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

• 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
• 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

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.

项目摘要/摘要 疟疾影响全球30亿人。尽管疟疾发病率显着降低 15年，最近的证据表明，我们的传统控制工具正在减弱。长期杀虫剂治疗 床网（LLIN）是预防疟疾的最广泛使用的工具，并为疟疾发病率降低做出了重大贡献，但最近的研究表明，LLIN的效果不如以前，或者是人 没有按报告使用它们。严格评估矢量暴露与LLIN的现实使用方式如何相交的时间和位置对于恢复疟疾控制中的主动行动至关重要。但是， 缺乏可靠的LLIN使用方法提出了一个重大挑战。当前的测量工具，例如自我报告 使用，主观，无法说明使用的时间变化。为了解决这些限制，我发明了 LLIN使用的电子监视器。 SmartNet使用标准LLIN中嵌入的传感器来连续评估 是否以98％的准确性来展开它。我们已经完成了成功的可行性，可接受性和现场试验 Smartnet。该项目的中心原理是对单个LLIN使用的持续监控合并 通过量化的疟疾载体接触将允许比以前更有可能的分析 LLIN在实践中如何减少向量暴露。该K23提案的研究目标是开发高收益 通过识别个人暴露媒介风险和 个人使用。为了促进这项工作，我可以进入乌干达480个人的纵向队列。 我们的方法利用该队列中已经每两周收集一次强化昆虫学监测。此外，我们将在每个睡眠空间上部署智能网络，以覆盖多个人 年。通过追求三个具体目标来确定高收益干预措施：1）量化暴露于疟疾 向量和确定与较高风险相关的因素，2）量化LLIN的使用并确定与 依从性差和3）确定LLIN使用和向量暴露之间的不匹配，制定解决这些差距的干预措施，然后系统地确定减少矢量 - 人类的最高收益干预措施 使用矢量暴露模型接触。我的长期职业目标是建立一项独立研究 发展创新方法以改善疟疾控制。这个K23提案补充了我的先前 在疟疾昆虫学和流行病学和传染病建模方面的指导和培训经验。拟议的研究活动和补充培训旨在带来强大的培训 未来工作的计划。我将从为强大的NIH R01申请准备的该奖项中出来应用 在不同的传输设置中进行方法，以开发高收益干预措施的运营研究 识别并扩大范围，从减少载体 - 人类接触到降低实际疟疾的发生率。这 K23奖提供了我当前的经验与实现我的职业目标之间的关键联系 国际领导者发明，部署和测试用于改善疟疾预防的创新方法。

项目成果

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