Below is a summary of the projects to by conducted by the 2010 NEWAID Finalists.

The Impact of Vector Control, Knowledge, and Behavior on Zoonotic Visceral Leishmaniasis in Brazil

Kevin Esch, DVM: University of Iowa / Iowa State University, College of Public Health / Department of Veterinary Pathology

Visceral leishmaniasis (VL), caused by Leishmania chagasi infantum, transmitted by the sand fly, is responsible for deaths in dogs and humans globally. In Brazil, 51,222 new cases of human (VL) were reported between 1980 and 2003. Infected dogs have been identified as a major risk factor for human infection. While the infection rate of dogs in Brazil is high, the number of animals becoming visibly ill is significantly lower. This results in a population of dogs able to spread the disease, while not showing any signs of illness. Risk factors such as malnutrition, home construction, education, income, HIV infection, and knowledge, have also been identified as risk factors for human visceral leishmaniasis.

Our goal is two-fold. First, we will administer a household survey to determine what factors may be leading to VL in the study community, and to evaluate their knowledge of VL and methods of disease prevention in themselves and their pets. This will allow us to identify risk factors specific for VL and aid in developing educational materials directed toward the populations at greatest risk. Secondly, we will draw blood from human and canine study participants to evaluate the frequency of disease in the population at the beginning of the study. We will then begin a canine treatment group on monthly topical insecticide to prevent sand fly feeding, and test for the disease in canines, humans, and sand flies at 3 months, 6 months, and 12 months to determine the impact of preventive treatment on canine and human disease, and the feeding habits of sand flies. This will allow us to determine the effectiveness of insecticides in preventing canine infection, sand fly infection, and human
infection. If successful, our results could be used to further develop educational materials for the population of Rio Grande do Norte, and allow human health professionals and veterinarians make recommendations regarding treatment of dogs to prevent visceral leishmaniasis.

The effect of acute T. cruzi infection on cognitive development in children

Jess Edwards & Lydia Feinstein (Joint Application) , University of North Carolina, Chapel Hill School of Public Health

Chagas disease infects more than 18 million people in Latin America. Because the triatome insect that carries the disease lives primarily in human dwellings with thatched roofs or cracked adobe walls, families living in poverty are at greatest risk for contracting the disease. Neurological effects of Chagas disease have been documented, but the long-term effects on the central nervous system in children are not well understood. This study will assess the relationship between infection with T. cruzi, the parasite responsible for Chagas disease, and cognitive development in children living in rural Nicaragua. We will also document the prevalence of infection with T. cruzi among school-aged children and investigate common risk factors for the disease.

Pathogen Investigation and Discovery Study in Sri Lanka

Wenfeng Gong, Duke Global Health Insitute

Pathogen investigation and discovery refers to the research procedure of recognizing the distribution and transmission patterns of emerging or reemerging pathogens. It is the cornerstone of subsequent actions surrounding emerging infectious disease prevention, including the evaluation of epidemiological potential of local infectious diseases, the redistribution of healthcare infrastructure and workforce, health system strengthening, and policy development and modification. However, pathogen investigation research in developing countries, even where people are facing a deadly threat of emerging/reemerging pathogens, is usually limited in scale and quality, due to insufficient funding, lack of pathogen detection technology and skilled staff, as well as the neglect of policy makers. As a graduate student in Global Health with a biomedical research background, I expect to help address the threat of emerging/reemerging infectious diseases in developing countries by conducting pathogen investigation in a more efficient way.

As one of the innovations of this study, we will utilize the cutting edge molecular pathogen detection and typing system at Duke-NUS Medical School in Singapore to solve the lack of technological support in Sri Lanka. Compared with sending specimens to other countries with advanced facilities, conducting tests in Singapore can largely reduce the shipping cost and days of specimens in storage before being tested. At the same time when samples are collected from patients presenting in the hospital with acute febrile diseases, epidemiological data and clinical symptoms of each patient will also be recorded for systemic analysis. By combining the clinical symptoms, epidemiological histories, and biological features, this study will be able to provide a description of pathogen emergence in Sri Lanka and offer an evaluation of the epidemiological potential by unveiling relationship between emerging pathogen transmission and people’s living pattern.

Novel In Vitro Antimalarial Drug Susceptibility Assays

Kansas Sparks, University of South Florida College of Public Health

Malaria continues to exert a devastating impact on the health of human populations in tropical regions, with over 500 million cases and the death of 1-3 million each year. The hardest hit is sub-Saharan Africa where an estimated 90% of deaths occur, primarily in children less than 5 years old infected with falciparum malaria. Although the burden of disease is in Africa, the impact of malaria in other tropical regions is no less dramatic. The malaria situation in Southeast Asia is particularly important as this region is the focus for the most drug resistant malaria in the world and resistance problems that emerge here can then spread to other regions of the world. The two most important emerging drug resistance issues in SE Asia are clinical resistance to artemisinin combination therapy (ACTs) and mergence of drug resistance in vivax malaria. In order to combat this problem, we propose two aims: 1) to assess a novel in vitro assays for artemisinin resistant falciparum malaria, and 2) to assess the therapeutic potential of two new drug series for chloroquine resistant vivax malaria in a new in vitro assay developed at the Shoklo Malaria Research Unit (SMRU). The population in which we plan to assess both aims will include patients admitted to the local clinic that display symptoms of malaria. In doing so, we hypothesize that the optimization of the methods employed at SMRU will identify both an effective control measure for falciparum malaria and potential new antimalarial drugs for the treatment of vivax malaria.