The main objective of this project Is to determine the clinical outcomes and their associafion with parasite and host features of malaria-infected individuals living In non-Amazon regions of Lafin America (LA) with different intensities of malaria transmission. It is hypothesized that clinical manifestations of malaria in infected individuals living in high malaria transmission areas are different from those observed in low transriiission areas in which both parasites P. vivax and P. falciparum co-exist. These studies will be conducted through the following specific alms: 1) establishment of the clinical profile of malaria In different epidemiological settings and their association with parasite and host immunological status:;2) assess the prevalence of malaria mixed infecfions and its influence in the clinical outcomes of the disease;3) determine the prevalence of hematological manifestafions related to malaria infecfion and their associafion with concomitant immune status nutrifional factors, and helminth co-infections, and 4) determine the prevalence of placental malaria and Its impact on neonatal health and child development. This is a multisite center study in Lafin America in which cross-sectional, cohort studies and longitudinal and cohort studies will be performed In 3,600 individuals for alms 1-3 and 200 newborns for aim 4. Parasitological, hematological, and immunological evaluafions will be performed and concomitant non-malaria infections will be evaluated. The impact of malaria on child growth and development and level of impairment will be assessed using locally standardized quesfionnaires based on Internafional guidelines (BMI and ICF). The overall studies proposed in this project will not only provide a better understanding ofthe immunopathogenesis of malaria in LA but will also generate useful Informafion for malaria case management, control strategies including anfimalaria therapy, future use of malaria vaccine and points of intervention to improve developmental outcomes of children living in malaria endemic regions of LA.
Coordinated mulfi-site studies on malaria immunopathogenesis will be conducted in three countries of Latin America. This will be the first large-scale comprehensive study on malaria Immunopatogenesis of malaria in low-to-moderate malaria endemic regions of Lafin America.
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