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Distinct parasite populations infect individuals identified through passive and active case detection in a region of declining malaria transmission in southern Zambia.

Abstract Substantial reductions in the burden of malaria have been documented in parts of sub-Saharan Africa, with elimination strategies and goals being formulated in some regions. Within this context, understanding the epidemiology of low-level malaria transmission is crucial to achieving and sustaining elimination. A 24 single-nucleotide-polymorphism Plasmodium falciparum molecular barcode was used to characterize parasite populations from infected individuals identified through passive and active case detection in an area approaching malaria elimination in southern Zambia.
PMID
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Authors

Mayor MeshTerms
Keywords

Malaria elimination

Molecular barcode

Molecular epidemiology

Parasite genetics

Population genetics

Sub-Saharan Africa

Zambia

Journal Title malaria journal
Publication Year Start




PMID- 28420399
OWN - NLM
STAT- In-Process
DA  - 20170419
LR  - 20170421
IS  - 1475-2875 (Electronic)
IS  - 1475-2875 (Linking)
VI  - 16
IP  - 1
DP  - 2017 Apr 19
TI  - Distinct parasite populations infect individuals identified through passive and
      active case detection in a region of declining malaria transmission in southern
      Zambia.
PG  - 154
LID - 10.1186/s12936-017-1810-3 [doi]
AB  - BACKGROUND: Substantial reductions in the burden of malaria have been documented 
      in parts of sub-Saharan Africa, with elimination strategies and goals being
      formulated in some regions. Within this context, understanding the epidemiology
      of low-level malaria transmission is crucial to achieving and sustaining
      elimination. A 24 single-nucleotide-polymorphism Plasmodium falciparum molecular 
      barcode was used to characterize parasite populations from infected individuals
      identified through passive and active case detection in an area approaching
      malaria elimination in southern Zambia. METHODS: The study was conducted in the
      catchment area of Macha Hospital in Choma District, Southern Province, Zambia,
      where the parasite prevalence declined over the past decade, from 9.2% in 2008 to
      less than 1% in 2013. Parasite haplotypes from actively detected, P.
      falciparum-infected participants enrolled in a serial cross-sectional,
      community-based cohort study from 2008 to 2013 and from passively detected, P.
      falciparum-infected individuals enrolled at five rural health centres from 2012
      to 2015 were compared. Changes in P. falciparum genetic relatedness, diversity
      and complexity were analysed as malaria transmission declined. RESULTS: Actively 
      detected cases identified in the community were most commonly rapid diagnostic
      test negative, asymptomatic and had submicroscopic parasitaemia. Phylogenetic
      reconstruction using concatenated 24 SNP barcode revealed a separation of
      parasite haplotypes from passively and actively detected infections, consistent
      with two genetically distinct parasite populations. For passively detected
      infections identified at health centres, the proportion of detectable polyclonal 
      infections was consistently low in all seasons, in contrast with actively
      detected infections in which the proportion of polyclonal infections was high.
      The mean genetic divergence for passively detected infections was 34.5% for the
      2012-2013 transmission season, 37.8% for the 2013-2014 season, and 30.8% for the 
      2014-2015 season. The mean genetic divergence for actively detected infections
      was 22.3% in the 2008 season and 29.0% in the 2008-2009 season and 9.9% across
      the 2012-2014 seasons. CONCLUSIONS: Distinct parasite populations were identified
      among infected individuals identified through active and passive surveillance,
      suggesting that infected individuals detected through active surveillance may not
      have contributed substantially to ongoing transmission. As parasite prevalence
      and diversity within these individuals declined, resource-intensive efforts to
      identify the chronically infected reservoir may not be necessary to eliminate
      malaria in this setting.
FAU - Searle, Kelly M
AU  - Searle KM
AD  - Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins
      University, Baltimore, MD, USA. [email protected]
FAU - Katowa, Ben
AU  - Katowa B
AD  - Macha Research Trust, Choma District, Zambia.
FAU - Kobayashi, Tamaki
AU  - Kobayashi T
AD  - Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins
      University, Baltimore, MD, USA.
FAU - Siame, Mwiche N S
AU  - Siame MNS
AD  - Macha Research Trust, Choma District, Zambia.
FAU - Mharakurwa, Sungano
AU  - Mharakurwa S
AD  - Biomedical Research Training Institute, Harare, Zimbabwe.
FAU - Carpi, Giovanna
AU  - Carpi G
AD  - Johns Hopkins Malaria Research Institute, Department of Molecular Microbiology
      and Immunology, Bloomberg School of Public Health, Johns Hopkins University,
      Baltimore, MD, USA.
FAU - Norris, Douglas E
AU  - Norris DE
AD  - Johns Hopkins Malaria Research Institute, Department of Molecular Microbiology
      and Immunology, Bloomberg School of Public Health, Johns Hopkins University,
      Baltimore, MD, USA.
FAU - Stevenson, Jennifer C
AU  - Stevenson JC
AD  - Macha Research Trust, Choma District, Zambia.
AD  - Johns Hopkins Malaria Research Institute, Department of Molecular Microbiology
      and Immunology, Bloomberg School of Public Health, Johns Hopkins University,
      Baltimore, MD, USA.
FAU - Thuma, Philip E
AU  - Thuma PE
AD  - Macha Research Trust, Choma District, Zambia.
AD  - Johns Hopkins Malaria Research Institute, Department of Molecular Microbiology
      and Immunology, Bloomberg School of Public Health, Johns Hopkins University,
      Baltimore, MD, USA.
FAU - Moss, William J
AU  - Moss WJ
AD  - Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins
      University, Baltimore, MD, USA.
AD  - Johns Hopkins Malaria Research Institute, Department of Molecular Microbiology
      and Immunology, Bloomberg School of Public Health, Johns Hopkins University,
      Baltimore, MD, USA.
CN  - Southern Africa International Centers of Excellence for Malaria Research
LA  - eng
PT  - Journal Article
DEP - 20170419
PL  - England
TA  - Malar J
JT  - Malaria journal
JID - 101139802
PMC - PMC5395854
OTO - NOTNLM
OT  - Malaria elimination
OT  - Molecular barcode
OT  - Molecular epidemiology
OT  - Parasite genetics
OT  - Population genetics
OT  - Sub-Saharan Africa
OT  - Zambia
EDAT- 2017/04/20 06:00
MHDA- 2017/04/20 06:00
CRDT- 2017/04/20 06:00
PHST- 2016/09/13 [received]
PHST- 2017/04/08 [accepted]
AID - 10.1186/s12936-017-1810-3 [doi]
AID - 10.1186/s12936-017-1810-3 [pii]
PST - epublish
SO  - Malar J. 2017 Apr 19;16(1):154. doi: 10.1186/s12936-017-1810-3.

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