Multidisciplinary research for malaria control and prevention in West Africa (ICEMR-MALI)
The overall goal of this application is to improve the effectiveness of 1) SMC implementation and 2) Referral and management of severe disease in rural Mali and consist of two projects: a Study Type 2 (Observational study) and Study Type 3 (Implementation study).
- 1.1) To describe the community and health systems context for implementation of SMC, and implementation of protocols for referral and management of severe malaria;
- 1.2) To explore factors determining success, and barriers and pitfalls related to the SMC implementation strategy including perception of SMC in the population and by health providers, delivery strategy and coverage, and sustainability; and
- 1.3) To evaluate household and health system responses to severe malaria, including provision of appropriate pre-referral management, and implementation of case management protocols
- 2.1) To assess the impact of extended SMC on the incidence and prevalence of malaria among children under 5 and older children (5-10years) in intervention areas vs. control;
- 2.2) To determine the long-term effect of SMC on acquisition of immunity, parasite population structure, and drug resistance markers
- 2.3) To assess the cost-effectiveness of SMC delivery and implementation strategies
This ICEMR encompasses 3 Projects with the goals summarized as follow:
- Epidemiology Project (Project 1): The goal is to understand why different patterns of malaria epidemiology and endemicity are resilient to current control strategies at four sites in Mali, representing different eco-zones across West Africa,
- Malaria immuno- genomics Project (Project 2): The goal of this project is to identify genetic variation in the malaria parasite and human host, and assess the impact of these differences on malaria transmission and effectiveness of malaria control measures in four sites of Mali,
- Malaria vector and transmission field ecology project (Project 3): The project goal is to investigate important neglected aspects of malaria vector and transmission field ecology at four sites in Mali, representing three eco-zones across West Africa.
These projects link the different aspects of malaria transmission and disease into a unified whole, adding the ability to distinguish the contributions of different malaria control interventions on parasite population and range of immune responses (Project 2, Immunopathogenesis) and seasonal and geographical distribution of anopheline mosquitoes vectors (Project 3). Understanding the factors relating to entomological and epidemiological patterns of transmission will provide more definitive guidelines for malaria control efforts in Mali and in West Africa.
Research Narrative Malaria remains a major life-threatening disease across sub-Sahara Africa, particularly among children less than 5 years of age and pregnant women. Because malaria control interventions are being focused on children under 5 years old in many countries, the burden of the disease is shifting on older children. This field-based research will contribute not only to provide plausible evidence of the effectiveness of key malaria control interventions, but also determine a potential long-term impact of the malaria control strategies on the epidemiology of the disease.
Observational and implementation studies