Investigating the Biology and Behavior of Anopheles Squamosus and Its Role in Residual Malaria Transmission in Southern Zambia

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Investigating the Biology and Behavior of Anopheles Squamosus and Its Role in Residual Malaria Transmission in Southern Zambia INVESTIGATING THE BIOLOGY AND BEHAVIOR OF ANOPHELES SQUAMOSUS AND ITS ROLE IN RESIDUAL MALARIA TRANSMISSION IN SOUTHERN ZAMBIA By Jordan Hoffman A thesis submitted to the Johns Hopkins University in conformity with the requirements for the degree of Master of Science. Baltimore, Maryland April 2019 © Jordan Hoffman 2019 All Rights Reserved. Abstract In the last decade, malaria cases in Southern Zambia have declined by 90% due in part to national control efforts. Despite this dramatic reduction, prevalence has remained near 1-2% for the past several years. In 2011, higher than expected rates of anthropophily were observed among Anopheles squamosus in the area, a “zoophilic” species and one that had sporadically been found to contain Plasmodium falciparum sporozoites, indicating the potential importance of secondary vectors. The importance of An. squamosus as a secondary vector was confirmed in 2016 when P. falciparum sporozoites were detected in the species in the region. An. squamosus have been shown thus far to be mainly exophilic and exophagic (feeding and resting outdoors). If this is the case in Southern Province, new control measures may be necessary for achieving and sustaining malaria elimination. Due to its previously presumed lack of importance to malaria transmission, little is known about the biology or behavior of An. squamosus. This study analyzes mosquito collections from two different collection schemes - one performed as part of a reactive-test-and-treat program, and the second performed along a transect. Adult mosquitoes were collected using CDC light traps and morphologically identified. Molecular verification of anopheline species, P. falciparum infectiousness, and blood meal source were determined on samples brought to JHSPH. Household data were incorporated to evaluate associations between household factors and An. squamosus presence, abundance, and behavior. Data from these collections support exophagic and zoophilic behavior by An. squamosus. Although no anthropophily was detected and P. falciparum infectiousness could not be confirmed in any An. squamosus in this study, trends in composite evidence suggest a dominant role of An. squamosus in malaria ii transmission in the area. The phylogenetic structure generated from the An. squamosus specimens in this study indicate the existence of an An. squamosus species complex, which further emphasizes the importance of molecular identification of vectors to direct vector control efforts. This study confirms that indoor vector control strategies will not be sufficient for elimination of malaria in southern Zambia. Primary Reader: Dr. Douglas Norris Secondary Reader: Dr. William Moss iii Acknowledgments All my work on this thesis could not have been achieved without the unwavering support I received from Dr. Douglas Norris. I came into the program with little molecular biology or even laboratory experience, and he made sure I developed the skills I needed to work on this project and to pursue my professional goals. He weathered my bizarre turns in career goals and never lost faith in my ability to accomplish whatever I decided I wanted to do. I cannot stress enough the value of his patience, kindness, and sincerity in my development as a scientist and as a human being. Doug’s leadership was modeled in the laboratory; my experience was shaped tremendously by Christine Jones, Ilinca Ciubotariu, Julia Pringle, Mary Gebhardt, and Giovanna Carpi. They welcomed me into the lab and spent an inordinate amount of time teaching me basic science, answering my endless questions, and reassuring me in the depths of data analysis that it would all work out. They also provided a practically constant supply of tea and chocolate and discussed with equivalent enthusiasm the species of trees we saw on the way to work or the best way to measure tornado incidence across geographic areas. I am incredibly fortunate to have had such a wonderful team supporting me these past two years. In addition to the Norris lab, I would like to thank the ICEMR team at Hopkins, most notably Bill Moss and Tim Shields. Bill was a fantastic travel companion, and his practice of unexpectedly asking for updates during weekly group meetings kept me intimately familiar with my data. It was a joy getting to know him, and I hope someday I can have as full a life as he has (although I would like a bit more sleep). Tim helped me make sense of spatial data, both in the classroom and in meetings, and equipped me with the skills to analyze it independently. He also kept me nourished by alerting me to free food and provided expert advice for traveling west, which I will make use of just as soon as I submit this thesis. Supplementing all this professional support was the company of my peers, most especially that of Hannah MacLeod, Victoria Garcia, Ty Pan, Laura Canaday, and Abeer Sayeed. They gave my life some normalcy, shared in the frustrations of science and life, and, most importantly, made sure I ate regularly. Literally keeping a roof over my head while I pursued this degree, and ultimately who I have to thank for all of this, is my sister, Andrea HoffmAn. She has never stopped believing in me, and it has been so much fun to spend the last few years with her. Finally, I owe so much gratitude to the Macha Research Trust (MRT) team in Zambia for their work with me on this project, along with their help getting me settled in Zambia. Jenny Stevenson for her advice in the set up; Limonty Simubali for leading me through field collections and mosquito morphology; and Harry Hamapumbu for sharing his knowledge of the area and teaching me the ins and outs of study design. The collections used in this study were performed by both the MRT field teams, and none of this project could have been completed without their hard work and advice. iv Table of Contents Sections Page Title Page ............................................................................................................................ i Abstract .............................................................................................................................. ii Acknowledgments ............................................................................................................ iv Table of Contents ............................................................................................................... v List of Tables .................................................................................................................... vi List of Figures ................................................................................................................. viii Introduction ........................................................................................................................ 1 Research Aims ................................................................................................................. 14 Methods ............................................................................................................................ 15 Results .............................................................................................................................. 28 Discussion ........................................................................................................................ 58 Future Directions ............................................................................................................. 66 Conclusions ...................................................................................................................... 67 References......................................................................................................................... 68 Appendices of Protocols....................................................................................................75 Curriculum Vitae...............................................................................................................90 v List of Tables Table 1. Summary of trap-nights excluded from analysis under each collection scheme. Table 2. Outdoor molecular species composition of Anopheles in Collection Scheme I. Table 3. Indoor molecular species composition of Anopheles in Collection Scheme I. Table 4. Impact of household factors on indoor presence of An. squamosus at first visit in Collection Scheme I. Table 5. Impact of household factors on indoor presence of An. squamosus at all three visits in Collection Scheme I. Table 6. Impact of household factors on outdoor presence of An. squamosus at first visit in Collection Scheme I. Table 7. Impact of household factors on outdoor presence of An. squamosus at all three visits in Collection Scheme I. Table 8. Results of Plasmodium assays for JHSPH samples from Collection Scheme I. Table 9. Outdoor morphological species composition of Anopheles in Collection Scheme II. Table 10. Indoor morphological species composition of Anopheles in Collection Scheme II. Table 11. Impact of household factors on indoor presence of An. squamosus in Collection Scheme II. Table 12. Impact of household factors on outdoor presence of An. squamosus in Collection Scheme II. Table 13. Impact of household factors on outdoor abundance of An. squamosus in Collection Scheme II. vi Table 14. Molecular species composition of Anopheles in JHSPH Samples from Collection Scheme II. Table 15. Results of Plasmodium assays for JHSPH samples from Collection Scheme II. Table 16. Individual sample results of blasting NCBI database with sequences from JHSPH samples from Collection
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