David Wright of Vanderbilt University in the U.S. will develop a new low-cost diagnostic tool in which a droplet of malaria-infected blood deposited on a glass slide will, based on fluid dynamics, leave a ring-like pattern as the blood evaporates. The slide will be prepared with a solution that will interact with a particular protein of the malaria parasite to visualize this "coffee ring stain," allowing for easy interpretation and ready diagnosis.

Keith Bartlett of True Energy in the United Kingdom will work with stakeholders in the immunization community to create a prototype vaccine storage device that uses the properties of water density to maintain vaccines at 4°C during the "last mile" of the cold chain. A water container that maintains the liquid at a steady temperature of 4°C will be in contact with the vaccine storage area, preventing temperature fluctuations that can damage or destroy vaccines.

France Daigle of the University of Montreal in Canada will identify the microorganisms that enable the survival of the typhoid fever-causing bacterium, Salmonella enterica serovar Typhi, at low levels in water, and thereby enhances disease spread. Typhoid fever spreads through contaminated food and water, and results in over 125,000 deaths annually worldwide. S. Typhi are so-called auxotrophic bacteria because they rely on an external source of the essential amino acids that they need to grow. Microbial interactions may provide nutrients and also increase bacterial fitness and support persistence by protecting them from the environment, thereby increasing the rate of disease transmission. They will assemble a microbial community in water consisting of three components: one protozoan (from a group known to promote bacterial survival); a defined consortium of bacteria representative of the human fecal microbiota; and fluorescently-tagged S. Typhi. They will evaluate the ability of S. Typhi to grow in these microcosms, and how they grow, such as in biofilms or inside the protozoa. They will also determine whether these persistent S. Typhi are better able to infect and survive in human cells. Finally, water samples from an endemic region in East Africa will be analyzed for the presence of S. Typhi and identified beneficial microbial partners using quantitative PCR.

Windy Tanner and Jim VanDerslice of the University of Utah in the U.S., together with colleagues from Mehran University of Engineering and Technology in Pakistan, will analyze water samples to determine the conditions that promote the survival of the typhoid fever causing bacterium Salmonella Typhi, and they will use metagenomic deconvolution to identify any gene exchange from other microbial species that may produce drug-resistant strains. S. Typhi is responsible for over 100,000 deaths each year, mostly in the developing world where fecal contamination of food and drinking water is common. The emergence of drug-resistant strains has limited the available treatment options. Biofilms are environmental niches with complex microbial communities and are ubiquitous in the environments where S. Typhi is commonly found. They will sample water and biofilms from a variety of these environments along the fecal-drinking water transmission route in the Sindh province of Pakistan and test for the presence of S. Typhi using qPCR and culture methods. They will also evaluate whether specific organisms stabilize and protect S. Typhi in these biofilms and could cause resistance gene exchange.

Ben Gilbert and Andrew Brown of the University of Canberra in Australia will develop a regional support network for medical supply managers in Pacific Island countries that can help them to better apply the formal training they received to manage vaccine supply systems. By engaging them in a buddy support system, Gilbert and Brown hope to empower these managers to overcome cultural, educational, social and historical factors that hinder effective management styles, and help them operate supply systems that are more responsive to immunization challenges in those developing countries.

L. David Sibley at Washington University in St. Louis in the U.S. is developing a long-term in vitro intestinal epithelial culture system for the intracellular parasite Cryptosporidium, which causes severe diarrheal disease in both humans and animals, and is refractory to many anti-parasitic drugs. Currently, Cryptosporidium can only be grown in infected calves or in short-term in vitro cultures, which cannot be used for the high-throughput chemical screens needed to identify new drugs. In Phase I, they optimized the in vitro culture of isolated intestinal stem cells from human and mouse biopsies, and identified factors to control their differentiation into primary epithelial monolayers, which can better support the growth of intestinal pathogens. This led to around a five-fold increase in the rate of asexual replication of Cryptosporidium, which was enough to successfully test a chemical growth inhibitor. In Phase II, they will further improve culture conditions to support longer-term in vitro growth of Cryptosporidium, which will then be tested for stability and infectivity. They will also develop antibodies against specific developmental stages to help identify culture conditions that enable the parasite to undergo a complete life cycle, which will be valuable for culturing and screening efforts.

Ian Matthews of Cardiff University in the United Kingdom proposes to develop a self-sampling micro-needle patch device for the collection of small volumes of blood. Micro-needles will be fabricated using Deep Reactive Ion Etching. The device will permit non-refrigerated transport of collected blood for subsequent assays for diagnosis of infectious disease.

