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Subtle changes in Plasmodium falciparum infection complexity following enhanced intervention in Malawi

Sisya, Tamika J, Kamn'gona, Raphael M, Vareta, Jimmy A, Fulakeza, Joseph M, Mukaka, Mavuto F J, Seydel, Karl B, Laufer, Miriam K, Taylor, Terrie E and Nkhoma, Standwell (2014) 'Subtle changes in Plasmodium falciparum infection complexity following enhanced intervention in Malawi'. Acta Tropica, Vol 142, pp. 108-114.

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Abstract

With support from the Global Fund, the United States President's Malaria Initiative (PMI) and other cooperating partners, Malawi is implementing a comprehensive malaria control programme involving indoor residual spraying in targeted districts, universal coverage with insecticide-treated bed nets, use of rapid diagnostic tests to confirm the clinical diagnosis of malaria and use of the highly effective artemisinin-based combination therapy, artemether-lumefantrine (AL), as the first-line treatment for malaria. We genotyped 24 genome-wide single nucleotide polymorphisms (SNPs) in Plasmodium falciparum infections (n = 316) sampled from a single location in Malawi before (2006 and 2007) and after enhanced intervention (2008 and 2012). The SNP data generated were used to examine temporal changes in the proportion of multiple-genotype infections (MIs), mean number of heterozygous SNPs within MIs, parasite genetic diversity (expected heterozygosity and genotypic richness), multilocus linkage disequilibrium and effective population size (Ne). While the proportion of MIs, expected heterozygosity, genotypic richness, multilocus linkage disequilibrium and Ne were unchanged over time, the mean number (±standard deviation) of heterozygous SNPs within MIs decreased significantly (p = 0.01) from 9(±1) in 2006 to 7(±1) in 2012. These findings indicate that the genetic diversity of P. falciparum malaria parasites in this area remains high, suggesting that only subtle gains, if any, have been made in reducing malaria transmission. Continued surveillance is required to evaluate the impact of malaria control interventions in this area and the rest of Malawi, and to better target control interventions.

Item Type: Article
Subjects: QU Biochemistry > Genetics > QU 500 Genetic phenomena
QX Parasitology > Protozoa > QX 135 Plasmodia
WC Communicable Diseases > Tropical and Parasitic Diseases > WC 765 Prevention and control
Faculty: Department: Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI): https://doi.org/10.1016/j.actatropica.2014.11.008
Depositing User: Jessica Jones
Date Deposited: 01 Feb 2016 15:46
Last Modified: 06 Feb 2018 13:11
URI: http://archive.lstmed.ac.uk/id/eprint/5582

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