Malaria is very highly endemic in the Democratic Republic of the Congo (DRC). We propose to use >16,000 dried blood spots from the 2007 and 2012 Demographic and Health Surveys (DHS) in the DRC to conduct the first longitudinal, nation-wide study of malaria genetic epidemiology. We have already measured and mapped malaria in the DRC from the 2007 DHS by high-throughput real-time PCR.
Our first aim i s to determine the effects of malaria control efforts on the prevalence of P. falciparum and other malaria species. We have a unique opportunity to do this now; malaria control programs were minimal in 2007 but are being dramatically scaled up this year (by the Global Fund, USAID and other agencies). Multilevel modeling will be used to identify individual- and cluster-level variables associated with increases or decreases in malaria prevalence.
Our second aim i s to measure molecular markers of drug resistance (dhps, pfcrt and pfmdr1) in P. falciparum samples from 2007 and 2012, and identify individual- and cluster-level factors associated with changes in the prevalence of drug resistance.
Our third aim i s to measure neutral microsatellite markers in P.falciparum from 2007 and 2012. Landscape genetic analyses will measure genetic distances in the P. falciparum populations between clusters and over time. This will allow the identification of dispersal corridors and barriers. It will also permit estimation of the rate of gene flow. The latter could be used to predict the rate at which malaria might reinvade an area from which it was eliminated. Taken together, our findings could offer a scientific foundation for malaria control programs.
Malaria represents a huge public health problem, especially in the Democratic Republic of the Congo (DRC) where almost 1/3 of adults were found to be infected in a 2007 national survey. Now, some health zones in the DRC have been targeted for malaria control. In this project, we propose to use real- time PCR and DNA sequencing to determine the effects of these interventions on the prevalence of malaria and drug-resistant malaria in the DRC. We will also genotype parasites and use population and landscape genetics to measure the rates at which parasite genes spread and estimate how quickly malaria could repopulate areas which were formerly under control. The results of this study could guide future malaria control efforts.
| Carrel, Margaret; Patel, Jaymin; Taylor, Steve M et al. (2015) The geography of malaria genetics in the Democratic Republic of Congo: A complex and fragmented landscape. Soc Sci Med 133:233-41 |
| Patel, Jaymin C; Taylor, Steve M; Juliao, Patricia C et al. (2014) Genetic Evidence of Importation of Drug-Resistant Plasmodium falciparum to Guatemala from the Democratic Republic of the Congo. Emerg Infect Dis 20:932-40 |
| Lin, Jessica T; Saunders, David L; Meshnick, Steven R (2014) The role of submicroscopic parasitemia in malaria transmission: what is the evidence? Trends Parasitol 30:183-90 |
| Messina, Jane P; Mwandagalirwa, Kashamuka; Taylor, Steve M et al. (2013) Spatial and social factors drive anemia in Congolese women. Health Place 24:54-64 |
