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The Intransigence of Malaria in Malawi: Understanding Hidden Reservoirs, Successful Vectors and Prevention Failures

Award Number: U19AI089683
ORGANIZATION: NATIONAL INSTITUTE OF ALLERGY & INFECTIOUS DISEASES
OPDIV: NIH
AWARD CLASS: COOPERATIVE AGREEMENT
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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At the population level, malaria remains an intractable problem in Malawi, a small but ecologically diverse country in southeastern Africa. The reasons for malaria's intransigence are enigmatic, but new findings emerging from our current ICEMR investigations have provided some clues:  Plasmodium parasite infection prevalence is greater in school-age children than in under-five year olds  School-age children are also most likely to carry gametocytes, the stage infectious to Anopheles vectors  Molecular (q-PCR) diagnostic tests revealed low-level infection in people who were asymptomatic, hence not being treated ("hidden reservoirs"), hence a likely source of undetected transmission  Anopheles vector abundance varied across a 20-km radius around a major urban center, with "hot spots" being linked to micro-environmental heterogeneity, and not to a simple urban-rural designation  Prevention failures may result from insecticide resistance and patterns of insecticide treated net use. At the individual level, only a small proportion of people infected with Plasmodium parasites ever experience symptoms of malaria illness; most co-exist asymptomatically with the parasite. An even smaller proportion evolves into severe and complicated malaria, but the mortality rates are high. The mechanisms underlying progression along the infection-to-disease spectrum are not known, in part because reliably identifying individuals at the infection extremes (persistently asymptomatic and life-threatening cerebral malaria) has only recently become feasible. The Malawi ICEMR team has the capacity to sustain long-term observations of human cohorts in different transmission settings and to collect extensive ecological, entomological and parasitological data to evaluate:  patterns of pathogen transmission and human host responses,  effectiveness of multiple interventions against transmission and infection in different environments,  relationships between infection frequency/duration and disease severity,  impacts of insecticide resistance and insecticide treated net (ITN) quality and use on disease patterns,  contributions of parasite growth rate, clonality, pro- and anti-inflammatory host responses  importance of “holes” in the immune response to variant surface antigens to disease progression. Over the course of seven years of research, which will span Malawi's next large national ITN distribution program, the Malawi ICEMR will identify why malaria control efforts in Malawi have been ineffective thus far, and will provide data-driven suggestions regarding approaches that are more likely to be effective. Studies will be undertaken in three ecologically and epidemiologically different districts that span a range of transmission intensities. Analyses of changing transmission and disease will compare patterns before, during and after the nation-wide ITN distribution program.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2025 ( Subtotal = -$620,326 )
2025	2023	MICHIGAN STATE UNIVERSITY	426 AUDITORIUM RD RM 2	EAST LANSING	MI	48824	INGHAM	USA	Allergy and Infectious Diseases Research	000	14	10/25/2024	NON-COMPETING CONTINUATION	-$620,326
														Subtotal = -$620,326

Issue Date FY: 2024 ( Subtotal = $0 )
2024	2023	MICHIGAN STATE UNIVERSITY	426 AUDITORIUM RD RM 2	EAST LANSING	MI	48824	INGHAM	USA	Allergy and Infectious Diseases Research	000	14	2/27/2024	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2023 ( Subtotal = $1,645,866 )
2023	2023	MICHIGAN STATE UNIVERSITY	426 AUDITORIUM RD RM 2	EAST LANSING	MI	48824	INGHAM	USA	Allergy and Infectious Diseases Research	000	14	3/30/2023	NON-COMPETING CONTINUATION	$1,645,866
														Subtotal = $1,645,866

Issue Date FY: 2022 ( Subtotal = $1,785,089 )
2022	2022	MICHIGAN STATE UNIVERSITY	426 AUDITORIUM RD RM 2	EAST LANSING	MI	48824	INGHAM	USA	Allergy and Infectious Diseases Research	001	13	8/19/2022	NON-COMPETING CONTINUATION	$661,166
2022	2022	MICHIGAN STATE UNIVERSITY	426 AUDITORIUM RD RM 2	EAST LANSING	MI	48824	INGHAM	USA	Allergy and Infectious Diseases Research	002	13	9/14/2022	NON-COMPETING CONTINUATION	$0
2022	2022	MICHIGAN STATE UNIVERSITY	426 AUDITORIUM RD RM 2	EAST LANSING	MI	48824	INGHAM	USA	Allergy and Infectious Diseases Research	000	13	4/13/2022	NON-COMPETING CONTINUATION	$1,123,923
														Subtotal = $1,785,089