Elijah Songok of the Kenya Medical Research Institute in Kenya will design and test a fortified school meal product with deworming properties for treating soil transmitted helminths (parasitic worms) among schoolchildren in developing countries. Schoolchildren are most at risk of infection-associated morbidities such as stunting and chronic dysentery. However, current mass drug administration strategies are associated with the development of drug resistance, and may not be sustainable long term. They will fortify cornflour with seed extracts of the tropical fruit, Carica papaya (pawpaw), which can significantly increase clearance of the parasite, and use it to make porridge, which is cheap and a common school meal snack in developing countries. They will test its efficacy in a randomized pilot study in six elementary schools in rural Kenya.

Ricardo Capúcio de Resende of Universidade Federal de Viçosa in Brazil will design and test a new machine to enable women smallholder farmers in sub-Saharan Africa to more efficiently and effectively plant seeds. He has designed a new seeder concept using only two rotating parts, which is light, easy to use and maintain, and can simultaneously plant two crops. He will query local manufacturers and users to further develop the design, and then produce prototypes that will be bench- and field-tested for manufacturability and performance. The results will be used to produce the final seeder design, and this design concept could be applied to other agricultural machines.

Alice Telesnitsky of the University of Michigan in the U.S. seeks to define and characterize HIV interactions with host RNA. The team will attempt to determine whether disrupting or mimicking essential interactions with host RNAs may lead to antiviral strategies to which HIV cannot readily develop resistance.

Ahsan Khandoker of Khalifa University in the United Arab Emirates will build a low-cost, non-invasive abdominal phonogram device that can be used on a mobile phone to assess sounds that indicate fetal well being such as heart rate and body movement. The device will employ a software algorithm to extract fetal noises in an acoustic signal from maternal and environmental noises, allowing health care workers in remote locations to conduct obstetric assessments without expensive or invasive equipment.

Ahmad Khalil of Boston University in the U.S. will develop a low-cost bioreactor platform to simultaneously optimize growth conditions of multiple bacterial species for large scale production of biotherapeutics. The human gut microbiome plays an essential role in health and development and living microbial biotherapeutics could be an effective treatment in the case of damage by illness or malnutrition. Commercial production is limited by the capacity of bioreactors, which are costly and challenging to scale and relatively inflexible. Using their eVOLVER continuous culture system, which is modular, inexpensive, and highly scalable, they will adapt the set-up and optimize protocols to allow for the management of unique growth conditions for individual species in parallel, and dynamic mixing of cultures from individual pools to precisely tune multi-species formulations. They will conduct full-scale tests to evaluate their approach for optimizing production of human gut microbiota.

Christina Smolke of Stanford University in the U.S. will develop synthetic biology platforms to improve the scale and efficiency of microbial systems used to discover, develop, and produce drugs based on natural products. Such new biosynthesis approaches could lead to new and less expensive drugs for global health.

Alain Labrique of Johns Hopkins Bloomberg School of Public Health in the U.S. will develop and field test in rural Bangladesh a cloud-based mobile phone system that will allow for universal access to vaccination records, send vaccine reminders and messaging, and provide incentives to parents and health care workers via a phone application. This new strategy could increase the reach, coverage, and public acceptance of immunization.

Philip J. Shaw of Thailand's National Center for Genetic Engineering and Biotechnology will seek to identify potential drug targets and vaccine antigens in the malaria parasite using a novel technology to reduce specific gene expression. By fusing a natural genetic “riboswitch” onto gene targets, the team will attempt to attenuate gene expression and thereby determine gene function.

David Sokal of Family Health International in the U.S., with colleagues at Cambridge and Drexel Universities, will develop and test low-cost filters coated with safe microbicides that can be inserted into tips of nipple shields to prevent HIV transmission during breastfeeding.

Postpartum hemorrhage (PPH) is the leading cause of maternal mortality in low-income countries. The majority of these deaths occur outside the health care system, and so an intervention that could be used in any setting and with minimal training could save lives. We will use an animal model to demonstrate appropriate uterine fill, and a proof-of-concept study to show stoppage of post-delivery bleeding and test ease of removal. Standard care for treating PPH consists of massage, uterotonics, and tamponade (i.e., "holding pressure"). Devices used to treat PPH via tamponade are not easily adaptable to low-resource settings with diverse climates and providers. A novel agent, the XSTAT mini sponge dressing, has proven successful in the acute cessation of traumatic non-compressible bleeding analogous to PPH. This device utilizes pre-packaged, environmentally stable, compressed medical sponges soaked with a hemostatic agent and administered by a light-weight applicator. The sponges, once deployed, exert uniform pressure to address multiple sources of bleeding and are easily removable.

