Malaria -- Copyright -- Preface -- Acknowledgements -- LIAISON PANEL -- CONTRIBUTORS TO THE STUDY -- Contents -- Malaria -- 1 Conclusions and Recommendations -- DEFINING THE PROBLEM -- THE REPORT -- Background -- Organization -- Sponsorship -- CONCLUSIONS AND RECOMMENDATIONS -- Policy -- Commitment and Sustainability -- Surveillance -- Inter-Sectoral Cooperation -- New Tools for Malaria Control -- Coordination and Integration -- Malaria Research Priorities -- Research in Support of Available Control Measures -- Development of New Tools -- Malaria Control -- Organization of Malaria Control -- Paradigm Approach -- Management -- Monitoring and Evaluation -- Problem Solving (Optional Research) and Evaluation -- Training -- 2 Background -- MALARIA AS A DISEASE -- Clinical Aspects -- Immunity -- Role of Genetics -- DIAGNOSIS -- THE PARASITE -- Life Cycle -- Relapse and Recrudescence -- THE MOSQUITO -- Life Cycle -- Host-Seeking and Feeding Behavior -- THE ENVIRONMENT -- EPIDEMIOLOGY -- Geographic Distribution -- Transmission -- MALARIA CONTROL -- Drugs -- Source Reduction -- Larviciding -- Spraying -- Contact Reduction -- Vaccines -- BIBLIOGRAPHY -- 3 Overview -- PRE-COLUMBIAN HISTORY -- MALARIA IN AMERICA -- DISCOVERY OF QUININE -- DISCOVERY OF THE MALARIA PARASITE AND ITS LIFE CYCLE -- MALARIA AND THE MILITARY -- MALARIA CONTROL -- ERADICATION -- Background -- Eradication Campaign -- Financial Support for Eradication -- Eradication to Control -- 1970 to Present -- U.S. AND INTERNATIONAL SUPPORT FOR MALARIA ACTIVITIES -- United States -- U.S. Agency for International Development -- Centers for Disease Control -- Department of Defense -- National Institute of Allergy and Infectious Diseases -- REFERENCES -- 4 Clinical Medicine and the Disease Process -- WHERE WE WANT TO BE IN THE YEAR 2010 -- WHERE WE ARE TODAY -- Clinical Aspects of Malaria.

Severe Malaria -- Other Clinical Features -- Uncomplicated Malaria -- Malaria Chemoprophylaxis and Treatment -- RESEARCH AGENDA -- Pathogenesis -- Treatment -- Chemoprophylaxis -- REFERENCES -- 5 Diagnostic Tests -- WHERE WE WANT TO BE IN THE YEAR 2010 -- WHERE WE ARE TODAY -- Microscopy -- Standard Technique -- Quantitative Buffy Coat Technique -- QBC Versus Microscopy -- Alternatives to Microscopy -- Immunoassays -- Genetic-Probe Assays -- Polymerase Chain reaction -- Antibody Assays -- Other Assays -- Specifications for Diagnostic Tests -- Evaluation of Diagnostic Tests -- RESEARCH AGENDA -- REFERENCES -- 6 Parasite Biology -- WHERE WANT TO BE IN THE YEAR 2010 -- WHERE WE ARE TODAY -- The Parasite -- Parasite-Host Interactions -- Liver Phase -- Blood Phase -- Mosquito Phase -- Parasite Physiology and Biochemistry -- Feeding -- Permeability Changes in Erythrocyte Membranes -- Other Parasite-Directed Changes in Erythrocyte-Membrane Structure -- Nutrition and Metabolism -- Energy Transformations and Mitochondria -- Parasite Lipids -- Evasion of Host Defenses -- Cytoadherence -- Neoantigens -- Molecular Biology -- Parasite Genetic Diversity -- Karyotype -- Protein Expression -- Other Mechanism of Genetic Variability -- Drug Resistance -- Cloning of Genes for Functional Proteins -- Differential Gene Expression -- Research Training -- RESEARCH AGENDA -- Sporogonic Phase -- Liver Phase -- Blood Phase -- Physiology and Biochemistry -- Developmental Biology -- Drug Action and Resistance -- Clinical Immunity -- Cytoadherence -- Parasite Genes -- In Vitro Cultivation -- REFERENCES -- 7 Vector Biology, Ecology, and Control -- WHERE WE WANT TO BE IN THE YEAR 2010 -- WHERE WE ARE TODAY -- Vector-Parasite Interactions -- Sporogonic Development in Anopheles Mosquitoes -- Factors Affecting Susceptibility -- Factors Affecting Transmission -- Malaria Transmission.

