Sub-Saharan Africa • ICEMR

International Center of Excellence for Malaria Research

ICEMR Program

Good morning, Malaria

and in case I don't see ya, good afternoon, good evening, and good night!

Kenya Study

Adaptive Interventions
and Smart Trial

Optimizing Malaria Intervention Control with A Cluster-Randomized SMART Trial

Smart Trial

Environmental Modifications
in sub-Saharan Africa

Changing Epidemiology, Transmission and Pathogenesis of Plasmodium falciparum and P. vivax

Homa Bay Lab

Environmental Modifications
in sub-Saharan Africa

Changing Epidemiology, Transmission and Pathogenesis of Plasmodium falciparum and P. vivax

Ethiopia Study

ICEMR • International Centers
of Excellence for Malaria Research

established a global network of independent research centers in malaria-endemic settings

ICEMR Program
/

Why Kenya & Ethiopia

Unlike other areas of the world, chronic hunger, food insecurity and famine
continue to affect millions of residents of sub-Saharan Africa

Extensive environmental changes

Many large dams and micro dams and irrigated agriculture projects ongoing

P. vivax in Africa

To address African vivax malaria epidemiology and vivax among Duffy negatives

Primaquine Treatment

Ethiopia recently approved primaquine in the treatment regime, ideal for evaluating its effectiveness under field conditions

Mosquito insecticide resistance

Evolution of resistance. We will evaluate of new interventions (e.g., next generation nets, IVM)

Residual transmission

In low transmission settings can pose significant challenges to achieving malaria elimination goals

Impact of changing malaria transmission

The acquisition and maintenance of immunity and how this relates to susceptibility to symptomatic and severe malaria

About SSA-ICEMR

Environmental Modifications in sub-Saharan Africa: Changing Epidemiology,
Transmission, and Pathogenesis of Plasmodium falciparum and P. vivax Malaria

To assess the impact of human environmental modifications such as dam construction, irrigation canals and shifting agricultural practices on the epidemiology, vector biology, transmission, pathogenesis and clinical manifestations of P. falciparum and P. vivax infection in the East African setting.
Understanding the consequences of expanding environmental modifications on local malaria ecosystems will allow for the rational development of novel and culturally appropriate surveillance and control/elimination strategies in a highly populated area of East Africa where high level insecticide resistance exists and public health interventions against malaria are limited primarily to insecticidal bed nets and indoor residual spraying of insecticides. Knowledge gained from this ICEMR is pertinent to malaria control in other under-studied regions of Africa where P. falciparum and P. vivax are co-endemic and drought, famine and/or human population movement and displacement are frequent.

Pop. at Risk: Ethiopia (Total Pop: 82M)

52

Pop. at Risk: Kenya (Total Pop: 53M)

70

ITN Coverage: Ethiopia

15

ITN Coverage: Kenya

57

P.vivax % in Ethiopia

18
2
Study Counties
4
Study Sties
165
Study Clusters
300
Field Staff
28010
Total Household Enrolled
298961
Total Resident-Visits
75060
Mosquito Sampling Trap/Night
25564
Larval Habitats Visits
11460
IRS Sprayed Houses
12600
PBO Net Distributed
13
LLIN Net Average Holes
125
Deployed Tablets

ICEMR Central Theme

To assess the impact of human environmental modifications on Plasmodium falciparum
and P. vivax infection in the East African setting

  • Epidemiology
  • Vector & Transmission
  • Pathogenesis & Immunity
  • Adaptive Interventions

Impact of Environmental Modifications on falciparum and vivax Malaria Epidemiology and Disease Burden.
Research Question: How do environmental modifications such as the construction of dams and shifting agricultural practices affect malaria epidemiology at the molecular, individual, field, and population levels?
Hypothesis: Environmental modifications from water resource development projects such as the construction of dams, irrigation, and shifting agricultural practices affect malaria epidemiology at the molecular, individual, field, and population levels.

