Disease Surveillance Using Molecular and Geographic Methods in the Congo
Project Summary
Infectious diseases are still the leading cause of disability and death in developing countries. However, only educated guesses about the distributions and burdens of important diseases like malaria, trypanosomiasis, and HIV have been made at the national, and subnational levels for the Democratic Republic of Congo (DRC). This lack of clarity impedes effective resource allocation, implementation of control measures, and the monitoring and evaluation of interventions.
This project has expanded the mission of MEASURE DHS to include gathering prevalence data on endemic and emerging infectious diseases using high-throughput molecular diagnostics. Demographic Health Surveys (DHSs) are well-respected, time-tested sources of population-based data on demography, reproductive health, and HIV. By leveraging the DHS infrastructure, this project focuses on (1) acquiring population-based data for multiple infectious diseases in the DRC. The DHS data is used to calculate national disease prevalence, (2) mapping the spatial distribution of disease prevalence for several important disease including HIV, malaria, trypanosomiasis, and anemia, and (3) develping methods that use geographic information systems (GIS) to determine prevalence for ecological mapping and analysis.
The prevalences these important disease are shared with the DRC Ministry of Health to help guide control programs. Prevalence maps are integrated with population-level factors in order to identify population and environmental factors that are related to disease prevalence. This ecological analysis is then used to estimate potential prevalence where dried blood spots are unavailable or surveillance programs are not in place. This extrapolation is done by initially overlaying population and environmental ecosystem variables that are hypothesized to be related to each disease with the prevalence maps.
Project Team Members
Michael Emch
Janey Messina
Sophia Giebultowicz
Publications
Messina, JP; Taylor, SM; Hand, CC; Juliano, JJ; Muwonga, J; Tshefu, AK; Atua, B; Alam, MT; Udhayakumar, V; Emch, M; Meshnick, SR (2011, in press) Measurement of malaria in the Democratic Republic of the Congo by molecular analyses of leftover dried blood spots from the 2007 Demographic Health Survey. The Lancet. Published abstract.
Messina, JP; Taylor, SM; Meshnick, SR; Linke, A; Tshefu, AK; Atua, B; Mwandagalirwa, K; Emch, M (2011) Population, behavioral and environmental drivers of malaria prevalence in the Democratic Republic of Congo. Malaria Journal. 10:161. link to article
Mumba, D; Bohorquez, E; Messina, J; Kande, V; Taylor, SM; Tshefu, A; Muwonga, J; Mwandagalirwa, MK; Emch, M; Tidwell, R; Büscher, P; Meshnick, SR. (2011) Prevalence of human african trypanosomiasis in the Democratic Republic of the Congo. PLoS Neglected Tropical Diseases. 5(8): e1246. link to article
Taylor, SM.; Messina, JP.; Hand, CC.; Juliano, JJ.; Muwonga, J; Tshefu, AK; Atua, B; Emch, M; Meshnick, SR. (2011) Molecular malaria epidemiology: mapping and burden estimates for the Democratic Republic of the Congo, 2007. PLoS One. 6(1): 1-9. link to article
Taylor, SM; van Eijk, A; Hand, CC; Mwandagalirwa, MK; Messina, J; Tshefu, A; Atua, B; Emch, M; Muwonga, J; Meshnick, SR; ter Kuile, F. (2011) Quantification of the burden and consequences of pregnancy-associated Malaria in the Democratic Republic of the Congo. Journal of Infectious Diseases. 204(11): 1762-1771. link to article
Messina, JP, Emch, M, Muwonga, J, Mwandagalirwa, K, Edidi, SB, Mama, N, Okenge, A; Meshnick, SR. (2010) Spatial and socio-demographic patterns of HIV prevalence in the Democratic Republic of Congo. Social Science and Medicine. 71(8): 1428-1435. link to article
Presentations
Messina, J; Taylor, S; Meshnick, SR; Emch, M. “Population, Behavioral and Environmental Drivers of Malaria Prevalence in the Democratic Republic of Congo.” Association of American Geographers, Seattle. 4/15/11.
Messina, J; Taylor, S; Emch, M; Meshnick, S. “Measuring Malaria in the Democratic Republic of the Congo by Molecular Analyses of Leftover Dried Blood Spots from the 2007 Demographic Health Survey.” Global Health Metrics & Evaluation: Controversies, Innovation, Accountability, Seattle. 3/14/11.
Funding
Meshnick, S. (PI), Emch, M.E. (Co-PI), and Miller, M. (Co-PI). Center for Accurate Data on Endemic and Emerging Infectious Diseases in Developing Countries, Gillings Innovation Labs, UNC School of Public Health, $504,452. 2008-10.
