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1 Mar 2018

1.

An area has two different Anopheles species, both of which can vector Plasmodium, although Plasmodiumdevelops best and is transmitted best by species B. Species A is dominant because its larvae outcompete species B in the main shared breeding sites, small lakes and ponds. Therefore the population of B is currently small. The small lakes and ponds are also the source for the main food source in the region, fish, grown in fish farms. There is grazing land, but other than chickens, the local population does not have livestock. Species A is largely endophagous and endophilic, species B is exophilic. In other sites, both species A and B will also feed on cattle, and B appears to prefer cattle. Both species also like to roost during the hot day in rock overhangs and small caves. To give some context to your answers use the IPM terminology considered in class.

A) The national malaria control agency sends in a new person to develop a malarial control strategy. (S)he recommends oiling the lakes and ponds, and intensive house spraying . Discuss why each of these two options would be a good or bad idea. In your answer consider effects on species A, species B, and malaria incidence. And remember, the idea is to help the local population.

B) Develop an alternative targeted strategy that might work well in this situation. Explain why this would be a good fit. Use only strategies that have been used successfully in the field, and avoid "just spray everything" strategies. Explain why your strategy should work.

2.

After roughly 15 years we have the first malaria vaccine going into phase 4 trials. Meanwhile a Zika vaccine is starting phase 2b trials, only 2-3 years after the first major outbreak in Brazil.

A) Discuss in some detail why it is so much more difficult to develop a vaccine for malaria than for e.g. the Zika or rubella virus. I am looking for at least 2 reasons, and a brief explanation of those reasons. Just stating that one is complex and the other simple is insufficient. If that is what you want to say, back it up with facts.

B) Both the CRISPR bacterial defense system and the adaptive immune system in mammals have means to recognize “signatures” of invading organisms. In what way are the two systems different?

3.

The malaria control team in a given area has access to 5 different drugs, chloroquine, mefloquine, pyrimethamine, amodiaquine, and artimisinin. Nothing else will be available for the foreseeable future. Some resistance to all 5 is already observed.

A) Provide a strategy to maximize the time you can cure malaria using these 5 drugs. Explain why you want to use this strategy (what is the idea behind your plan), and be precise: when do you plan to use what drugs. What are the potential problems you can face and how do you plan to deal with them? Remember, you are working with humans, not robots.

B) Hypnozoites are forms of P. vivax and P. ovale that are dormant, with barely any metabolic activity. After long periods of time (months, a year), they can be re-activated start invading red blood cells, and causing malaria. Explain why artemisinin would or would not be a good drug for people suspected of carrying hyponozoites.

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Sixta Kovacek
Sixta KovacekLv2
2 Mar 2018

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