Program for Resistance, Immunology, Surveillance, and Modeling of Malaria in Uganda (PRISM) (East Africa ICEMR)

Objectives

The main objective of this project is to improve the understanding of the disease and to measure the impact of population-level control interventions.

PRISM has implemented a comprehensive malaria surveillance program including enhanced health facility-based surveillance and detailed longitudinal studies in three regions with differing transmission intensities. Complementary laboratory-based studies include surveillance for markers of antimalarial drug and insecticide resistance and serologic measures of malaria exposure. These studies have greatly improved our understanding of the epidemiology of malaria in Uganda and of the impact of control interventions.

The program will consist of three research projects linked together in an integrated manner to maximize scientific discovery.

• Research project 1 (Resistance project) will use samples collected over time at multiple sites to characterize the evolution of phenotypic and genotypic markers of drug and insecticide resistance and assess the impacts of these markers on malaria transmission.
• Research project 2 (Epidemiology project) will use longitudinal samples from cohorts to characterize factors that determine whether sporozoite inoculation results in the establishment of blood stage infection and characterize factors affecting the duration, density, and clinical consequences of blood stage infections.
• Research project 3 (Transmission project) will use cohort samples to determine factors associated with gametocyte production and development, evaluate infectivity of the human host to mosquito vectors, and characterize the human infectious reservoir.

These highly interrelated projects will be conducted in settings with varied malaria epidemiology and differing population level control intervention to provide critical information needed to optimize strategies for the control and ultimate elimination of malaria in Uganda.