Malaria Transmission Consortium A multi-institution, 5-year malaria research project funded by the Bill & Melinda Gates Foundation
MTC Participants University of Notre Dame Centers for Disease Control & Prevention Durham University Highlands Malaria Project, Kenya & Uganda Indonesia National Malaria Control Program Unicef, WHO UGM, Litbang, Eijkmann, UI, UnAir Kenya Medical Research Institute, MOH London School of Hyg. & Trop. Med. Swiss Tropical Institute Tanzania Dar es Salaam City Council Ifakara Health R & D Center Zambia MACEPA Project
Key Assumptions Underlying MTC 1. MTC research is malaria transmission focused 2. All DEC partners have funded malaria control programs (GF, PMI) 3. All non-dec partners have relationships with DEC malaria control programs 4. MTC resources will help evaluate programs funded largely with other resources 5. MTC research objectives must support NMCPs as determined across multiple countries and settings 6. Current MTC objectives important, but can be modified 7. MTC resources cannot be used for capacity building independent of objectives and structure of current proposal 8. New MTC objectives can be added over time (with approval of Foundation) 9. Gates Foundation supports other Malaria Consortiums
Global Malaria Eradication 1. Announced by BMGF and WHO at Malaria Forum and Meeting of ASTMH 2. Eradication Language Used in NIAID Draft Malaria Research Agenda 3. Eradication Goal Will Impact all MTC Objectives 5. Convergence of Malaria Control and Malaria R & D Streams
Main Consortium Objectives 1. Develop and Validate Standard Measures of Malaria Transmission 2. Compare and Evaluate Transmissionreducing Malaria Control Strategies 3. Evaluate Impact of Phenomena like Insecticide Resistance and Vector Behavior on Control 4. Use Malaria Simulation Models to Inform above Objectives
1. Malaria Transmission Measures 1. Develop Sampling Techniques for Estimating Vector Populations (esp. low level transmission) - Biting Population - Resting Population - House Entering/Exiting Population 2. Assess Efficacy of Laboratory Assays - SPZ antigen, Vector Species, etc. 3. Assess Serological Measures of Transmission (esp. low level transmission) 4. Assess Parasite Diagnostic Approaches in Human Population (esp. low level transmission) - Incidence in Cohorts - Prevalence Surveys
Study Sites for Malaria Transmission Measures Highlands Dar es Salaam Indonesia L Indonesia M Zambia Indonesia H Kenya
Standardized Protocols Develop Public Protocols Develop Public Web Site (Wiki) Develop Controlled Vocabularies Develop Relational Database Management System Develop Data Capture Systems (PDAs)
Evaluate Interventions 1. LLIN: full coverage vs high risk coverage (Western Kenya, Indonesia L & M) 2. Compare annual IRS vs IRS/LLIN vs LLIN alone (Western Kenya, Zambia, Indonesia M & H, Highlands) 3. Assess LLIN versus LLIN plus Larval Control (Dar es Salaam, Western Kenya, Indonesia) 4. Assess effect of ACTs on transmission (Indonesia M & H) 5. Malaria in pregnancy: prompt treatment vs LLIN vs IPTp (Indonesia M & H) 6. Low Transmission Settings: Assess IRS and ITN alone or with case detection and ACT (Indonesia L)
Study Sites for Evaluating Interventions 1 2 3 4 5 6 T Highlands 0 X 0 0 0 0 1 Dar es Salaam 0 0 X 0 0 0 1 Indonesia L X X 0 X 0 X 4 Indonesia M X X 0 X X 0 4 Zambia 0 X 0 X 0 0 2 Indonesia H 0 X X 0 X 0 3 Kenya X X X 0 0 0 3
Evaluate Impact of Insecticide Resistance and Vector Behavior 1. Compare resistance genotype and control effectiveness 2. Assess pyrethroid resistance emergence in response to IRS versus ITN use of insecticides 3. Establish routine resistance monitoring at all sites 4. Develop standard tools for monitoring vector behavior 5. Assess relationship between control effectiveness and behavior 6. Assess impact of control on behavior (evolution) 7. Assess effectiveness of LLIN and/or IRS against exophagic, exophilic vectors (not on original list per se)
Study Sites for Resistance & Behavior 1 2 3 4 5 6 Highlands 0 0 X 0 0 X Dar es Salaam 0 0 X X 0 X Indonesia L 0 0 X X X X Indonesia M 0 0 X X X X Zambia 0 X X X 0 X Indonesia H 0 0 X 0 X X Kenya X X X X X X
Participants MTC Annual Review (Zambia 26-30 Nov. 2007) PIs (Objective & Country) Country NMCP Representative External Scientific Advisory Committee Presentation of Protocols Review by Participants Report to BMGF
Immediate Actions by Indonesian (and other) MTC partners 1. Review and approve objectives in proposal or offer modifications (NMCP leader and MTC Indonesia PIs) 2. Establish protocols for subcontracts from Notre Dame 3. Establish roles of Indonesian scientists involved in projects 4. Work with Objective PIs to write detailed protocols for project implementation 5. Determine and identify relevant review boards 6. Establish field and lab sites, hire field and laboratory teams 7. Start process for major equipment (vehicles, lab equipment) and supplies purchases 8. Prepare for late November 2007 workshop
VectorBase: General Issues Support Ontology & IRBase Development Model for Community Submission of Data Genomes at the Core of VectorBase Population Genetics/Genomics and other Population Issues
VectorBase: Pop. Genomics Lanzaro/Taylor Forced Marriage Issues that will emerge Resistance Cytogenetics Population Genetics Ecology (Mapping, Weather, etc.) Array Data (genome & expression)
Questions?