Scientific Findings of the Southern and Central Africa International Center of Excellence for Malaria Research: Ten Years of Malaria Control Impact Assessments in Hypo-, Meso-, and Holoendemic Transmission Zones in Zambia and Zimbabwe

Author:

Ippolito Matthew M.12,Gebhardt Mary E.2,Ferriss Ellen2,Schue Jessica L.2,Kobayashi Tamaki2,Chaponda Mike3,Kabuya Jean-Bertin3,Muleba Mbanga3,Mburu Monicah4,Matoba Japhet4,Musonda Michael4,Katowa Ben4,Lubinda Mukuma4,Hamapumbu Harry4,Simubali Limonty4,Mudenda Twig4,Wesolowski Amy2,Shields Timothy M.2,Hackman Andre2,Shiff Clive2,Coetzee Maureen5,Koekemoer Lizette L.5,Munyati Shungu6,Gwanzura Lovemore67,Mutambu Susan8,Stevenson Jennifer C.24,Thuma Philip E.4,Norris Douglas E.2,Bailey Jeffrey A.9,Juliano Jonathan J.10,Chongwe Gershom11,Mulenga Modest12,Simulundu Edgar4,Mharakurwa Sungano68,Agre Peter C.2,Moss William J.2,_ _

Affiliation:

1. Johns Hopkins University School of Medicine, Baltimore, Maryland;

2. Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland;

3. Tropical Diseases Research Centre, Ndola, Zambia;

4. Macha Research Trust, Choma, Zambia;

5. Wits Research Institute for Malaria, Faculty of Health Sciences, University of the Witwatersrand and National Institute for Communicable Diseases, Johannesburg, South Africa;

6. Biomedical Research and Training Institute, Harare, Zimbabwe;

7. University of Zimbabwe Faculty of Medicine and Health Sciences, Harare, Zimbabwe;

8. Africa University, Mutare, Zimbabwe;

9. Brown University, Providence, Rhode Island;

10. University of North Carolina School of Medicine, Chapel Hill, North Carolina;

11. University of Zambia, Lusaka, Zambia;

12. Directorate of Research and Postgraduate Studies, Lusaka Apex Medical University, Lusaka, Zambia

Abstract

ABSTRACT. For a decade, the Southern and Central Africa International Center of Excellence for Malaria Research has operated with local partners across study sites in Zambia and Zimbabwe that range from hypo- to holoendemic and vary ecologically and entomologically. The burden of malaria and the impact of control measures were assessed in longitudinal cohorts, cross-sectional surveys, passive and reactive case detection, and other observational designs that incorporated multidisciplinary scientific approaches: classical epidemiology, geospatial science, serosurveillance, parasite and mosquito genetics, and vector bionomics. Findings to date have helped elaborate the patterns and possible causes of sustained low-to-moderate transmission in southern Zambia and eastern Zimbabwe and recalcitrant high transmission and fatality in northern Zambia. Cryptic and novel mosquito vectors, asymptomatic parasite reservoirs in older children, residual parasitemia and gametocytemia after treatment, indoor residual spraying timed dyssynchronously to vector abundance, and stockouts of essential malaria commodities, all in the context of intractable rural poverty, appear to explain the persistent malaria burden despite current interventions. Ongoing studies of high-resolution transmission chains, parasite population structures, long-term malaria periodicity, and molecular entomology are further helping to lay new avenues for malaria control in southern and central Africa and similar settings.

Publisher

American Society of Tropical Medicine and Hygiene

Subject

Virology,Infectious Diseases,Parasitology

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