Issue Date FY: 2021 ( Subtotal = $1,164,752 )
2021	2021	MICHIGAN STATE UNIVERSITY	426 AUDITORIUM RD RM 2	EAST LANSING	MI	48824	INGHAM	USA	Allergy and Infectious Diseases Research	001	12	4/5/2021	NON-COMPETING CONTINUATION	$1,164,752
2021	2021	MICHIGAN STATE UNIVERSITY	426 AUDITORIUM RD RM 2	EAST LANSING	MI	48824	INGHAM	USA	Allergy and Infectious Diseases Research	002	12	8/31/2021	NON-COMPETING CONTINUATION	$0
2021	2020	MICHIGAN STATE UNIVERSITY	426 AUDITORIUM RD RM 2	EAST LANSING	MI	48824	INGHAM	USA	Allergy and Infectious Diseases Research	000	11	12/8/2020	NON-COMPETING CONTINUATION	$0
														Subtotal = $1,164,752

Issue Date FY: 2020 ( Subtotal = $1,646,933 )
2020	2020	MICHIGAN STATE UNIVERSITY	426 AUDITORIUM RD RM 2	EAST LANSING	MI	48824	INGHAM	USA	Allergy and Infectious Diseases Research	001	11	3/26/2020	NON-COMPETING CONTINUATION	$1,646,933
2020	2020	MICHIGAN STATE UNIVERSITY	426 AUDITORIUM RD RM 2	EAST LANSING	MI	48824	INGHAM	USA	Allergy and Infectious Diseases Research	002	11	6/25/2020	NON-COMPETING CONTINUATION	$0
2020	2019	MICHIGAN STATE UNIVERSITY	426 AUDITORIUM RD RM 2	EAST LANSING	MI	48824	INGHAM	USA	Allergy and Infectious Diseases Research	000	10	2/19/2020	NON-COMPETING CONTINUATION	$0
														Subtotal = $1,646,933

Issue Date FY: 2019 ( Subtotal = $1,636,893 )
2019	2019	MICHIGAN STATE UNIVERSITY	426 AUDITORIUM RD RM 2	EAST LANSING	MI	48824	INGHAM	USA	Allergy and Infectious Diseases Research	002	10	7/24/2019	SUPPLEMENT FOR EXPANSION	$471,173
2019	2019	MICHIGAN STATE UNIVERSITY	426 AUDITORIUM RD RM 2	EAST LANSING	MI	48824	INGHAM	USA	Allergy and Infectious Diseases Research	001	10	3/28/2019	NON-COMPETING CONTINUATION	$1,165,720
2019	2018	MICHIGAN STATE UNIVERSITY	426 AUDITORIUM RD RM 2	EAST LANSING	MI	48824	INGHAM	USA	Allergy and Infectious Diseases Research	000	9	12/21/2018	NON-COMPETING CONTINUATION	$0
														Subtotal = $1,636,893

Issue Date FY: 2018 ( Subtotal = $1,191,008 )
2018	2018	MICHIGAN STATE UNIVERSITY	426 AUDITORIUM RD RM 2	EAST LANSING	MI	48824	INGHAM	USA	Allergy and Infectious Diseases Research	003	9	8/20/2018	NON-COMPETING CONTINUATION	$0
2018	2018	MICHIGAN STATE UNIVERSITY	426 AUDITORIUM RD RM 2	EAST LANSING	MI	48824	INGHAM	USA	Allergy and Infectious Diseases Research	002	9	3/23/2018	NON-COMPETING CONTINUATION	$1,191,008
2018	2017	MICHIGAN STATE UNIVERSITY	426 AUDITORIUM RD RM 2	EAST LANSING	MI	48824	INGHAM	USA	Allergy and Infectious Diseases Research	001	8	2/22/2018	COMPETING CONTINUATION	$128,288
2018	2016	MICHIGAN STATE UNIVERSITY	426 AUDITORIUM RD RM 2	EAST LANSING	MI	48824	INGHAM	USA	Allergy and Infectious Diseases Research	000	7	2/22/2018	EXTENSION WITH OR WITHOUT FUNDS	-$128,288
														Subtotal = $1,191,008