Regulation of Vector Population-Larval Ecology -- Vector Incrimination -- Vector Species and Distributions -- Mosquito Taxonomy and Species Complexes -- Parasite Transmission -- Field Studies -- Indices of Malaria Transmission -- Surveillance Strategies -- Entomological Components of Malaria Vaccine Development -- Vector Control -- Prevention and Control of Transmission -- Selection of Antivector Measures -- Personal Protection Measures -- Insecticide Resistance -- Ecological and Public Health Impacts of Pesticides -- Innovative Vector Control Measures -- Training in Vector Biology -- RESEARCH AGENDA -- Field Investigations -- Patterns of Transmission -- Microepidemiology -- Regulation of Anopheline Populations -- Country-Wide Vector Surveillance -- Vaccine Field Trials -- Laboratory-Based Research -- Malaria Parasite Development in Mosquitoes -- Technique Development for Field Studies -- Innovative Methods for Malaria Control -- Antimosquito Vaccines -- Genetic Modification of the Mosquito Vector -- Drug Development -- Evaluation of Vector Control Methods -- REFERENCES -- 8 Drug Discovery and Development -- WHERE WE WANT TO BE IN THE YEAR 2010 -- WHERE WE ARE TODAY -- Principles of Prophylaxis and Treatment -- Status of Prophylaxis and Treatment -- Plasmodium malariae and P.ovale -- Plasmodium vivax -- Plasmodium falciparum -- Available Antimalarial Drugs -- Causal Prophylactics -- Drugs Used for Treatment -- Drug Discovery and Development -- Walter Read Army Institute of Research -- World Health Organization -- Role of Drug Companies -- Other Participants -- Drugs Under Development -- Arteether -- WR 238605 -- BW566c -- Antibiotics -- Agents That Reverse Chloroquine Resistance -- Agents in Preclinical Development -- Pharmaceutics and Clinical Pharmacology -- RESEARCH AGENDA -- Artemisinin -- Drug Mechanisms of Action -- Quinoline Resistance.

New Drug Targets -- Transformation -- Plasmodium vivax Culture System -- Drug Delivery -- Botanical Preparations -- Secondary Metabolites -- REFERENCES -- 9 Vaccines -- WHERE WE WANT TO BE IN THE YEAR 2010 -- WHERE WE ARE TODAY -- Prospects For a Vaccine -- Approaches To Vaccine Development -- Pre-Erythrocytic Vaccines -- Mechanisms of Immunity -- Targets of Pre-Erythrocytic Immunity -- Impediments to Pre-Erythrocytic Vaccine Development -- Induction of the Appropriate Immune Response -- Asexual Blood-Stage Vaccines -- Mechanisms of Immunity -- Targets of Blood-Stage Immunity -- Preclinical and Clinical Trials -- Impediments to Asexual Blood-Stage Vaccine Development -- Merozoite Surface Antigen 1: A Case Study in Vaccine Development -- Transmission-Blocking Vaccines -- Mechanisms of Immunity -- Targets of Transmission-Blocking Immunity -- Impediments to Transmission-Blocking Vaccine Development -- Antimosquito Vaccines -- RESEARCH AGENDA -- Identification of Mechanisms and Targets of Protective Immunity -- Vaccine Formulation -- In Vitro Assays -- Culture Systems -- REFERENCES -- 10 Epidemiologic Approaches to Malaria Control -- WHERE WE WANT TO BE IN THE YEAR 2010 -- WHERE WE ARE TODAY -- Infection and Disease -- Morbidity and Mortality -- Approaches to Malaria Control -- Tactical Variants and Stratification -- The Epidemiologic Approach to Malaria Control -- Development of the Paradigms -- Description of the Paradigms -- Principal Determinants -- Malaria Control Tools -- Application of the Paradigm Approach -- Program Planning and Evaluation -- Policy Formulation -- Intervention Strategy -- Training -- Reporting -- Problem Solving (Operational Research) -- Logistical Support and Transportation -- Evaluation -- Central Core of Expertise -- Decentralized Activities -- RESEARCH AGENDA -- Infection, Immunity, and Disease -- Pregnancy and Birth Outcome.

Chemoprophylaxis and Therapy -- Drug Resistance -- Paradigms -- Bednets -- REFERENCES -- 11 Economics of Malaria Control -- WHERE WE WANT TO BE IN THE YEAR 2010 -- WHERE WE ARE TODAY -- Applications of Economics to Malaria -- The Economic Costs of Malaria -- Costs and Effects of Malaria Control -- Operational Research -- Economics and Policymaking -- Determining Policy Option -- Epidemiology and Economics -- Example 1: The Burden of Disease and Priority Setting -- Example 2: Decreasing Returns -- Example 3: More Decreasing Returns -- Example 4: Average Versus Marginal Costs and Benefits -- Example 5: Economics and Epidemiologic Paradigms -- RESEARCH AGENDA -- Decision Making Skills -- Data Collection -- Information, Education, and Communication Programs -- Resources -- REFERENCES -- 12 Social and Behavioral Aspects of Malaria -- WHERE WE WANT TO BE IN THE YEAR 2010 -- WHERE WE ARE TODAY -- Factors Favoring Malaria Transmission -- Agricultural Development -- Type I and Type II Farming Systems -- Human Population Movements -- Urbanization -- Implications for Malaria Control Programs -- Acceptance and Usage of Control Methods -- Perceptions of Cerebral Malaria -- Causes of Malaria -- Water and Mosquitoes -- Distinguishing Malaria from Other Diseases -- Drug Side Effects and Beliefs About Drug Action -- Logistical and Organizational Problems -- Lack of Community Participation -- RESEARCH AGENDA -- Understanding Community Beliefs -- Health-Seeking Behavior -- Research Methods -- Health Communications -- Community Participation -- Community Involvement in Planning and Evaluation -- REFERENCES -- Appendix A Paradigms -- TYPES OF MALARIA -- DETERMINANTS -- TOOLS -- Appendix B Dissenting Opinion -- REFERENCES -- Glossary A -- Index.