ICEMR-MALI : Multidisciplinary Research For Malaria Control And Prevention in West Africa

Wide deployment of malaria control tools in the past decade, has significantly contribute to substantial reduction of the incidence and deaths related to the disease in Sub-sahara Africa[1]. Yet, the region continues to carry a disproportionately high share of the global malaria burden of malaria deaths.

Several studies report a high but stable malaria incidence in Africa [2-5]. Other studies have also shown that after a long period of decreasing burden related to intensive control interventions, malaria rebound occurred presumably associated with resistance to drug and insecticides[6, 7].

Moreover, rebounded in others setting after a long period of decrease associated with intensive deployment of malaria control tools. There is a need to understand the relationships interaction among current combination of malaria control interventions, entomologic aspects of transmission and the incidence of human infection and disease in different eco-zones across West Africa that span the savanna and sub-Saharan Sahel region.

A challenge in malaria immunological research was how people naturally clear malaria parasites from the blood stream or why some people and not others develop severe malaria[8, 9].

Recent advances in genome research have now provided unprecedented opportunities to tackle these questions. Indeed, most human or parasite genes show variation between individuals and between different settings. By investigating how this natural genetic variation affects malaria susceptibility and efforts to control malaria, we can build a catalogue of host/parasite molecules that are critical for protective immunity[10-12].

Most recently, P. falciparum has developed resistance to the artemisinins, the most important and most widely used antimalarial drug today[13, 14]. Furthermore, P. falciparum can evade the human immune response and cope with changes in the Anopheles vector and other environment fluctuations[15].

 

 

 

OVERALL GOALS

The Overall goal of this ICEMR is to understand the variable effectiveness of current malaria control interventions in different ecological settings of West Africa through research to understand interactions between the parasite (response to drug treatment, genotypes, gametocyte survival), human (immune response and host genetics) and the vector (ecology, behaviors, and response to insecticides) and regulating influences of the local environment and human behavior. This ICEMR encompasses 3 Projects with the goals summarized as follow:

1]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,

2] 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

3] 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 links 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, Immunopahtogenesis) and seasonal and geographical distribution of anopheline mosquitoes vectors (Project 3). Understanding the factors relating entomological and epidemiological patterns of transmission will provide more definitive guidelines for malaria control efforts in Mali and in West Africa.

OBJECTIVES

GENERAL OBJECTIVE

GENERAL OBJECTIVE

To determine the intensity of the Impact of current malaria control strategies across three different patterns of malaria epidemiology and endemicity in Mali and provide evidence basis for improving these strategies.

MD : Determine effect of current malaria control strategies in three different epidemiological settings in Mali SD: To study the variability of effects of current malaria control strategies in different epidemiological settings in Mali MT: To study malaria transmission dynamic in three different epidemiological settings in Mali in relation to existing control strategies.

THREE RESEARCH SITES

CHARACTERISTICS DANGASSA KOULIKORO DIORO
Ecology South Savana North Savana Sahel, irrigated
Transmission June-Nov June-Oct July-Oct
Malaria Control Intervention
ACTs Free for children <5 +ICEMR cohort Free for children < 5 Free for all up to 2014
LLINs/Univers 2012 – 2015 – 2018 2012 – 2015 – 2018 2008 – 2014 – 2019
IRS NO 2008-2016 NO
SMC 2015 2015 2015