Impact of Environmental Modifications on Malaria Vector Ecology and Transmission
Research Question: How do environmental modifications from water resource development projects alter the ecology and behaviors of malaria vectors and subsequently malaria transmission?
Hypothesis: Environmental modifications from water resource development projects alter the ecology and behaviors of malaria vectors and subsequently malaria transmission

Impact of Environmental Modifications on Malaria Pathogenesis and Immunity
Research Questions: 1. How do environmental modifications affect protective immune mechanisms of uncomplicated and severe malaria due to blood stage infection? 2. How do antibodies to sexual stage antigens mediate transmission-reducing immunity?
Hypothesis:

Adaptive Interventions for Optimizing Malaria Control: A Cluster-Randomized SMART Trial
Objective: To identify the optimal combination of malaria vector control interventions to have the maximum impact of reduction of malaria burden based on an available set of interventions at the point in time; Malaria transmission risk and vector ecology at a point in time; Incorporating past experience to a point in time and variables predicting future risk of malaria.
Hypotheses: Interventions through adaptive use of vector control will reduce clinical malaria incidence in a cost-effective manner; Strategies with adaptive intervention will result in better outcomes than those without in measures related to transmission risk such as asymptomatic infection prevalence, insecticide resistance, or drug resistance.

Special Reseach

Special research projects related to Sub-Saharan Africa ICEMR

Spatial Repellents

Evaluation of Spatial Repellents against Pyrethroid-Resistant Malaria Vectors in Malaria Spheres Research Aims: Evaluate the effect of spatial repellent products sold in Africa on preventing pyrethroid-resistant mosquitoes from approaching houses and entering houses.

High-Altitude Migration

Wind-assisted, Long-distance, High-altitude Flight of Malaria Mosquitoes Research Question: Does high-altitude, long-distance flight occur in malaria vectors, and what is its role in malaria transmission maintenance?

Ultra-Sensitive PCR

Malaria Infection Diagnosis: The Value of Ultra-sensitive PCR Method Rationale: Asymptomatic individuals act as silent reservoirs of malaria transmission, perpetuating low-density transmission. Only the most mature gametocyte (stages iv – v) exist in peripheral blood circulation and offer a link in malaria transmission. .

Ultra-Sensitive RDT

Added Value of Ultra-sensitive RDT for Malaria Surveillance in the Context of Rapidly Changing Epidemiology? Aim: Evaluate whether recently developed ultrasensitive RDT (usRDT) provides a more sensitive and accurate diagnosis of Plasmodium falciparum in community and healthcare settings.

Hydro-Climatic Transmission Model

Water & Malaria: Hydrologic Model Development & Simulation Objective:Understand the location and duration of surface water detention being related to mosquito breeding; Investigate the impact of irrigation on the soil moisture and water storage in the field.

Urban Malaria

Urban Malaria and Invasive Vectors Malaria is traditionally associated with rural and tropical regions, but it is increasingly becoming a concern in urban settings, particularly in invasive vector areas.

Key Investigators

We are the malaria professionals

Guiyun Yan

Guiyun Yan

Program Director

Guiyun Yan, Ph.D.
Chancellor's Fellow
Professor, Population Health and Disease Prevention, Public Health
University of California Irvine, CA, USA
James W. Kazura

James W. Kazura

Project Lead

James Kazura, M.D.
Distinguished University Professor, School of Medicine
Member, Center for Global Health & Diseases, School of Medicine
Case Western Reserve University, OH, USA
Andrew K. Githeko

Andrew K. Githeko

Admin Core Co-Director

Andrew K. Githeko, Ph.D.
Chief Research Officer, Climate and Human Health Research Unit
Kenya Medical Research Institute (KEMRI), Kisumu, Kenya
Delenasaw Yewhalaw

