(Proyecto) Aplicación de Nuevas herramientas Moleculares para Fortalecer Detección y Eliminación de malaria en Republica Dominicana.
(Proyecto) Aplicación de Nuevas herramientas Moleculares para Fortalecer Detección y Eliminación de malaria en Republica Dominicana.
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Date
2026
Authors
Francisco Cuevas
Edita Aquino
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Abstract
In Dominican Republic (DR), effective malaria control measures for prevention and diagnosis combined with raised funding, has resulted in a 50-75% reduction of the malaria burden over the last decade. Recognizing this achievement, DR is now (2016-2020) under a strategic plan towards malaria elimination. Critical for malaria elimination is an accurate diagnosis of the disease. Light microscopy, the standard of practice for malaria diagnosis in DR, and the malaria rapid diagnostic tests can detect up to 50parasite/mm3 of blood. But as malaria prevalence declines in the country, the proportion of cases that fall below this detection level increase, leading to patients untreated. Clearing this parasite reservoir is critical for malaria elimination as these individuals still remain infectious to the mosquito promoting the disease transmission. We aim to understand the number of cases that fall below the detection limit of standard diagnosis and explore the usage of alternative molecular diagnosis easy to use in the field, with sensitivity of detecting 1 parasite/mm3 of blood and to a relatively low cost. Moreover, although in the country the antimalarial chloroquine, proclaim still effective, reported resistance in neighbor country constitutes a serious threat. We propose to genetic and phenotypic characterize the Dominican parasites to evaluate known drug resistance markers and perform in vitro drug sensitivity tests to understand the level of resistance to chloroquine and to other antimalarial drugs worldwide used. Our findings will be valuable to establish a scientific framework that supports the development of a cost effective intervention strategy for malaria elimination in Dominican Republic.
Description
Objetivo General:
The project’s goal is to evaluate the malaria control strategy used in Dominican Republic, in regard to the diagnosis of the disease and drug treatment used, combining improved diagnostic tools with full characterization (phenotypic and genotypic) of the Dominican parasite.
Objetivos específicos:
• To determinate the level of malaria infections with low-density parasiteamia circulating in Dominican Republic by retrospective assessment of cases diagnosed negative through the use of RDTs. This will be achieved by reusing the RDT cartridge containing the stored patient blood to extract the DNA and apply a highly sensitive realtime PCR to detect malaria parasite.
• To evaluate and implement of a low-cost molecular diagnosis tool that is easy to use in malaria endemic areas. The use of LAMP (isothermal amplification) to detect malaria and disclose Plasmodium species present.
• To characterize genetically the Plasmodium populations from Dominican Republic in regards of molecular markers of resistance to present chloroquine antimalarial drug and to artemisinin based combination therapy drugs.
• To make whole genome sequencing a subset of clinical Plasmodium positive cases to provide worldwide knowledge on the parasite genetics fluctuating in Dominican Republic. (in collaboration with Sanger Institute).
• To culture-adapt In vitro Dominican Plasmodium falciparum clinical isolates to evaluate their sensitivity to present treatment and to drugs used in artemisinin based combination therapy.
• To create of a biobank of cryopreserved Plasmodium falciparum from Dominican Republic