Malaria Operations Research to Improve Malaria Control and Reduce Morbidity and Mortality in Western Kenya

疟疾行动研究旨在改善肯尼亚西部的疟疾控制并降低发病率和死亡率

• 批准号: 10595686
• 负责人: FEIKO OLAF TER KUILE
• 金额: $ 368.51万
• 依托单位: TMLIVERPOOL SCHOOL OF TROPICAL MEDICINE
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-01 至 2025-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10595686
• 关键词: Malaria; Operations; Research; Improve; Control

Project summary This application is for the fourth, 5-year CoAG between CDC’s Malaria Branch and the Liverpool School of Tropical Medicine (LSTM). Activities take place in western Kenya under the umbrella of the long-term collaboration between the Kenya Medical Research Institute (KEMRI), CDC, and LSTM and benefit from LSTM’s existing infrastructure in Kenya. The research strategy follows the 5 objectives of the NOFO. The first objective involves the expansion in 2020/21 of the epidemiological (1.1) and entomological surveillance (1.2) platform to track progress towards malaria transmission reduction targets following the introduction of population-wide interventions in 2021/22. To maintain low transmission status, this requires a shift from the existing periodic, district-level surveillance to systems where surveillance itself becomes an intervention and can detect individual geo-located cases near real-time for rapid notification and foci investigation. We will support the Kenyan Ministry of Health (MoH) with their goal to digitise the data collected on their paper-based health registers using software that makes them scannable (1.1.5). This will include registers that capture case-burden data used in out-patient departments (1.1.6) and by community health workers as part of integrated community case management (ICCM) (1.1.7), and antenatal clinic registers that capture malaria infection prevalence during first antenatal clinic visits. This is a novel method to track the asymptomatic parasite reservoir in populations (1.1.8). Combined, this allows, for the first time, sustainable, daily, near real-time surveillance to track progress towards malaria transmission reduction targets. We will also conduct continuous malaria indicator household surveys (cMIS) to track malaria prevalence and intervention coverage (1.1.9) and entomological monitoring (1.2), both using adaptive sampling frameworks that can respond to challenges related to rapid changes in malaria transmission. As part of the second objective, we will implement population-wide interventions targeting malaria transmission, starting in 2021/22. The optimal combination of novel or improved interventions will be developed in close collaboration with CDC in 2020/21. This is likely to include enhanced case- management using digitally supported quality improvement approaches of ICCM, enhanced vector control with larval source management and insecticide-treated piperonyl butoxide (PBO) nets, and mass drug administration with dihydroartemisinin-piperaquine and ivermectin targeting the asymptomatic parasite reservoir (2.1). The third objective involves assessing the safety effectiveness of currently deployed antimalarials for the prevention (3.2.1) and treatment (3.2 and 3.3) of malaria in the context of increasing antimalarial drug resistance. We will liaise with CDC’s laboratories in Atlanta for the molecular monitoring of drug resistance. The fourth objective aims to maximise the public health impact by supporting the creation of a knowledge centre at the KEMRI’s CGHR for evidence synthesis and information exchange to enhance the translation of global malaria control policies (4). Objective 5 involves the strengthening of research capacity of the partners in Kenya by the provision of internships (5.1) and MSc, PhD and post-doctoral studentships and research leadership mentoring (5.1).

项目概要 本申请适用于 CDC 疟疾分部与利物浦热带学院之间的第四次 5 年 CoAG 医学 (LSTM) 活动是在肯尼亚西部开展的长期合作的框架下进行的。 肯尼亚医学研究所 (KEMRI)、CDC 和 LSTM，并受益于 LSTM 的现有基础设施 肯尼亚。研究战略遵循 NOFO 的 5 个目标。第一个目标涉及扩大。 2020/21 年流行病学（1.1）和昆虫学监测（1.2）平台用于跟踪疟疾防治进展 2021/22 年引入全民干预措施后，减少传播的目标维持不变。 低传播状态，这需要从现有的定期、区级监测转向系统 监视本身成为一种干预措施，可以近乎实时地检测单个地理定位病例，以便快速 我们将支持肯尼亚卫生部 (MoH) 实现数字化目标。 使用可扫描的软件在纸质健康登记册上收集的数据（1.1.5）。 包括记录门诊部门 (1.1.6) 和社区卫生部门使用的病例负担数据的登记册 作为综合社区病例管理 (ICCM) (1.1.7) 一部分的工作人员，以及产前诊所登记 在第一次产前门诊就诊时了解疟疾感染率，这是一种追踪疟疾感染的新方法。 人口中的无症状寄生虫储存库（1.1.8）结合起来，首次实现了可持续的、每日的、 我们还将进行近乎实时的监测，以跟踪减少疟疾传播目标的进展情况。 持续疟疾指标家庭调查（cMIS），以跟踪疟疾患病率和干预措施覆盖范围（1.1.9） 和昆虫学监测（1.2），两者都使用可以应对挑战的自适应采样框架 作为第二个目标的一部分，我们将在全民范围内实施。 从 2021/22 年开始针对疟疾传播的干预措施 新型或改进的最佳组合。 2020/21 年将与 CDC 密切合作制定干预措施，这可能包括加强病例干预。 使用 ICCM 数字化支持的质量改进方法进行管理，加强病媒控制 幼虫源管理和经杀虫剂处理的胡椒基丁醚 (PBO) 蚊帐，以及大规模药物管理 双氢青蒿素-哌喹和伊维菌素针对无症状寄生虫储存库 (2.1)。 目标涉及评估当前部署的抗疟药物预防的安全有效性（3.2.1） 在抗疟药物耐药性增加的情况下进行疟疾治疗（3.2 和 3.3）。 疾病预防控制中心位于亚特兰大的实验室用于耐药性分子监测，第四个目标旨在最大限度地提高耐药性。 支持在 KEMRI 的 CGHR 建立知识中心以获取证据，从而对公共卫生产生影响 综合和信息交流，以加强全球疟疾控制政策的转化（4）。 涉及通过提供实习机会加强肯尼亚合作伙伴的研究能力（5.1）和 理学硕士、博士和博士后奖学金以及研究领导力指导（5.1）。