Anders Hakansson of the University of Buffalo in the U.S. has identified a protein from human breast milk (Human Alpha Lactalbumin Made Lethal to Tumor cell, or HAMLET), that kills respiratory tract bacteria. Hakansson will attempt to understand the mechanism by which HAMLET binds to and kills pheumococci without the bacteria developing resistance.

Because Leishmania is transmitted to humans when sand flies feed on humans, Jesus Valenzuela of the National Institutes of Health in the U.S. proposes to develop a novel vaccine against salivary proteins of sand flies with the aim to induce a strong immune response against the parasite.

To optimize the effectiveness of current anti-tuberculosis drugs, Boitumelo Semete of the CSIR in South Africa will work with collaborators to develop “sticky nanoparticles” that specifically attach to TB-infected cells. Once taken in by these cells, the nanoparticles will slowly degrade, releasing the anti-TB drugs and killing the bacteria. With this novel drug delivery system, the team aims to improve the bioavailability of the current therapies, with the possibility of shortening the treatment period for TB as well as reduce drug side effects.

Alexander Douglas of the Jenner Institute, University of Oxford in the United Kingdom will use synthetic nucleic acid molecules known as aptamers to develop a model that can be used to predict the success or failure of new vaccines in clinical trials. This work could help to remove some of the uncertainty in the early-stage development of new vaccines.

David Sullivan of the Johns Hopkins Bloomberg School of Public Health in the U.S., along with Martin N. Martinov of Gradient Biomodeling LLC, will create a quantum physics computer model of liver-stage malaria parasite infection to screen existing commercial drug and compound databases to identify molecules that possess liver-stage specific anti-malarial activity. Those molecules will then be tested in vivo and in vitro, and the ones that are effective will be optimized via computer modeling for future pre-clinical development.

Douglas Weibel of the University of Wisconsin-Madison in the U.S. proposes to develop a portable diagnostic system that uses inexpensive plastic assay cartridges that wick samples into chambers loaded with reagents to detect bacteria associated with neonatal sepsis. The cartridges will be attached to a smart phone loaded with an application that collects data and transmits results to a clinical lab for further treatment instructions.

Feng Qian of Tsinghua University in China will work to develop an inhaled drug particle using a scalable formulation process to deliver tuberculosis drugs directly into the lungs. They will develop micro-particles containing current TB drugs and will test their utility when inhaled.

Stéphane Blanc of the Institut National de la Recherche Agronomique (INRA) in France will minimize the destructive effects of aphids on crop plants by studying a newly described structure, the acrostyle, which is found at the tip of the piercing mouthparts of the insects and thought to be important for feeding and for transmitting disease-causing viruses between plants. Aphids spread an array of different plant viruses to many crop species including banana, chickpea, and sweet potato. Work during Phase I involved developing tools including acrostyle-targeting antibodies and methods to genetically manipulate aphids, which led to the identification of one protein in the acrostyle that is likely to be a receptor for the cauliflower mosaic virus. Consistent with this, binding of this virus to the insect could be blocked with an antibody targeting that specific protein. In Phase II, they will complete their cataloguing of peptides at the acrostyle using mass spectrometry to identify more candidate receptors that are important for virus binding and transmission, and potentially also for insect feeding. These peptides will be further analyzed using newly developed genetic tools to determine their precise function. They will also use structural methods including nuclear magnetic resonance to identify key amino acid residues in the peptides that could be exploited to block both virus transmission and insect feeding, and thereby weaken the aphids.

Joseph Turner of the Liverpool School of Tropical Medicine in the United Kingdom will develop a small animal model of the parasitic disease onchocerciasis, also called river blindness, which is the second leading infectious cause of blindness. Treatment options for filarial infections are currently limited and lack effectiveness. Thus, small animal models of filarial infections are invaluable for preclinical testing of candidate drugs. In Phase I, they established the mouse model by infecting mice lacking an adaptive immune system with Onchocerca parasites isolated from infected cows, and tested its feasibility for screening drugs. In Phase II, they will expand their model, and use it for preclinically testing the safety and efficacy of several candidate drugs currently under development.

