Identifying gaps between LLIN use and vector exposure to improve malaria control

确定 LLIN 使用和媒介暴露之间的差距，以改善疟疾控制

基本信息

批准号：
10647800
负责人：
Paul Joseph Krezanoski
金额：
$ 19.72万
依托单位：
UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-07-01 至 2024-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10647800
关键词：
Address Adherence Affect Africa African Anopheles Genus Area Award Beds Bite Blood Cessation of life Characteristics Child Classification Cohort Studies Culicidae Data Dedications Electronics Entomology Epidemiology Exposure to Female Future Genotype Goals Health Hour Household Human Incidence Individual Insecticides International Intervention Life Link Location Longitudinal cohort Malaria Malaria prevention Measurement Measures Mentored Patient-Oriented Research Career Development Award Mentorship Modeling Monitor Multivariate Analysis National Institute of Allergy and Infectious Disease Participant Patient Self-Report Pattern Persons Predisposition Prevention Public Health Recommendation Reporting Research Research Activity Resolution Risk Sleep Testing Training Uganda United States National Institutes of Health Universal Coverage Update Variant Vertebral column Work World Health Organization career cohort density design disease transmission experience high risk improved infectious disease model innovation invention malaria transmission new technology novel strategies programs scale up sensor skills tool transmission process vector

项目摘要

PROJECT SUMMARY/ABSTRACT Malaria affects three billion people worldwide. Despite remarkable reductions in malaria incidence over the last 15 years, recent evidence shows that our traditional control tools are weakening. Long-lasting insecticide-treated bednets (LLINs) are the most widely used tool for malaria prevention and have contributed significantly to decreases in malaria incidence, but recent studies suggest that LLINs are either less effective than before or people are not using them as reported. A rigorous assessment of how the timing and location of vector exposure intersects with real-life use of LLINs could be vitally important to regain the initiative in malaria control. However, the lack of a reliable measure of LLIN use presents a major challenge. Current measurement tools, like self-reported use, are subjective and unable to account for temporal variations in use. To address these limitations, I invented an electronic monitor of LLIN use. SmartNet uses sensors embedded in a standard LLIN to continuously assess whether it is unfurled with 98% accuracy. We have completed successful feasibility, acceptability and field trials of SmartNet. The central rationale for this project is that continuous monitoring of individual LLIN use combined with quantified exposure to malaria vectors will allow a more robust analysis than has previously been possible of how LLINs reduce vector exposure in practice. The research goal of this K23 proposal is to develop high-yield interventions for improving malaria control by identifying gaps between individual risk of vector exposure and individual LLIN use. To facilitate this work, I have access to a longitudinal cohort of 480 individuals in Uganda. Our approach leverages intensive entomology surveillance already being gathered every two weeks in this cohort. Additionally, we will deploy SmartNets over every sleeping space to cover every individual over multiple years. High-yield interventions will be identified by pursuing three specific aims: 1) quantify exposure to malaria vectors and identify factors associated with higher risk, 2) quantify LLIN use and identify factors associated with poor adherence and 3) identify mismatches between LLIN use and vector exposure, develop interventions addressing these gaps and then systematically determine the highest-yield interventions for reducing vector-human contact using a model of vector exposure. My long-term career goal is to establish an independent research career developing innovative approaches for improving malaria control. This K23 proposal supplements my prior experience with mentorship and training in malaria entomology and epidemiology and infectious disease modelling. Together, the proposed research activities and complementary training are designed to lead to a robust program of future work. I will emerge from this award prepared for a strong NIH R01 application to apply this approach in different transmission settings, to develop operational studies of the high-yield interventions we identify and to expand the scope from reducing vector-human contact to reducing actual malaria incidence. This K23 award provides the crucial link between my current experience and achieving my career goal of becoming an international leader inventing, deploying and testing innovative approaches for improving malaria prevention.

项目概要/摘要疟疾影响着全世界三十亿人。尽管过去几年疟疾发病率显着下降 15年来，最近的证据表明我们的传统控制工具正在减弱。经过长效杀虫剂处理蚊帐 (LLIN) 是预防疟疾最广泛使用的工具，对降低疟疾发病率做出了重大贡献，但最近的研究表明，LLIN 的效果要么不如以前，要么对人们的健康产生了负面影响。没有按照报道使用它们。严格评估媒介暴露的时间和地点与现实生活中 LLIN 的使用如何交叉对于重新获得疟疾控制的主动权至关重要。然而，缺乏 LLIN 使用的可靠衡量标准是一个重大挑战。当前的测量工具，例如自我报告使用是主观的，无法解释使用的时间变化。为了解决这些限制，我发明了 LLIN 使用的电子监控器。 SmartNet 使用嵌入标准 LLIN 的传感器来持续评估展开的准确度是否达到 98%。我们已成功完成可行性、可接受性和现场试验的智能网。该项目的核心原理是持续监测单独的 LLIN 使用情况通过量化疟疾病媒的暴露量，可以进行比以前更可靠的分析 LLIN 如何在实践中减少媒介暴露。该K23提案的研究目标是开发高产通过确定个人接触媒介的风险与疟疾控制之间的差距来改善疟疾控制个人 LLIN 使用。为了促进这项工作，我接触到了乌干达 480 人的纵向队列。我们的方法利用了该队列中每两周收集一次的密集昆虫学监测。此外，我们将在每个睡眠空间部署 SmartNet，以覆盖多个睡眠空间中的每个人。年。高收益干预措施将通过追求三个具体目标来确定：1）量化疟疾暴露程度向量并识别与较高风险相关的因素，2) 量化 LLIN 使用并识别与高风险相关的因素依从性差；3) 识别 LLIN 使用和媒介接触之间的不匹配，制定解决这些差距的干预措施，然后系统地确定减少媒介人类传播的最高产率干预措施使用矢量暴露模型进行接触。我的长期职业目标是建立一个独立的研究机构职业发展创新方法以改善疟疾控制。这个 K23 提案补充了我之前的建议在疟疾昆虫学、流行病学和传染病建模方面拥有指导和培训经验。拟议的研究活动和补充培训共同旨在形成强大的今后的工作计划。我将从这个奖项中脱颖而出，为强大的 NIH R01 申请做好准备，以应用此在不同的传播环境中采取方法，以开展我们的高产干预措施的操作研究确定并扩大范围，从减少媒介与人的接触到减少实际的疟疾发病率。这 K23 奖项在我目前的经验和实现我的职业目标之间提供了至关重要的联系发明、部署和测试改善疟疾预防的创新方法的国际领导者。

项目成果

期刊论文数量（1）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Evaluation of an accelerometer-based monitor for detecting bed net use and human entry/exit using a machine learning algorithm.

DOI：
10.1186/s12936-022-04102-z
发表时间：
2022-03-12
期刊：
Malaria journal
影响因子：
3
作者：
Koudou GB;Monroe A;Irish SR;Humes M;Krezanoski JD;Koenker H;Malone D;Hemingway J;Krezanoski PJ
通讯作者：
Krezanoski PJ