# Resistance Project

> **NIH NIH U19** · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · 2022 · $130,770

## Abstract

RESISTANCE PROJECT
SUMMARY
Our best available tools for the control and eventual elimination of malaria are effective antimalarial drugs and
insecticides. Prompt therapy prevents progression to severe disease and limits transmission to others.
Intermittent preventive therapies (IPTs) decrease the incidence of malaria in high-risk groups, in particular
infants and pregnant women. Appropriate use of insecticides in indoor residual spraying (IRS) and insecticide-
treated bednet (ITN) programs decreases malaria transmission. However, the value of all of these
interventions is limited by the development of resistance in malaria parasites to available drugs and in
anopheline mosquitoes to available insecticides. Therefore, consideration of the resistance and transmission
implications of antimalarial drugs and insecticides is required to optimize control policies. This project will
perform surveillance for markers of antimalarial drug and insecticide resistance in Uganda, utilizing a network
of established surveillance sites. These sites have undergone different interventions over time, with dramatic
impacts on malaria. In addition to offering insights into the prevalence of resistance to different agents across
time and space, we will assess the impacts of malaria control interventions and the epidemiology of malaria on
resistance progression. We hypothesize that benefits of current malaria control measures, including effective
therapies, IPT, IRS, and ITNs, will be challenged by increasing resistance in malaria parasites and anopheline
vectors; that the rate of resistance development will vary depending on the degree of implementation of control
measures, level of malaria transmission, and other measurable factors at different locations; that novel
contributors to resistance will be identified by interrogating samples with deep sequencing approaches; and
that some resistance mediators will impact upon malaria transmission. We will test these hypotheses with
serial surveillance for resistance mediators in parasites and mosquitoes across Uganda; searches for
associations between control interventions and factors specific to parasites and vectors; deep sequencing to
identify novel resistance mediators; and measures of impacts of polymorphisms on malaria transmission. Our
specific aims will be (1) to assess impacts of malaria control interventions on drug resistance, (2) to assess
impacts of malaria control interventions on insecticide resistance, and (3) to characterize impacts of drug and
insecticide resistance on malaria transmission. These studies will offer insights into the evolution of drug and
insecticide resistance across Uganda over time, the impacts of specific malaria interventions on this evolution,
and the impacts of specific resistance mediators on malaria transmission. Overall, the program will offer novel
insights regarding mechanisms of resistance and inform on optimal interventions to achieve malaria
elimination.

## Key facts

- **NIH application ID:** 10376307
- **Project number:** 5U19AI089674-13
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
- **Principal Investigator:** SAM NSOBYA
- **Activity code:** U19 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $130,770
- **Award type:** 5
- **Project period:** 2010-07-01 → 2024-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10376307

## Citation

> US National Institutes of Health, RePORTER application 10376307, Resistance Project (5U19AI089674-13). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10376307. Licensed CC0.

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