Dr. Lisa Reimer (Liverpool School of Tropical Medicine)
Dr. Lisa Reimer
Liverpool School of Tropical Medicine
Department of Vector Biology
Senior Lecturer
Dr. Lisa Reimer is Senior Lecturer at the Liverpool School of Tropical Medicine, where she is affiliated both to the Department of Vector Biology and Department of Parasitology. Dr. Reimer's work has focused on entomology and insecticide-resistance, including a tenure as head of Entomology at the Papua New Guinea Institute of Medical Research. Recently, Dr. Reimer's research projects have included the following: investigating the pleiotropic effects of insecticide resistance on vector behaviour and disease transmission; integrated complementary strategies to support the elimination of Lymphatic Filariasis in Ghana; and the role of vector excreta surveillance to support the rapid detection of vector-borne diseases.
In this Infectious Thoughts interview, Dr. Reimer speaks about her current work in monitoring the vectors of tropical diseases to detect the presence of a pathogen in the human population, thus offering sustainable and low-cost innovative approaches to improve disease surveillance and ultimately control.
What is Molecular Xenomonitoring (MX) and what is the role of MX in disease monitoring and control? What are the specific advantages of MX and how can this help to improve the diagnostics, surveillance and monitoring of diseases in communities endemic for tropical diseases?
Molecular xenomonitoring is the detection of pathogen DNA or RNA in an insect as a proxy for infection in humans. It allows for non-invasive surveillance of diseases which may be present at low levels in the community. It’s particularly beneficial if the disease of interest results in a high proportion of asymptomatic infections and where the response would be community-wide interventions such as vector control or mass drug administration. It can be applied to neglected tropical diseases where there is an interest in monitoring the decline of disease and ensuring no rebounds in infection which could compromise elimination efforts.
The method has been successfully evaluated in field in Ghana against malaria and lymphatic filariasis - what have you learned from this? Will you be testing this approach in other areas or in context of other diseases?
We found that, when collections preferentially target bloodfed and gravid mosquitoes we see a high proportion of pathogen DNA, we also found a high proportion of mosquitoes contained DNA the midge-borne pathogen, Mansonella. These findings open up the opportunity to screen mosquitoes for other fly-borne NTDs. We have just completed an evaluation in India and will be looking to scale up in other NTD contexts.
What are currently some of the challenges or limitations of the MX approach to monitoring the prevalence of disease within a community? Are there specific innovations or technologies which you are working towards or hoping to use in future?
Collecting and processing mosquitoes is time consuming and costly, particularly when a pathogen may be present at very low levels. We have developed an approach to collect the excreta and faeces of mosquitoes rather than processing the whole mosquito. This is a relatively ‘clean’ sample with a high pathogen:vector DNA ratio which allows us to significantly increase the pool sizes that we process at a time. It is an approach that could be integrated with other entomological surveillance activities, or could be adapted as part of a passive trap design.
What partnerships would you be interested in consolidating, whether in terms of MX or at the country, government or field level?
We are interested in developing a multiplexed surveillance approach that could provide valuable information across vector-borne and neglected tropical diseases. We would like to work with partners currently conducting entomological surveillance that might want to extend the impacts of their findings to other diseases. We would also like to work with industry partners to further develop a passive trap design to aid xenomonitoring.
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For more information please contact:
Dr. Lisa Reimer
Liverpool School of Tropical Medicine
lisa.reimer@lstmed.ac.uk
https://www.lstmed.ac.uk/about/people/dr-lisa-reimer
