The long-term project goal is to provide the evidence-base for the development of sustainable strategies to further reduce malaria transmission in southern Africa and assess the feasibility of malaria elimination through an integrated understanding of local malaria epidemiology, vector biology, parasite populafion structure and community and household-level beliefs and actions. Building upon the Johns Hopkins Malaria Research Institute field site in Choma District in rural southern Zambia as a regional center of excellence in malaria research, we propose to invesfigate the changing epidemiology of malaria in three disfinct transmission settings in southern Africa reflecting different stages of malaria control (successful - Choma, ineffective - Nchelenge, resurgent - Mutasa) through prospective hospital, clinic and community-based studies to address the following:
Aim 1) Measure changes in spafio-temporal patterns of malaria parasitemia in three disfinct epidemiological settings in southern Africa and identify individual, household and ecological risk factors for symptomafic and asymptomatic parasitemia in each setting;
Aim 2) Identify individual, household and ecological risk factors for gametocyte carriage during high and low transmission seasons in three disfinct epidemiological settings in southern Africa;
Aim 3) Measure spatio-temporal changes in agespecific anfibody responses to Plasmodium falciparium anfigens using sero-epidemiological surveys in the three regions of southern Africa;
Aim 4) Idenfify targeted, risk-based combinations of malaria control strategies that are cost-effective and acceptable to the community using mathematical modeling approaches to optimize decision algorithms based on locally available survey and surveillance data. Detailed understanding of malaria transmission dynamics in three different epidemiological settings will thus inform the development of locally-adapted, cost-effective and community-supported strategies for malaria control. These epidemiological invesfigafions will be closely linked with studies of spafio-temporal changes in the anopheline vector and Plasmodium populafion structure in response to ecological changes and malaria control efforts. This integrated, evidence-based approach to malaria control will form the foundation for a regional center of excellence for malaria research in southern Africa and the foundation for regional malaria eliminafion.

Public Health Relevance

The burden of malaria has decreased dramafically in parts of sub-Saharan Africa within the past several years, raising the possibility of regional malaria eliminafion. Our research activifies will provide the detailed knowledge of malaria transmission in southern Africa necessary to develop locally-adapted, targeted control strategies for the next stage of malaria control and possibily the regional elimination of malaria.

National Institute of Health (NIH)
National Institute of Allergy and Infectious Diseases (NIAID)
Research Program--Cooperative Agreements (U19)
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Special Emphasis Panel (ZAI1-AWA-M)
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Johns Hopkins University
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Searle, Kelly M; Lubinda, Jailos; Hamapumbu, Harry et al. (2017) Characterizing and quantifying human movement patterns using GPS data loggers in an area approaching malaria elimination in rural southern Zambia. R Soc Open Sci 4:170046
Das, Smita; Muleba, Mbanga; Stevenson, Jennifer C et al. (2017) Beyond the entomological inoculation rate: characterizing multiple blood feeding behavior and Plasmodium falciparum multiplicity of infection in Anopheles mosquitoes in northern Zambia. Parasit Vectors 10:45
Sutcliffe, Catherine G; Searle, Kelly; Matakala, Hellen K et al. (2017) Measles and Rubella Seroprevalence Among HIV-infected and Uninfected Zambian Youth. Pediatr Infect Dis J 36:301-306
Ippolito, Matthew M; Searle, Kelly M; Hamapumbu, Harry et al. (2017) House Structure Is Associated with Plasmodium falciparum Infection in a Low-Transmission Setting in Southern Zambia. Am J Trop Med Hyg 97:1561-1567
Venter, Nelius; Oliver, Sh?né V; Muleba, Mbanga et al. (2017) Benchmarking insecticide resistance intensity bioassays for Anopheles malaria vector species against resistance phenotypes of known epidemiological significance. Parasit Vectors 10:198
Searle, Kelly M; Katowa, Ben; Kobayashi, Tamaki et al. (2017) Distinct parasite populations infect individuals identified through passive and active case detection in a region of declining malaria transmission in southern Zambia. Malar J 16:154
Kanyangarara, Mufaro; Mamini, Edmore; Mharakurwa, Sungano et al. (2016) Individual- and Household-Level Risk Factors Associated with Malaria in Mutasa District, Zimbabwe: A Serial Cross-Sectional Study. Am J Trop Med Hyg 95:133-40
Stevenson, Jennifer C; Pinchoff, Jessie; Muleba, Mbanga et al. (2016) Spatio-temporal heterogeneity of malaria vectors in northern Zambia: implications for vector control. Parasit Vectors 9:510
Guo, Suqin; He, Lishan; Tisch, Daniel J et al. (2016) Pilot testing of dipsticks as point-of-care assays for rapid diagnosis of poor-quality artemisinin drugs in endemic settings. Trop Med Health 44:15
Stevenson, Jennifer C; Norris, Douglas E (2016) Implicating Cryptic and Novel Anophelines as Malaria Vectors in Africa. Insects 8:

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