Thursday, January 21, 2016

URSP Student Kathryn Snyder Researches the Efficacy of Artesunate for Malaria Treatment in the Peruvian Amazon

This week I had the opportunity to travel to Philadelphia, Pennsylvania to share the findings of my research at the American Society of Tropical Medicine and Hygiene (ASTMH) annual conference. Thanks to the Undergraduate Student Travel Fund (USTF) I was able to afford the cost of attending the conference. I had the opportunity to network with physicians and researchers well-respected in their fields and learn from them. Most importantly, I was able to explore the city of brotherly love and eat some incredible food. ASTMH is the nation’s leading professional society for infectious disease and as an undergraduate it was a great opportunity to not only attend, but to present.

My poster was on “Multiple Episodes of P. vivax Malaria in the Peruvian Amazon: Relapses or Frequent Reinfection?” This summer I had the opportunity to do research with the U.S. Naval Medical Research Unit-6 (NAMRU-6) in Iquitos, the largest city in the Peruvian Amazon. Some of the findings for my project are explained below, but the most important concept and take away for me is that health and infection unequally impact the poorest individuals in society the greatest.

Currently, the predominant species of malaria in South America is Plasmodium vivax, which is difficult to control or eliminate due to the prevalence of relapse cases. To compare potential differences in exposure, I carried out geospatial analysis of malaria cases in a village named Padrecocha, which is located 6 km from Iquitos City. Malaria cases presenting at the local health center from 2010 –2015 were defined as cases if they experienced more than one episode of P. vivax in a 12 month period, whereas those with a single episode during the study period were classified as controls, 56 controls and 48 cases were identified. The spatial distribution for cases versus controls was significantly different. Relapse cases lived closer to water bodies (p < 0.001) and lived further from the health post (p = 0.166) than cases  with a single malaria episode. Nearest neighbor analysis showed increased clustering of patients experiencing single infections in the center of the city compared to relapse cases that were more dispersed.

Further analysis is needed to determine what is leading to the relapse of these patients. Clustering in frequent malaria patients could be caused by an increased risk for infection, genetic similarities in individuals living farther from the city center, lack of access to medical resources, or increasing poverty with increased distance from the community’s economic center. Increased distance from the health center could contribute to relapse by making it more difficult for infected individuals to access antimalarial drugs for the duration of the recommended treatment course. Similarly, living further from the city center could contribute to reinfection through more frequent interactions with vectors (increased vector density outside the city center and poorer housing construction, leading to increased exposure).

Attending the conference and networking with professionals from around the globe enabled me to hear about incredible research and opportunities occurring far from Mason. Who knows where I will go next, maybe Africa or back to Peru.