raises several questions, including where are infections occurring, who is being infected, where are these infections being sourced from, and finally, the history and extent of ongoing transmission. The objective of this proposal is to fill this critical gap in knowledge and provide public health officials with the information needed to form strategies for targeted interventions. In this proposal, we will use data collected by the Demographic Health Survey (DHS) during the 2013-2014 Standard DHS Survey of the Democratic Republic of the Congo (Study ID: DRC DHS-II). This nationally representative survey included approximately 25,000 adult men, women, and children across the DRC. From each individual, we have over 500 demographic and behavioral covariates, P. vivax malaria status, and geographical information. Using this robust dataset, the Specific Aims of this proposal are: (1) Map P. vivax prevalence and identify risk factors associated with infection in the Democratic Republic of the Congo using the 2013-2014 Demographic Health Survey and (2) Using whole genome sequencing, identify the source of infection and determine the extent of ongoing transmission among the Democratic Republic of the Congo P. vivax population. Through this research proposal and associated training plan, I will gain a unique and interdisciplinary skill-set that combines epidemiology with population genetics in an innovative manner that is at the forefront of infectious disease epidemiology. This training will provide me with the technical, statistical, and professional skills I need to become a leader at an academic center and to pursue my goals of practicing international medicine and research as a physician scientist.