Recent evidence suggests that HIV infection may be drastically enhanced when a specific protein found in human semen is present in fibril form. David Eisenberg of UCLA in the U.S. will design and test a small peptide that can effectively block formation of fibrils on this protein. If successful, the therapy could be administered via spray or liquid drops to inhibit transmission of HIV.

Robert Abramovitch of Michigan State University in the U.S. will use their high-throughput drug discovery platform to identify new drugs for treating chronic tuberculosis and for potentially shortening the current treatment time of six to nine months. Their platform exploits a genetic region known as the DosR regulon thought to underlie the behavior of the causative bacteria in humans under low oxygen conditions, when they become dormant and thereby resistant to current drugs. In Phase I, they screened over 250,000 compounds and identified around 170 candidates that could either stop bacterial persistence under low oxygen conditions or could potently inhibit bacterial growth. In Phase II they will optimize one of the candidate DosR regulon inhibitors and test the ability of this class to block chronic infection, as well as characterizing the compounds that inhibit bacterial growth.

Antibodies and the complement system work together to specifically detect and clear viruses, but they are circumvented by HIV, which hides itself and the cells it infects by hijacking host proteins such as CD59. Qigui Yu of Indiana University School of Medicine in U.S. will attempt to unmask HIV and HIV-infected cells and render them susceptible to antibody-complement attack. In this project's Phase I research, Yu and his team identified a potent, specific, and non-toxic inhibitor of human CD59, which is used by HIV to escape destruction by antibody-complement attack. In Phase II, Yu will continue to research how this inhibitor might allow antibodies to regain their complement-mediated activity to destroy the virus and HIV-infected cells, and will also research how HIV-1 incorporates human CD59 onto viral particles to escape antibody-complement immunity.

Thomas Neumann of Nortis, Inc. in the U.S. will develop a tissue-engineered model of the mosquito midgut for use in an in vitro assay on a disposable, chip-like microfluidic device. This device could be developed into a standardized and automated platform to screen anti-malarial compounds that target the parasite in the mosquito before transmission to human hosts.

Anton Middelberg of the University of Queensland in Australia proposes to develop a new vaccine for rotavirus by the directed self-assembly of a safe virus-like particle in industrial reactors. The approach uses low-technology engineering methods suitable for the developing world, ensuring relevance to the communities most in need of vaccine.

Wendy Picking and a team at Oklahoma State University in the U.S. will work to develop a new vaccine for Salmonella that uses a serotype-independent Salmonella antigen combined with an adjuvant to deliver immunity against all serotypes of the bacteria. This vaccine, when administered intradermally, could be a cost-effective way to reduce the overall incidence and severity of diarrhea in children in the developing world.

Tania Maria Ruffoni Ortiga from the Universidade Federal do Rio de Janeiro in Brazil will measure the levels of so-called ABC transporters throughout pregnancy, and during normal and preterm labor, and how they are influenced by infections such as malaria and influenza, to determine whether they might increase the risk of preterm labor. ABC transporters sit in the outer membranes of cells and actively transport drugs, toxins and immune signaling molecules out of them. In this way, they regulate the immune response, hormonal signaling and the activity of drugs such as antibiotics, which become particularly important during pregnancy and labor. They will collect human intrauterine tissue at different time points during pregnancy and during cesarean delivery from hospitals in Brazil and Canada, and investigate the distribution of ABC transporters and the association with infection. They will also use a mouse model of malaria to evaluate the effect on the levels and activity of the transporters.

Ashish Ganguly and colleagues from the CSIR-Institute of Microbial Technology in India will make an affordable paper-based diagnostic to quickly and precisely measure plasma gelsolin levels in expectant mothers to help predict premature delivery and postpartum recovery, thereby reducing new mother and child mortality rates. They will determine the value of plasma gelsolin levels for predicting postpartum-related problems using patient sampling and an animal model of preterm birth. They will also develop the diagnostic by identifying a plasma gelsolin binding peptide that will be used to coat an optimized paper strip, along with a cell phone based read-out to enable remote analysis by a centralized unit. This grant was selected through India's IKP Knowledge Park and their IKP-GCE program.

Laser light at a specific setting can activate antigen presenting cells in the skin and temporarily make cellular membranes permeable. Mei X. Wu and colleagues at Massachusetts General Hospital/Harvard Medical School in the U.S. will test whether injection of a vaccine into laser-exposed skin can significantly enhance immune responses stimulated by the vaccine.

