R01AI163201

Malaria Across Borders: Measuring Imported Infections and Contributions to Local Transmission in Uganda and Zimbabwe - Project Summary/Abstract

Malaria cases and deaths primarily caused by Plasmodium falciparum have declined significantly in sub-Saharan Africa as a result of the broad deployment of vector control and effective clinical management. In low to moderate-transmission settings slated for elimination, imported cases become an increasingly important epidemiological consideration. In these settings, imported cases may:

A) Represent a high but poorly defined proportion of the overall malaria burden,
B) Result in secondary transmission that can impede local elimination efforts, and
C) Require additional or alternative interventions than standard control measures.

Imported cases, when currently evaluated at all, are operationally defined as infections acquired outside of a defined geographic area and identified based on travel history. However, the lack of capture of asymptomatic infections together with variable quality of travel history collection limit the utility of this standard approach to identifying imported infections and quantifying their role in transmission. Furthermore, there are no routinely collected data that would allow evaluation of the impact of imported cases on local transmission.

In this proposal, we will collect detailed travel histories, perform active surveillance for asymptomatic infections, and generate parasite genomic data to more accurately define the role of imported infections in two representative border regions of sub-Saharan Africa (Tororo District, Uganda and Mutasa District, Zimbabwe). These regions leverage substantial surveillance infrastructure from the NIH-funded International Centers of Excellence for Malaria Research (ICEMR) network and will employ active (via a longitudinal study) and passive (via health facility surveillance) designs to capture asymptomatic and symptomatic infections.

We propose the following specific aims:

1) To quantify and characterize imported malaria infections. We will use a probabilistic approach to classify infections as imported or local via detailed travel and other behavioral survey data and determine the travel patterns and risk factors associated with importation.

2) To determine the impact of importation on local transmission and identify appropriate targeted interventions. We will use parasite genomics and epidemiological data to define local transmission and the impact of imported infections, taking advantage of dense sampling of symptomatic and asymptomatic infections in focused geographies. We will use a robust set of statistical modeling approaches, including Bayesian estimation of transmission networks incorporating all genomic and epidemiologic data. We will use these data to model the predicted impact of various combinations of targeted interventions.

The expected outcome of the proposed research is evidence on appropriate surveillance methods for imported malaria infections and on the contribution of these infections to sustaining transmission. By identifying ways to better target interventions, these results will impact national and international malaria control efforts as they strive for elimination and require evidence on how to mitigate the risk of imported malaria infections.

San Francisco Regents Of The University Of California

TO ASSIST PUBLIC AND PRIVATE NONPROFIT INSTITUTIONS AND INDIVIDUALS TO ESTABLISH, EXPAND AND IMPROVE BIOMEDICAL RESEARCH AND RESEARCH TRAINING IN INFECTIOUS DISEASES AND RELATED AREAS, TO CONDUCT DEVELOPMENTAL RESEARCH, TO PRODUCE AND TEST RESEARCH MATERIALS. TO ASSIST PUBLIC, PRIVATE AND COMMERCIAL INSTITUTIONS TO CONDUCT DEVELOPMENTAL RESEARCH, TO PRODUCE AND TEST RESEARCH MATERIALS, TO PROVIDE RESEARCH SERVICES AS REQUIRED BY THE AGENCY FOR PROGRAMS IN INFECTIOUS DISEASES, AND CONTROLLING DISEASE CAUSED BY INFECTIOUS OR PARASITIC AGENTS, ALLERGIC AND IMMUNOLOGIC DISEASES AND RELATED AREAS. PROJECTS RANGE FROM STUDIES OF MICROBIAL PHYSIOLOGY AND ANTIGENIC STRUCTURE TO COLLABORATIVE TRIALS OF EXPERIMENTAL DRUGS AND VACCINES, MECHANISMS OF RESISTANCE TO ANTIBIOTICS AS WELL AS RESEARCH DEALING WITH EPIDEMIOLOGICAL OBSERVATIONS IN HOSPITALIZED PATIENTS OR COMMUNITY POPULATIONS AND PROGRESS IN ALLERGIC AND IMMUNOLOGIC DISEASES. BECAUSE OF THIS DUAL FOCUS, THE PROGRAM ENCOMPASSES BOTH BASIC RESEARCH AND CLINICAL RESEARCH. SMALL BUSINESS INNOVATION RESEARCH (SBIR) PROGRAM EXPANDS AND IMPROVES PRIVATE SECTOR PARTICIPATION IN BIOMEDICAL RESEARCH. THE SBIR PROGRAM INTENDS TO INCREASE AND FACILITATE PRIVATE SECTOR COMMERCIALIZATION OF INNOVATIONS DERIVED FROM FEDERAL RESEARCH AND DEVELOPMENT, TO INCREASE SMALL BUSINESS PARTICIPATION IN FEDERAL RESEARCH AND DEVELOPMENT, AND TO FOSTER AND ENCOURAGE PARTICIPATION OF SOCIALLY AND ECONOMICALLY DISADVANTAGED SMALL BUSINESS CONCERNS AND WOMEN-OWNED SMALL BUSINESS CONCERNS IN TECHNOLOGICAL INNOVATION. THE SMALL BUSINESS TECHNOLOGY TRANSFER (STTR) PROGRAM STIMULATES AND FOSTERS SCIENTIFIC AND TECHNOLOGICAL INNOVATION THROUGH COOPERATIVE RESEARCH AND DEVELOPMENT CARRIED OUT BETWEEN SMALL BUSINESS CONCERNS AND RESEARCH INSTITUTIONS, TO FOSTER TECHNOLOGY TRANSFER BETWEEN SMALL BUSINESS CONCERNS AND RESEARCH INSTITUTIONS, TO INCREASE PRIVATE SECTOR COMMERCIALIZATION OF INNOVATIONS DERIVED FROM FEDERAL RESEARCH AND DEVELOPMENT, AND TO FOSTER AND ENCOURAGE PARTICIPATION OF SOCIALLY AND ECONOMICALLY DISADVANTAGED SMALL BUSINESS CONCERNS AND WOMEN-OWNED SMALL BUSINESS CONCERNS IN TECHNOLOGICAL INNOVATION. RESEARCH CAREER DEVELOPMENT AWARDS SUPPORT THE DEVELOPMENT OF SCIENTISTS DURING THE FORMATIVE STAGES OF THEIR CAREERS. INDIVIDUAL NATIONAL RESEARCH SERVICE AWARDS (NRSAS) ARE MADE DIRECTLY TO APPROVE APPLICANTS FOR RESEARCH TRAINING IN SPECIFIED BIOMEDICAL SHORTAGE AREAS. IN ADDITION, INSTITUTIONAL NATIONAL RESEARCH SERVICE AWARDS ARE MADE TO ENABLE INSTITUTIONS TO SELECT AND MAKE AWARDS TO INDIVIDUALS TO RECEIVE TRAINING UNDER THE AEGIS OF THEIR INSTITUTIONAL PROGRAM.

93.855 - Allergy and Infectious Diseases Research

National Institute of Allergy and Infectious Diseases (NIAID) [HHS - NIH]

San Francisco, California 941102859 United States

Single Zip Code

NIH Research Project Grant (Parent R01 Clinical Trial Not Allowed) (PA-20-185)

Amendment Since initial award the total obligations have increased 422% from $704,544 to $3,679,817.