Grand Challenges is a family of initiatives fostering innovation to solve key global health and development problems. Each initiative is an experiment in the use of challenges to focus innovation on making an impact. Individual challenges address some of the same problems, but from differing perspectives.
This study intends to evaluate the use of long- lasting insecticide-impregnated nets (LLINs) and their implications in a municipality of five Brazilian Amazonian states. Brazil has been using LLINs as a supplementary control tool for over 10 years and during this period many questions regarding its effectiveness were raised. Therefore, the present project aims to verify if the distribution strategy was accompanied by specific information, such as individual or group orientations, calendar provision, explanation about using, washing and caring in order to assess if there is a need to adapt this strategy to the population’s habits, culture and education, to the local dynamics of malaria transmission and environmental factors.
This project intends to establish a platform for colonization and mass infection of Nyssorhynchus darlingi, the primary vector in almost every state in the Amazon region and one of the more efficient vectors in the process of Plasmodium spp transmission. The establishing of a mass breeding colony of the main malaria vector in Brazil in the laboratory is extremely necessary and represents a primary condition for the development of malaria research in a multidisciplinary context. This project will allow establishing the first platform for mass production and infection of Ny. darlingi, supplying the scientific community with quality services, infection models and technical training.
This clinical trial seeks to fill a global gap in the treatment of uncomplicated vivax malaria: to evaluate the safety and tolerability of short and long-term primaquine treatment regimens for uncomplicated vivax malaria in children. Thus, it hopes to provide a clinical and laboratory description of the main adverse events related to primaquine treatment in children, whether long (14 days) or short (7 days). This will inform safe and tolerable treatment for thousands of children who suffer from successive vivax malaria infections and are cared for by the Brazilian public health service and will help prevent complications after treatment begins.
The objective of this project is to develop data visualization tools and malaria outbreaks spreading simulation-based in machine learning methods, using demographic, epidemiological, climatic and clinical data related to malaria in the Brazilian Amazon. Such tools will be provided through a Web Platform with supporting tools to public administrators; the goal is for it to be ready for use in the short term. All the infrastructure for the creation and provision for a Web Platform had been developed.
This study seeks to search for molecular markers capable of predicting the activation of hypnozoites, unique and dormant forms of vivax malaria. To do so, a metabolomic approach will be used in samples from patients with a chance of recurrence in several malaria-endemic areas. The project is innovative because it combines strict clinical follow-up and analysis of metabolites through the processing of samples using high sensitivity and resolution instrumentalization.
The study proposes to follow patients with malaria in locations with different transmission scenarios to determine the factors related to infection recurrence. For that, clinical follow-up protocols will be applied, as well as molecular biology techniques, medicine quality assessment, treatment adherence, adverse effect frequency and molecular and pharmacogenetics aspects. The project will improve the knowledge about factors associated with recurrence and classify those episodes, making possible to adjust the recommendation on case management.
Artesunate/mefloquine (ASMQ) has good efficacy, safety, and tolerability when used with primaquine (PQ) on the treatment of vivax malaria, falciparum malaria and mixed infections. However, there is little knowledge of the possible interactions of its use with PQ or TQ, recently approved by ANVISA. The results of this study will provide evidence for the option of using ASMQ with TQ and PQ, thereby subsidizing new research for universal treatment of malaria in the Amazon. This is a parallel, randomized, open, phase I clinical trial with the goal of characterizing the effect of interactions between ASMQ, TQ, and PQ on healthy volunteers over 18 years of age.
This project intends to add the simplified filter paper-DNA extraction protocol to the portability of the Q3-Plus instrument and the ease of use of gelified 'ready to use' qPCR reactions to assemble a complete technological solution that can detect Plasmodium DNA in low-resource or remote areas, such as settlements and gold mining regions in the Amazon. Composed as a kit, the proposed technological solution comprises all steps necessary to perform a molecular base test in the field, allowing health agents to initiate eventual treatments in persistently asymptomatic patients, with no need for the population to travel several hours to the nearest malaria diagnostic center, in the closest city.
This project intends to determine the susceptibility profile to new and existing insecticides used in the public health in high malaria-endemic areas in Brazil and to fill knowledge gaps on the genetic mechanisms involved in insecticide resistance (IR). This issue is important because, although chemical control of anopheline via indoor residual spraying (IRS) and pyrethroid-impregnated mosquito nets contributed to the reduction of malaria cases, the selection of resistant mosquito populations is a threat to the malaria elimination plan. Therefore, knowledge of the mechanisms selected in natural populations is essential for decision-makers to better choose which insecticides to use.
This study intends to address two important issues related to the asymptomatic P. vivax-infected individuals: diagnosing asymptomatic individuals with submicroscopic parasitemia in the field and defining whether low parasitemic patients transmit the infection to Anopheles darlingi. Following the belief that deploying a novel point-of-care rapid test (RDT) and understanding the importance of asymptomatic individuals in P. vivax transmission will have important implications for developing new strategies for malaria elimination, the study’s main objective is to validate an RDT to detect antibodies from asymptomatic individuals and define at which level subpatent parasitemia and gametocytaemia are infective against the A. darlingi.