Frans Walther of the Los Angeles Biomedical Research Institute in the U.S. will adapt a low-cost synthetic lung surfactant for aerosol delivery as a non-invasive and simple method to support breathing in premature infants. Surfactant is composed of lipids and proteins, and keeps the lungs open during expiration. It is normally administered to premature infants with breathing difficulties by tracheal intubation, which can be problematic in low-resource settings and cause side effects. In Phase I, they produced the surfactant aerosol and found that it improved oxygenation and lung function in a small animal model. In Phase II, they will continue preclinical development by analyzing different application methods, dosing levels, and safety, and evaluate dry surfactant formulations that would not require refrigeration.

Fredos Okumu of the Ifakara Health Institute in Tanzania will develop technology to evaluate mosquito control interventions using a combination of artificial intelligence, infrared spectroscopy, and entomology. Malaria caused over 400,000 deaths in 2017, the majority in the developing world, and an effective way to control the disease is to target the mosquitoes that transmit it. Current tools cannot precisely measure mosquito age or life-expectancy, and are therefore unable to predict the impact of mosquito control interventions. The biochemical composition of the mosquito exoskeleton varies with species and age; as the types of chemical bonds change so does the amount of light absorbed in the mid-infrared region. This can be measured with mid-infrared spectroscopy (MIRS), and they will combine this with machine learning to measure the age of mosquito populations. Using a dataset collected from over 25,000 lab-raised mosquitoes, they have developed a supervised machine learning model that accurately predicts mosquito age and species. They will optimize this model to work also on wild mosquito populations, develop an online platform for real-time analysis of mosquito MIRS data, and test its ability to measure the effectiveness of malaria control interventions.

H.V. Jagadish of the University of Michigan in the U.S. will take disparate datasets on diverse topics, including education, health, and the environment, which are often reported using different geographical units such as Zip Code or County, and realign them to a common unit so they can be better compared and used. Jagadish will develop four general techniques for aligning data partitions and apply them to existing datasets in one state in the U.S. so that they can be viewed according to different geographical units. Jagadish will also produce an interface so that policy analysts and NGOs can easily access and query these data, and collect feedback to improve the approach.

Eric Loker of the University of New Mexico in the U.S., along with colleagues from KEMRI in Kenya, will test whether parasitic flatworms known as amphistome flukes can eradicate the human parasite Schistosoma with the goal of helping prevent human infections. These two types of worms co-inhabit the same snail species. The investigators will harvest large quantities of amphistome eggs from the rumens of routinely slaughtered goats and cattle, and use temperature and light to induce miracidia (larva) to hatch in the laboratory. These will then be tested for their ability to infect schistosome-transmitting snails and to block or prevent schistosome infections in these snails. This low-tech, low-cost approach is more environmentally friendly than current chemical approaches, and its application to transmission sites can be easily halted once infection rates are under control.

Mosquito transmitted pathogens such as dengue and malaria are a significant disease burden on the world's population. Paul Young of the University of Queensland in Australia aims to develop a novel vaccine approach that is based on blocking mosquito transmission of these disease agents rather than inducing pathogen- specific immunity.

Arturo Casadevall of Albert Einstein College of Medicine in the U.S. will work to develop a new vaccine for tuberculosis that uses an arabinomannan-protein conjugate to elicit strong antibody-mediated immunity. M. tuberculosis has a polysaccharide capsule composed of arabinomannan, which, when used as part of a vaccine, could lead to an immune response that prevents inflammation and disease transmission without impairing clearance of the bacteria.

Michael Leibowitz of the UMDNJ-Robert Wood Johnson Medical School in the U.S. will investigate whether malaria parasites bind to, invade and replicate in the endothelial cells that line the blood vessels to test the theory that endothelial cells play an important role in the development of malaria infection and may serve as undiscovered reservoirs for parasite latency.

