Project 1 - Epidemiology

Walter And Eliza Hall Inst Medical Res, Victoria

Investigators

Linked publications & trials

Abstract

Project summary To ensure continued progress towards the regional goal of malaria elimination all residual parasite reservoirs and emerging drug resistance need to be detected and eliminated with effective treatment to prevent ongoing transmission. This requires new surveillance tools and approaches to accurately quantify malaria transmission and identify the main drivers of continued transmission to ensure efficient allocation of resources to eliminate malaria. It requires new, more sensitive diagnostic tools and local evidence that can support a shift towards more effective radical cure of vivax malaria. We need to understand the emergence and spread of P. falciparum artemisinin and partner drug resistance in PNG, learning from the experience in Cambodia and using this evidence to guide PNG treatment policy. Additionally, there is a need to confirm and mitigate the emergence of P. vivax drug resistance in Cambodia. Lastly, there are gaps in our knowledge related to the role that parasite and host genetics play in determining the efficacy of 8-aminoquinolines, as well as the factors that underpin the rapid acquisition of clinical immunity to P. vivax that drives continued transmission by asymptomatic carriers. The overall aim of the Asia-Pacific ICEMR Epidemiology Project is therefore to generate evidence to improve surveillance, diagnosis and treatment of malaria, with a specific focus on P. vivax and drug resistance, which are major roadblocks to achieving elimination in the Asia-Pacific region. To achieve this novel genomic, sero-surveillance and point of care diagnostic approaches (Diagnostics and Surveillance Core) will be used to identify current Plasmodium spp. infections, drug resistance and population structure in samples from passive and active surveillance, enabling efficient and highly detailed resolution of malaria transmission risk. This data will be used in interventions scenario models (Data, Biostatistics and Modelling Core) to evaluate optimal surveillance, case management and targeted intervention approaches for different transmission settings in the Asia-Pacific region. Evidence generated will directly inform national diagnosis and treatment guidelines in Cambodia and PNG, to ensure the most effective case management in the face of drug resistance and persistent P. vivax.