Malaria Epidemiology and Control Within the International Centers of Excellence for Malaria Research.

William J Moss,Guofa Zhou,Lalitha Ramanathapuram,Donald J Krogstad,H C Srivastava,James W Kazura,Pradyumna K Mohapatra,Ashwani Kumar,Grant Dorsey,Daniel M Parker,Liwang Cui,Miriam K Laufer,Joseph M Vinetz,Angel Rosas-Aguirre ,Lisly Chéry ,Sócrates Herrera ,Myriam Arévalo‐Herrera ,Ivo Müeller ,Joaniter I Nankabirwa ,Mitchel Guzmán

doi:10.4269/ajtmh.15-0006

Abstract

Understanding the epidemiological features and metrics of malaria in endemic populations is a key component to monitoring and quantifying the impact of current and past control efforts to inform future ones. The International Centers of Excellence for Malaria Research (ICEMR) has the opportunity to evaluate the impact of malaria control interventions across endemic regions that differ in the dominant Plasmodium species, mosquito vector species, resistance to antimalarial drugs and human genetic variants thought to confer protection from infection and clinical manifestations of plasmodia infection. ICEMR programs are conducting field studies at multiple sites with the aim of generating standardized surveillance data to improve the understanding of malaria transmission and to monitor and evaluate the impact of interventions to inform malaria control and elimination programs. In addition, these epidemiological studies provide a vast source of biological samples linked to clinical and environmental “meta-data” to support translational studies of interactions between the parasite, human host, and mosquito vector. Importantly, epidemiological studies at the ICEMR field sites are integrated with entomological studies, including the measurement of the entomological inoculation rate, human biting index, and insecticide resistance, as well as studies of parasite genetic diversity and antimalarial drug resistance.

Highlights

Understanding the epidemiological features and metrics of malaria in endemic populations is a key component to monitoring and quantifying the impact of current and past control efforts to reduce morbidity due to plasmodia infection to a level that is acceptable from a public health perspective, eliminate malaria by decreasing the reproduction number (R0) to a level at which transmission is not sustained by local mosquito vectors in a defined geographic region, and to eradicate malaria by irrevocably reducing the global incidence of plasmodia infection to nil.[1]
Aside from infection diagnosed by microscopic inspection of blood smears, the sensitivity and specificity of metrics based on death and clinical manifestations attributable to plasmodia infection were unclear, in the many areas where other causes of acute febrile illness and anemia in children were common
Epidemiological studies at the International Centers of Excellence for Malaria Research (ICEMR) field sites are integrated with entomological studies, including measurement of the entomological inoculation rate (EIR), human biting index, and insecticide resistance, as well as studies of parasite genetic diversity and antimalarial drug resistance

Summary

Introduction

Understanding the epidemiological features and metrics of malaria in endemic populations is a key component to monitoring and quantifying the impact of current and past control efforts to reduce morbidity due to plasmodia infection to a level that is acceptable from a public health perspective, eliminate malaria by decreasing the reproduction number (R0) to a level at which transmission is not sustained by local mosquito vectors in a defined geographic region, and to eradicate malaria by irrevocably reducing the global incidence of plasmodia infection to nil.[1].

Results

Conclusion