Peruvian/Brazilian Amazon Center of Excellence in Malaria

秘鲁/巴西亚马逊疟疾卓越中心

• 批准号: 8101196
• 负责人: Joseph M. Vinetz
• 金额: $ 166.52万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 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 2017-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8101196
• 关键词: Peruvian; Brazilian; Amazon; Center; Excellence

DESCRIPTION (provided by applicant): The overall research aim of this Center of Excellence in Malaria Research is to organize a comprehensive approach to understanding the biological features of Amazonian malaria towards the ultimate goal of regional control and elimination of Plasmodium falciparum and P. vivax. We focus primarily on P. vivax due to its greater impact in the region. We anticipate that the lessons learned will contribute towards the audacious goal of global malaria eradication. An integrated and interactive set of 5 projects will be supported by Administrative, Data Management and Shared Laboratory Resource Cores to study malaria epidemiology, vector biology and ecology, diagnostics, transmission biology and clinical pathogenesis towards the goal of malaria control, regional elimination and eradication in the Amazon region of South America. Three epidemiological distinct sites primarily affected by P. vivax (~80% of cases) but also by P. falciparum (~20%) of cases will be studied: Acre, Brazil; Iquitos, Peru; and Madre de Dio/Puerto Maldonado, Peru. Investigators from University of Sao Paulo and the Universidad Peruana Cayetano Heredia in Lima, Peru will be the lead foreign collaborators, and will join forces with lead institution University of California San Diego, and collaborating institutions Wadsworth Center of the New York Health Department, Johns Hopkins School of Public Health, and the U.S. Naval Medical Research Center Detachment, Lima, Peru to carry out the aims of the Center. RELEVANCE: The Peru/Brazil Center of Excellence in Malaria Research will take an integrated approach to the study of malaria epidemiology, vector biology and ecology, diagnostics, transmission biology and clinical pathogenesis to underpin malaria control, elimination and eradication efforts in the Amazon region of South America. PROJECT 1: Title: Epidemiology of Malaria in the Peruvian and Brazilian Amazon Project Leader: Ferreira, M. PROJECT 1 DESCRIPTION (provided by applicant): Institutions based in two malaria-endemic countries, Brazil and Peru, are partnering with a leading research group in the USA with the long-term goal of providing scientific evidence that can be translated into effective public health interventions for malaria control in Amazonia. To determine whether asymptomatic parasite carriage is a major contributor to malaria transmission across the region, we aim: (a) to estimate the prevalence, incidence and risk factors for asymptomatic malaria parasite carriage in rural Amazonia; (b) to estimate the prevalence, incidence, average duration and risk factors for gametocyte carriage; (c) to compare the ability of symptomatic and asymptomatic carriers of gametocytes to experimentally infect wild-caught local vectors; (d) to compare prospectively the risk of subsequent clinical malaria among asymptomatic parasite carriers and non-infected controls living in the same communities and to determine whether these episodes are due to persistent parasite lineages or to new infections; and (e) to test whether intra-host competition of genetically distinct parasite clones contributes to increased parasite virulence, greater risk of disease, and increased gametocyte production. These aims will be achieved with population-based surveys, using uniformized clinical and laboratory protocols, in three epidemiologically diverse Amazonian settings: (a) a typical agricultural settlement with endemic malaria transmission in Brazil, (b) periurban villages in Peru that became recently exposed to epidemic malaria, and (c) gold-mining enclaves in Peru with explosive malaria outbreaks due to P. vivax. The field-based clinical and epidemiological analysis will be complemented with measurements of immunological parameters, extensive parasite genotyping and experimental infections of mosquitoes through membrane-feeding assays, providing a unique multidisciplinary perspective on the public health significance of asymptomatic parasite carriage in the Amazon Basin. Of crucial importance, the infrastructure and the data resulting from seven years of active malaria surveillance in the field sites will establish the bases for the vector biology and pathogenesis components of this proposal and for implementing future malaria vaccine trials in the Amazon region. RELEVANCE: At a time when eradication is advocated as the ultimate goal of malaria control strategies worldwide, it remains unclear why malaria proved so difficult to control in areas of relatively low levels of transmission across the Amazon Basin. We hypothesize that asymptomatic infections may represent a major reservoir of parasites in this region, which is not addressed by traditional malaria control strategies.

