# Malaria across borders:  Measuring imported infections and contributions to local transmission in Uganda and Zimbabwe

> **NIH NIH R01** · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · 2023 · $770,649

## Abstract

PROJECT SUMMARY/ABSTRACT
Malaria cases and deaths primarily caused by Plasmodium falciparum have declined significantly in sub-
Saharan Africa as a result of the broad deployment of vector control and effective clinical management. In low
to moderate-transmission settings slated for elimination, imported cases become an increasingly important
epidemiological consideration. In these settings, imported cases may a) represent a high but poorly defined
proportion of the overall malaria burden, b) result in secondary transmission that can impede local elimination
efforts, and c) may require additional or alternative interventions than standard control measures. Imported
cases, when currently evaluated at all, are operationally defined as infections acquired outside of a defined
geographic area and identified based on travel history. However, lack of capture of asymptomatic infections
together with variable quality of travel history collection limit the utility of this standard approach to identifying
imported infections and quantifying their role in transmission. Further, there are no routinely collected data that
would allow evaluation of the impact of imported cases on local transmission. In this proposal, we will collect
detailed travel histories, perform active surveillance for asymptomatic infections, and generate parasite
genomic data to more accurately define the role of imported infections in two representative border regions of
sub-Saharan Africa (Tororo District, Uganda and Mutasa District, Zimbabwe) that leverage substantial
surveillance infrastructure from the NIH-funded International Centers of Excellence for Malaria Research
(ICEMR) network and will employ active (via a longitudinal study) and passive (via health facility surveillance)
designs to capture asymptomatic and symptomatic infections. We propose the following Specific Aims.1) To
quantify and characterize imported malaria infections. We will use a probabilistic approach to classify infections
as imported or local via detailed travel and other behavioral survey data and determine the travel patterns and
risk factors associated with importation. 2) To determine the impact of importation on local transmission and
identify appropriate targeted interventions. We will use parasite genomics and epidemiological data to define
local transmission and the impact of imported infections, taking advantage of dense sampling of symptomatic
and asymptomatic infections in focused geographies. We will use a robust set of statistical modeling
approaches, including Bayesian estimation of transmission networks incorporating all genomic and
epidemiologic data. We will use these data to model the predicted impact of various combinations of targeted
interventions. The expected outcome of the proposed research is evidence on appropriate surveillance
methods for imported malaria infections and on the contribution of these infections to sustaining transmission.
By identifying ways to better target interven...

## Key facts

- **NIH application ID:** 10620337
- **Project number:** 5R01AI163201-03
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
- **Principal Investigator:** Isabel Rodríguez-Barraquer
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2023
- **Award amount:** $770,649
- **Award type:** 5
- **Project period:** 2021-06-16 → 2026-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10620337

## Citation

> US National Institutes of Health, RePORTER application 10620337, Malaria across borders:  Measuring imported infections and contributions to local transmission in Uganda and Zimbabwe (5R01AI163201-03). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10620337. Licensed CC0.

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