Delenasaw Yewhalaw

Project Lead

Delenasaw Yewhalaw, Ph.D.
Professor of Medical Entomology
Director, Tropical & Infectious Diseases Research Center (TIDRC)
Jimma University, Jimma, Ethiopia
Christopher L. King

Christopher L. King

Principal Investigator

Christopher L. King, M.D., Ph.D.
Professor, Department of Pathology, School of Medicine
Associate Professor, Department of Medicine
Member, Center for Global Health and Diseases, School of Medicine
Case Western Reserve University, OH, USA
Kuo-lin Hsu

Kuo-lin Hsu

Principal Investigator

Kuo-lin Hsu, Ph.D.,
Professor, Civil and Environmental Engineering
Samueli School of Engineering,
University of California Irvine, CA, USA
Kora Tushune

Kora Tushune

Site Coordinator

Kora Tushune, Ph.D.
Vice President, Associate Professor of Health Policy and Economics
Jimma University, Ethiopia

John Githure

John Githure

Project Investigator

John Githure, Ph.D.
Senior Project Lead
Tom Mboya University – UC Irvine Joint Laboratory, Kenya

Harrysone Atieli

Harrysone Atieli

Project Investigator

Harrysone E. Atieli, Ph.D.
Program Manager & Project Lead
Tom Mboya University – UC Irvine Joint Laboratory, Kenya

Arlene E. Dent

Arlene E. Dent

Project Investigator

Arlene E. Dent, M.D., Ph.D.
Assistant Professor, Pediatric Infectious Disease
School of Medicine,
Case Western Reserve University, Ohio, USA

Guofa Zhou

Guofa Zhou

Project Investigator

Guofa Zhou, Ph.D.
Project Scientist
Department of Population Health & Disease Prevention
College of Health Sciences
University of California, Irvine

Daibin Zhong

Daibin Zhong

Project Investigator

Daibin Zhong, Ph.D.
Project Scientist
Department of Population Health & Disease Prevention
College of Health Sciences
University of California, Irvine

Ming-Chieh Lee

Ming-Chieh Lee

Data Core Director & Project Investigator

Ming-Chieh, Alexander, Lee, Ph.D.
What?
Assistant Project Scientist
Department of Population Health & Disease Prevention
College of Health Sciences
University of California, Irvine

Ai-Ling Jiang

Ai-Ling Jiang

Project Investigator

Ai-Ling Jiang, Ph.D., P.E.
Postdoctoral Scholar
Center for Hydrometeorology and Remote Sensing
University of California Irvine

Hiwot Solomon

Hiwot Solomon

Ethiopia MoH Collaborator

Hiwot Solomon, Ph.D.
Lead Executive Officer
Disease Prevention And Control
Ministry of Health - Ethiopia

Charles O. Ochola

Charles O. Ochola

Kenya Collaborator

Prof. Charles O. Ochola, Ph.D.
Acting Vice Chancellor, Council Member
Tom Mboya University
Kenya Collaborator

Chloe Wang

Chloe Wang

Project Coordinator

Chloe Wang, PhD
Project Coordinator
Sub-Saharan Africa ICEMR
University of California, Irvine

UC Irvine
Case Western Reserve University
Burnet Institute
Ministry of Health - Ethiopia
Jimma University
Addis Ababa University
Dire Dawa University
Hawassa University
Samara University
Tom Mboya University
PMI VectorLink
KEMRI
Maseno University
Kenya MoH

Regional Impacts

In the past decade, sub-Saharan African countries have experienced a new era of large dam constructions and expansion of irrigated agricultural farms to resolve famine and food shortage. These environmental changes may have unforeseen ecologic consequences that adversely affect human health. Knowledge gained from this ICEMR is important to malaria control, not only for the two study countries studied, but also to other regions of Africa prone to drought, famine, and large-scale human population movement.

ICEMR 2019 Annual Workshop

ICEMR Annual Workshop, July 23-27, 2019, in Nairobi, Kenya

ICEMR 2019 Annual Meeting