4 resultados para INCREASE

em DRUM (Digital Repository at the University of Maryland)


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Human malaria is responsible for over 700,000 deaths a year. To stay abreast of the threat posed by the parasite, a constant stream of new drugs and vector control methods are required. This study focuses on a vaccine that has the potential to protect against parasite infection, but has been hindered by developmental challenges. In malaria prevention, live, attenuated, aseptic, Plasmodium falciparum sporozoites (PfSPZ) can be administered as a highly protective vaccine. PfSPZ are produced using adult female Anopheles stephensi mosquitoes as bioreactors. Production volume and cost of a PfSPZ vaccine for malaria are expected to be directly correlated with Plasmodium falciparum infection intensity in the salivary glands. The sporogonic development of Plasmodium falciparum in A. stephensi to fully infected salivary gland stage sporozoites is dictated by the activities of several known components of the mosquito’s innate immune system. Here I report on the use of genetic technologies that have been rarely, if ever, used in Anopheles stephensi Sda500 to increase the yield of sporozoites per mosquito and enhance vaccine production. By combining the Gal4/UAS bipartite system with in vivo expression of shRNA gene silencing, activity of the IMD signaling pathway downstream effector LRIM1, an antagonist to Plasmodium development, was reduced in the midgut, fat body, and salivary glands of A. stephensi. In infection studies using P. berghei and P. falciparum these transgenic mosquitoes consistently produced significantly more salivary gland stage sporozoites than wildtype controls, with increases in P. falciparum ranging from 2.5 to 10 fold. Using Plasmodium infection assays and qRT-PCR, two novel findings were identified. First, it was shown that 14 days post Plasmodium infection, transcript abundance of the IMD immune effector genes LRIM1, TEP1 and APL1c are elevated, in the salivary glands of A. stephensi, suggesting the salivary glands may play a role in post midgut defense against the parasite. Second, a non-pathogenic IMD signaling pathway response was observed which could suggest an alternative pathway for IMD activation. The information gained from these studies has significantly increased our knowledge of Plasmodium defense in A. stephensi and moreover could significantly improve vaccine production.

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African American women account for a disproportionate burden of cervical cancer incidence and mortality rate when compared to non-Hispanic White women. Cervical cancer is one of the most preventable types of cancer, and women can be screened for it with a routine Pap test. Given that religion occupies an essential place in African American lives, framing health messages with important spiritual themes and delivering them through a popular communication delivery channel may allow for a more culturally-relevant and accessible technology-based approach to promoting cervical cancer educational content to African American women. Using community-engaged research as a framework, the purpose of this multiple methods study was to develop, pilot test, and evaluate the feasibility, acceptability, and initial efficacy of a spiritually-based SMS text messaging intervention to increase cervical cancer awareness and Pap test screening intention among African American women. The study recruited church-attending African American women ages 21-65 and was conducted in three phases. Phases 1 and 2 consisted of a series of focus group discussions (n=15), cognitive response interviews (n=8), and initial usability testing that were conducted to inform the intervention development and modifications. Phase 3 utilized a non-experimental one-group pretest-posttest design to pilot test the 16-day text messaging intervention (n=52). Of the individuals enrolled, forty-six completed the posttest (retention rate=88%). Findings provided evidence for the early feasibility, high acceptability, and some initial efficacy of the CervixCheck intervention. There were significant pre-post increases observed for knowledge about cervical cancer and the Pap test (p = .001) and subjective norms (p = .006). Additionally, results post-intervention revealed that 83% of participants reported being either “satisfied” or “very satisfied” with the program and 85% found the text messages either “useful” or “very useful”. 85% of the participants also indicated that they would “likely” or “very likely” share the information they learned from the intervention with the women around them, with 39% indicating that they had already shared some of the information they received with others they knew. A spiritually-based SMS text messaging intervention could be a culturally appropriate and cost-effective method of promoting cervical cancer early detection information to African American women.