the EMERGENTS ICEMR will tackle two major knowledge gaps and emerging obstacles to achieving MEE:

• non-falciparum malaria. Expansion of Plasmodium vivax (Pv) cases (in Duffy-negative individuals), non-falciparum malaria (NFM), and low-density and submicroscopic malaria, either as mono- or mixed-infections with P. falciparum (Pf), is a considerable challenge to achieving MEE. Importantly, P. ovale (Po), representing two different species (P. ovale curtisi and P. ovale wallikeri), which like Pv has a dormant liver stage complicates control, impacts the understanding of clinical disease in Africa, and raises challenges for the understanding of parasite-parasite and parasite-host interactions. « Benign » NFM infections have now been recognized to be a significant cause of (severe) clinical illness and escalating morbidity and mortality.
• insecticide resistance (IR) of « primary » vectors and « secondary » mosquito vectors. In Cameroon, sixteen anopheline species vector malaria parasites, six of which are considered the « major » vectors: An. gambiae, An. coluzzii, An. arabiensis, An. funestus, An. nili, and An. moucheti. Widespread IR for An. gambiae, is well established but less is known for An. coluzzii, an emerging primary malaria vector, which has already developed pyrethroid resistance. An. funestus has also been shown to be the main vector not only for Pf mono-infections but also for Pf/NFM and Po/Pv/Pm mixed infections in this region. Broad generalizations with respect to distribution, abundance, species composition, zoophilic vs. anthropophilic and exophagic vs. endophagic behavior of funestus group members may in fact not hold true. Local temporal and spatial variations should be further explored to fully support MEE efforts.

To address these challenges, the ICEMR team will:

• develop parasite genotyping platforms to create advanced genomic tools tailored for studying NFM transmission, including subsequent development of field- deployable genomic approaches to support parasite and vector surveillance as well as basic and applied research.
• implement field-deployable laboratory techniques to increase testing speed, sensitivity, and accuracy of measurements for sporozoite infection status of mosquitoes.
• test novel insecticide synergists and chemical actives in country that were designed to kill insecticide- resistant mosquitoes against sampled vector species in Cameroon and Nigeria.
• establish an LMIC-suitable template for the application of Systems Translational Biology (metabolomics and proteomics) to understand the contribution of the human host to the unabated transmission of non-falciparum and falciparum malaria parasites across a region of heterogeneous malaria endemicity.
• explore how subclinical and clinical malaria host metabolomic and proteomic profiles influence persistence and infectiousness to mosquitoes.