描述（由申请人提供）：该疟疾研究卓越中心的总体研究目标是组织一种全面的方法来了解亚马逊疟疾的生物学特征，以实现区域控制和消除恶性疟原虫和间日疟原虫的最终目标。我们主要关注间日疟原虫，因为它在该地区的影响更大。我们预计所吸取的经验教训将有助于实现全球消灭疟疾的大胆目标。行政、数据管理和共享实验室资源核心将支持一组综合和互动的 5 个项目，以研究疟疾流行病学、媒介生物学和生态学、诊断学、传播生物学和临床发病机制，以实现疟疾控制、区域消除和根除的目标。南美洲亚马逊地区。将研究主要受间日疟原虫（约 80% 病例）影响但也受恶性疟原虫（约 20%）病例影响的三个流行病学地点：巴西阿克里；秘鲁伊基托斯；和秘鲁马德雷德迪奥/马尔多纳多港。来自圣保罗大学和秘鲁利马秘鲁卡耶塔诺埃雷迪亚大学的研究人员将成为主要的外国合作者，并将与牵头机构加州大学圣地亚哥分校以及合作机构纽约卫生部沃兹沃斯中心、约翰·霍普金斯大学联手公共卫生学院和位于秘鲁利马的美国海军医学研究中心支队共同实现该中心的目标。 相关性：秘鲁/巴西疟疾研究卓越中心将采取综合方法研究疟疾流行病学、媒介生物学和生态学、诊断学、传播生物学和临床发病机制，以支持亚马逊地区的疟疾控制、消除和根除工作。南美洲。 项目1： 标题：秘鲁和巴西亚马逊地区疟疾的流行病学 项目负责人：费雷拉，M. 项目 1 描述（由申请人提供）：巴西和秘鲁这两个疟疾流行国家的机构正在与美国的一个领先研究小组合作，其长期目标是提供可转化为有效公共卫生的科学证据亚马逊流域疟疾控制干预措施。为了确定无症状疟疾寄生虫携带是否是该地区疟疾传播的主要原因，我们的目标是： (a) 估计亚马逊农村地区无症状疟疾寄生虫携带的患病率、发病率和风险因素； (b) 估计配子体携带的患病率、发生率、平均持续时间和风险因素； (c) 比较有症状和无症状的配子体携带者通过实验感染野生捕获的当地媒介的能力； (d) 前瞻性地比较生活在同一社区的无症状寄生虫携带者和未感染对照者随后患临床疟疾的风险，并确定这些事件是由于持续存在的寄生虫谱系还是由于新的感染； (e) 测试遗传上不同的寄生虫克隆的宿主内竞争是否会导致寄生虫毒力增加、疾病风险增加以及配子体产生增加。这些目标将通过基于人口的调查，使用统一的临床和实验室方案，在三个流行病学不同的亚马逊环境中实现：(a) 巴西流行疟疾传播的典型农业定居点，(b) 最近暴露于疟疾传播的秘鲁城郊村庄流行性疟疾；(c) 秘鲁的金矿飞地因间日疟原虫爆发了爆炸性疟疾。基于现场的临床和流行病学分析将辅以免疫学参数测量、广泛的寄生虫基因分型和通过膜喂养测定对蚊子进行的实验感染，从而为亚马逊流域无症状寄生虫携带的公共卫生意义提供独特的多学科视角。至关重要的是，基础设施和七年实地疟疾主动监测所产生的数据将为该提案的媒介生物学和发病机制部分以及未来在亚马逊地区实施疟疾疫苗试验奠定基础。 相关性：在提倡根除疟疾作为全世界疟疾控制战略的最终目标之际，目前尚不清楚为什么在亚马逊流域传播水平相对较低的地区，疟疾控制如此困难。我们假设无症状感染可能是该地区寄生虫的主要储存库，而传统的疟疾控制策略无法解决这一问题。