Southeast Asia Malaria Research Center

东南亚疟疾研究中心

• 批准号: 10380169
• 负责人: LIWANG CUI
• 金额: $ 233.63万
• 依托单位: UNIVERSITY OF SOUTH FLORIDA
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-07-01 至 2024-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10380169
• 关键词: Achievement; Address; Affect; Anti-malarial drug resistance; Antibodies; Artemisinins; Behavioral; Biological Assay; Biology; Biostatistics Core; Blood Circulation; Breeding; Cambodia; China; Chloroquine resistance; Collaborations; Combined Modality Therapy; Communities; Complex; Country; Culicidae; Development; Disease; Drug resistance; Ecology; Effectiveness; Epidemiological trend; Epidemiology; Face; Falciparum Malaria; Family; Fostering; Foundations; Genomics; Goals; Heterogeneity; Human; Immunoassay; Individual; Insecticide Resistance; Insecticides; International; Intervention; Knowledge; Laos; Malaria; Measures; Migrant; Molecular; Monitor; Monoclonal Antibodies; Multi-Drug Resistance; Myanmar; Parasite resistance; Parasites; Pharmaceutical Preparations; Phase; Plasmodium falciparum; Plasmodium vivax; Politics; Population; Population Biology; Province; Public Health; Pyrimethamine; Research; Resistance; Sampling; Scientist; Series; Site; Southeastern Asia; Structure; System; Thailand; United States; Ursidae Family; Vietnam; Vivax Malaria; base; data management; detection assay; effectiveness evaluation; environmental change; human migration; improved; innovation; innovative technologies; interdisciplinary approach; malaria transmission; new combination therapies; point of care; programs; resistance mechanism; resistant Plasmodium falciparum; socioeconomic development; southeast Asian; transmission process; vector; vector control; vector mosquito

OVERALL SUMMARY Malaria in the Greater Mekong Subregion (GMS) of Southeast Asia remains an important public health problem. There is immense spatial heterogeneity in malaria distribution, with Myanmar having the highest regional malaria burden. Highly mobile populations crossing porous international borders are a major contributor to parasite introduction and continued transmission. The recent emergence of resistance to the artemisinin (ART) family of drugs as well as to their partner drugs raised global concerns. The vectorial system is highly diverse, and increased outdoor biting and development of insecticide resistance have rendered the two core vector control interventions – insecticide-treated nets and indoor residue spray less effective. Furthermore, falsified and substandard ART-based combination therapies (ACTs) have become a global crisis. Therefore, the central goal of this program is to improve our understanding of how mobile human populations, parasite drug resistance, and mosquito biology contribute to continuous malaria transmission at international borders so that innovative control strategies can be developed to propel the course of regional malaria elimination. To achieve this overarching objective, we have selected study sites in the international border regions of three GMS countries, Myanmar, China, and Thailand, with drastically different malaria epidemiology to conduct comprehensive research on humans, vectors, and parasites in four interrelated projects. In Project 1, the foundation of the whole program, we will conduct malaria surveillance, monitor human migration and its impact on parasite introduction, and evaluate the effectiveness of the current treatment of the predominant P. vivax malaria. Project 2 will study how environmental changes affect mosquito community structures and malaria transmission, identify whether behavioral changes of major vectors are genetically determined, and determine the extent and mechanisms of insecticide resistance in malaria vectors. In Project 3, we will address the emerging problem of resistance of P. falciparum to both the ART family of drugs and partner drugs through molecular studies of resistance mechanisms and by tracking resistance spread in the GMS. Finally, we want to develop monoclonal antibody-based immunoassays to detect both active ingredients in an ACT, and use our newly developed point-of-care dipstick assays for large-scale assessment of the extent of problem of the falsified and substandard ACTs in the GMS countries using a stratified random sampling approach. This program, built on the scientific achievements of the current ICEMR program and the strong network of international collaborators, aims to dissect the complex interactions between migrant human populations, diverse mosquito vectors, MDR parasites, and falsified and substandard ACTs, which are responsible for continued malaria transmission along international borders. These scientific questions are not only pertinent to the GMS nations, but are also applicable to other malaria regions. Therefore, findings from these studies will bear far-reaching impacts on global malaria elimination.

总体总结 东南亚大湄公河次区域（GMS）的疟疾仍然是一个重要的公共卫生问题 疟疾分布存在巨大的空间异质性，其中缅甸的异质性最高。 跨越松散的国际边界的高度流动人口是一个主要的区域性疟疾负担。 最近出现了对寄生虫的抵抗力。 青蒿素（ART）家族药物及其伙伴药物引起了全球的关注。 高度多样化，户外叮咬的增加和杀虫剂抗药性的发展使得 两项核心病媒控制干预措施——经杀虫剂处理的蚊帐和室内残留喷洒的效果较差。 此外，伪造和不合格的基于 ART 的联合疗法 (ACT) 已成为一场全球危机。 因此，该计划的中心目标是提高我们对流动人口如何、 寄生虫耐药性和蚊子生物学导致疟疾在国际上持续传播 边界，以便制定创新的控制战略来推动区域疟疾的发展 为了实现这一总体目标，我们在国际边境选择了研究地点。 缅甸、中国和泰国这三个大湄公河次区域国家的地区疟疾流行病学差异很大 在四个相互关联的项目中对人类、媒介和寄生虫进行全面研究。 1、整个计划的基础，我们将进行疟疾监测，监测人类迁徙及其影响 对寄生虫引入的影响，并评估当前对主要疟原虫的治疗的有效性。 项目 2 将研究环境变化如何影响蚊子群落结构和 疟疾传播，确定主要媒介的行为变化是否由基因决定，以及 确定疟疾病媒对杀虫剂耐药性的程度和机制 在项目 3 中，我们将解决这一问题。 恶性疟原虫对 ART 系列药物和伙伴药物产生耐药性的新问题 耐药机制的分子研究以及追踪大湄公河次区域耐药性的传播最后，我们想要。 开发基于单克隆抗体的免疫测定法来检测 ACT 中的两种活性成分，并使用我们的 新开发的即时检测试纸检测，用于大规模评估问题的严重程度 GMS 国家采用分层随机抽样方法发现伪造和不合格的 ACT。 计划，建立在当前 ICEMR 计划的科学成果和强大的网络之上 国际合作者，旨在剖析移民人口之间复杂的相互作用， 不同的蚊子媒介、MDR 寄生虫以及伪造和不合格的 ACT 是导致 这些科学问题不仅与疟疾沿国际边界的持续传播有关。 GMS 国家，但也适用于其他疟疾地区，因此，这些研究的结果将是。 对全球消除疟疾产生深远影响。