Project Grant R21AI197478

Federal Project Grant Award Summary

The University of North Carolina at Chapel Hill received a $190,825 Project Grant from the National Institute of Allergy and Infectious Diseases (NIAID) under the Allergy and Infectious Diseases Research program (CFDA 93.855), awarded February 10, 2026, with a completion date of January 31, 2028. The grant supports research applying novel genomic and bioinformatic tools to distinguish Plasmodium vivax malaria relapses from re-infections in clinical trials conducted in Southeast Asia. The research employs molecular inversion probes (MIPs) for deep sequencing of P. vivax infections and introduces the TAPESTRY bioinformatics tool to enable haplotype reconstruction and identity-by-descent analysis within multiclonal infections. Bayesian statistical models integrate genetic complexity, relatedness, and clinical factors to refine relapse predictions.

The project comprises two primary research aims: Aim 1 investigates primaquine failures in a Thai P. vivax relapse trial by using genomic analyses to assess infection complexity as a proxy for liver-stage hypnozoite burden in cases of suspected treatment failures; Aim 2 evaluates malaria elimination interventions in a Cambodian military cohort to determine whether rebound infections after cessation of monthly prophylaxis represent relapses driven by high hypnozoite burden. These research activities advance understanding of anti-relapse intervention efficacy and support malaria elimination objectives by providing improved molecular diagnostics to distinguish relapse phenomena from re-infection events.