Issue Date FY: 2017 ( Subtotal = $1,195,625 )
2017	2017	MICHIGAN STATE UNIVERSITY	426 AUDITORIUM RD RM 2	EAST LANSING	MI	48824	INGHAM	USA	Allergy and Infectious Diseases Research	002	8	4/28/2017	COMPETING CONTINUATION	$1,195,625
2017	2016	MICHIGAN STATE UNIVERSITY	426 AUDITORIUM RD RM 2	EAST LANSING	MI	48824	INGHAM	USA	Allergy and Infectious Diseases Research	001	7	11/25/2016	EXTENSION WITH OR WITHOUT FUNDS	$15,333
2017	2015	MICHIGAN STATE UNIVERSITY	426 AUDITORIUM RD RM 2	EAST LANSING	MI	48824	INGHAM	USA	Allergy and Infectious Diseases Research	000	6	11/25/2016	NON-COMPETING CONTINUATION	-$15,333
														Subtotal = $1,195,625

Issue Date FY: 2016 ( Subtotal = $1,577,614 )
2016	2016	MICHIGAN STATE UNIVERSITY	301 ADMINISTRATION BLDG	EAST LANSING	MI	48824	INGHAM	USA	Allergy and Infectious Diseases Research	000	7	6/30/2016	EXTENSION WITH OR WITHOUT FUNDS	$1,577,614
														Subtotal = $1,577,614

Issue Date FY: 2015 ( Subtotal = $1,817,796 )
2015	2015	MICHIGAN STATE UNIVERSITY	301 ADMINISTRATION BLDG	EAST LANSING	MI	48824	INGHAM	USA	Allergy and Infectious Diseases Research	000	6	6/18/2015	NON-COMPETING CONTINUATION	$1,817,796
														Subtotal = $1,817,796

Issue Date FY: 2014 ( Subtotal = $1,866,999 )
2014	2014	MICHIGAN STATE UNIVERSITY	301 ADMINISTRATION BLDG	EAST LANSING	MI	48824	INGHAM	USA	Allergy and Infectious Diseases Research	000	5	6/25/2014	NON-COMPETING CONTINUATION	$1,866,999
														Subtotal = $1,866,999

Issue Date FY: 2013 ( Subtotal = $1,709,135 )
2013	2013	MICHIGAN STATE UNIVERSITY	301 ADMINISTRATION BLDG	EAST LANSING	MI	48824	INGHAM	USA	Allergy and Infectious Diseases Research	000	4	6/28/2013	NON-COMPETING CONTINUATION	$1,709,135
														Subtotal = $1,709,135

Issue Date FY: 2012 ( Subtotal = $1,825,484 )
2012	2012	MICHIGAN STATE UNIVERSITY	301 ADMINISTRATION BLDG	EAST LANSING	MI	48824	INGHAM	USA	Allergy and Infectious Diseases Research	001	3	6/30/2012	SUPPLEMENT FOR EXPANSION	$231,850
2012	2012	MICHIGAN STATE UNIVERSITY	301 ADMINISTRATION BLDG	EAST LANSING	MI	48824	INGHAM	USA	Allergy and Infectious Diseases Research	002	3	6/30/2012	SUPPLEMENT FOR EXPANSION	$249,671
2012	2012	MICHIGAN STATE UNIVERSITY	301 ADMINISTRATION BLDG	EAST LANSING	MI	48824	INGHAM	USA	Allergy and Infectious Diseases Research	000	3	6/27/2012	NON-COMPETING CONTINUATION	$1,343,963
														Subtotal = $1,825,484

Issue Date FY: 2011 ( Subtotal = $1,328,917 )
2011	2011	MICHIGAN STATE UNIVERSITY	301 ADMINISTRATION BLDG	EAST LANSING	MI	48824	INGHAM	USA	Allergy and Infectious Diseases Research	000	2	7/15/2011	NON-COMPETING CONTINUATION	$1,328,917
														Subtotal = $1,328,917

Issue Date FY: 2010 ( Subtotal = $999,292 )
2010	2010	MICHIGAN STATE UNIVERSITY	301 ADMINISTRATION BLDG	EAST LANSING	MI	48824	INGHAM	USA	Allergy and Infectious Diseases Research	000	1	6/30/2010	NEW	$999,292
														Subtotal = $999,292

Grand Total All Awards = $20,771,077

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The Intransigence of Malaria in Malawi: Understanding Hidden Reservoirs, Successful Vectors and Prevention Failures

Award Number: U19AI089683

ORGANIZATION: NATIONAL INSTITUTE OF ALLERGY & INFECTIOUS DISEASES

OPDIV: NIH

AWARD CLASS: COOPERATIVE AGREEMENT

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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