Paul de Figueiredo and Daniel Alge of Texas A&M University in the U.S. will develop a portable, disposable bioreactor for the low-cost production of gut microbial biotherapeutics at an estimated $0.09 per dose in low-resource settings. Dysfunction of the human gut microbiome is a common consequence of malnutrition in poor countries. It may be effectively treated with live biotherapeutics, yet current production methods are complicated and expensive. Glucose oxidase consumes oxygen as a co-substrate in glucose oxidation and has been shown to create hypoxic microenvironments in vitro, similar to that in the human gastrointestinal tract. They will engineer an inexpensive bioreactor by immobilizing glucose oxidase in a hydrogel placed in dialysis tubing and incubated in liquid media; the glucose oxidation reaction will deplete the bioreactor of oxygen and create an oxygen gradient to mimic the intestinal lumen. This will enable growth of a consortium of anaerobic bacteria, after which the microparticles will be removed by filtration. They will optimize the system using an artificial consortium of at least ten strains of common gut bacteria.

Although intrauterine devices (IUDs) are effective long-acting contraceptives, IUD insertion is very complex, so IUDs are often unavailable in resource poor settings. Bioceptive's proposal is to create a reusable IUD inserter for the developing world with the goals that it is intuitive, Cu380A IUD compatible, safer, and low cost. Bioceptive will develop a reusable version of its patent-pending IUD inserter that makes the insertion procedure easier and safer, allowing more women worldwide to take advantage of one of the most effective forms of contraception. The design of this reusable inserter will be based on Bioceptive's disposable inserter, which is prohibitively expensive for use in the developing world. The reusable inserter will expand access to the most common type of intrauterine contraceptive device to millions of women at low cost. Bioceptive's IUD inserter will eliminate the need to use four separate instruments for IUD insertion, making the procedure simpler, safer and intuitive. Bioceptive's inserter replaces these other instruments with one intuitive device, allowing any healthcare worker to insert an IUD with minimal training, even in resource-poor settings. This will have a major impact on maternal health by addressing a major gap in access to IUDs, a most effective contraceptive option.

Carmine Bozzi of Akeso Associates in the U.S., along with Maurice Masoda of Heal Africa in the Democratic Republic of Congo, will test the effect of treating hookworm infections in women smallholder farmers in the Democratic Republic of Congo on disease prevalence, iron status, and capacity for labor over a 12-month period. Hookworm infections are endemic in many regions, and infection rates can reach 50% of the population. Hookworms reside in the intestinal wall where they mediate blood loss causing iron deficiency and anemia, which is exacerbated in women due to menstrual blood loss and iron demands during pregnancy. This anemia in turn leads to reduced aerobic work capacity, therefore successful treatment of these infections could result in significant gains in labor productivity.

Michael Klemba of Virginia Polytechnic Institute and State University in the U.S. will identify anti-malarial compounds from the Malaria Box that function as inhibitors of the cytostomal endocytic pathway used by the malaria parasite P. falciparum to internalize host erythrocyte proteins. Characterizing the molecular mechanisms of this process could lead to the discovery of new anti-malarial compounds.

Edward Mitre and colleagues at the Henry M. Jackson Foundation for the Advancement of Military Medicine in the U.S. will develop a short course therapy for clearing adult filarial worms, which cause substantial morbidity and mortality, to enhance eradication efforts. Current antifilarial medications target only larval forms of the worms, requiring repeated administration until the natural death of the adults. Filarial infections are known to induce immune cells to release histamine, which can regulate the immune response. Using mouse models of filarial infections, they will evaluate whether a short course of standard antifilarial treatment combined with an antihistamine can clear adult worms and thereby more quickly cure the disease.

Rajeev Shrestha and colleagues at Dhulikhel Hospital, Kathmandu University in Nepal will apply metagenomic, next generation sequencing technology to identify causative pathogens of fatal acute encephalitis to improve diagnosis and treatment. Acute encephalitis syndrome (AES) annually affects over 100,000 individuals in low- and middle-income countries, causing substantial morbidity and mortality. It is a diverse disease caused by over 100 different pathogens, including viruses and parasites, making accurate diagnosis difficult, even in high-resource settings. This hinders prevention and treatment efforts, even though several effective vaccines exist. To better characterize the pathogens causing AES, particularly treatable and emerging ones, they will apply metagenomic, next generation sequencing technology to 60 banked cerebral spinal fluid samples collected from fatal acute encephalitis cases in Nepal as part of a nationwide AES surveillance program that covered 189 hospitals. They will validate and refine their technique using previously validated samples.

Lena Hulden of the University of Helsinki in Finland will test the hypothesis that saliva from newly emerging mosquitoes activates dormant P. vivax parasites in the liver. By robust statistical analysis of the timing of P. vivax outbreaks, as well as molecular analysis of mosquito saliva, Hulden hopes to eventually identify the trigger for these relapses in hopes of controlling outbreaks.