Status: Funded - Open
Genetic epidemiology of P. falciparum transmission for malaria elimination and drug resistance monitoring
Alison Kuchta, MD, PhD
BACKGROUND: Malaria is one of the most important infectious diseases in the world, causing extensive mortality in young children, but despite advances in malaria control, progression to elimination is very challenging, in part due to persistence of unidentified parasite reservoirs. Countries approaching malaria elimination need to develop targeted intervention strategies to actively deliver antimalarial therapy to the 'hotspots' driving transmission. RCD and TPE offer two rational strategies, but they will likely differ in their abilities to decrease malaria incidence and select for antimalarial drug resistance.
GAP: The differential impacts on malaria transmission and selection of drug resistance of two key approaches to malaria elimination, RCD and TPE, are unknown; additionally, baseline prevalence of malaria resistance in Namibia is unknown.
HYPOTHESIS: We hypothesize that the widespread drug administration associated with TPE will decrease transmission more effectively than RCD, but that the increased drug pressure associated with this strategy will result in increased selection for drug resistance.
We will perform multilocus genotyping of parasites from all infected individuals, allowing us to define transmission networks and identify emergence of drug resistance, thereby comparing e the impacts of RCD and TPE. The study population consists of individuals exposed to malaria living in the western Zambezi Region in northeastern Namibia and the sample material will be blood samples obtained from all individuals with an identified malaria infection.
IMPACT: Comparing RCD vs TPE will directly impact the next iteration of malaria elimination strategy implementation, while determining baseline and changing drug resistance patterns will facilitate necessary monitoring of the effects of increased drug selection pressure.
Website Link: http://profiles.ucsf.edu/alison.kuchta
University of California, San Francisco