Characterising temporal trends in asymptomatic Plasmodium infections and transporter polymorphisms during transition from high to low transmission in Zanzibar, 2005–2013

Details

• Alternative Title:
  Infect Genet Evol
• Personal Author:
  Morris, Ulrika ; Xu, Weiping ; Msellem, Mwinyi I. ; Schwartz, Alanna ; Abass, Ali ; Shakely, Delér ; Cook, Jackie ; Bhattarai, Achuyt ; Petzold, Max ; Greenhouse, Bryan ; Ali, Abdullah S. ; Björkman, Anders ; Fröberg, Gabrielle ; Mårtensson, Andreas
• Description:
  Background:
  
  Improved understanding of the asymptomatic malaria parasite reservoir is a prerequisite to pursue malaria elimination efforts. We therefore characterised temporal trends and transporter polymorphisms in asymptomatic Plasmodium infections during the transition from high to low transmission in Zanzibar.
  
  Methods:
  
  Healthy individuals participating in cross-sectional surveys conducted 2005–2013 were screened for asymptomatic malaria by PCR. Complexity/diversity of infection and transporter polymorphisms were assessed in Plasmodium falciparum positive samples. Symptomatic samples were included for comparison of polymorphisms in 2013.
  
  Results:
  
  PCR-determined parasite prevalence declined from 21.1% (CI95% 17.4–24.9) to 2.3% (CI95% 1.7–2.9) from 2005 to 2013. P. falciparum remained the predominant species; prevalence was highest in children and young adults aged 5–25 years. Parasite densities and complexity of infection, but not population genetic diversity of P. falciparum, decreased from 2005–2009. pfcrt 76T (99.2–64.7%, p < 0.001) and pfmdr1 86Y frequencies (89.4–66.7%, p = 0.03) decreased over time. Pfmdr1 (a.a.86,184,1246) YYY and YYD haplotypes were more frequent in asymptomatic than symptomatic infections in 2013 (p < 0.001).
  
  Conclusions:
  
  There is a declining, albeit persistent, reservoir of parasites present at low-densities in asymptomatic individuals in Zanzibar. This study revealed important characteristics of the remaining parasite population, including intriguing temporal trends in molecular markers associated with antimalarial resistance, which need to be further investigated.
  
  
• Subjects:
  Adolescent Adult Antimalarial Drug Resistance Markers Article Asymptomatic Asymptomatic Infections Child Child, Preschool Cross-Sectional Studies Female Genotype Humans Infant Low Transmission Malaria, Falciparum Male Membrane Transport Proteins Middle Aged Molecular Surveillance Parasite Load Plasmodium Plasmodium Falciparum Polymorphism, Single Nucleotide Prevalence Protozoan Proteins Tanzania Young Adult

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• Source:
  Infect Genet Evol. 33:110-117
• Pubmed ID:
  25917493
• Pubmed Central ID:
  PMC10445533
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/ ; MR/K012126/1/MRC_/Medical Research CouncilUnited Kingdom/
• Place as Subject:
  Zanzibar ; Tanzania
• Volume:
  33
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:50d57eababaec95d9f4b783667f4646a89093670de617f18e4510e84056c0fe5
• Download URL:
  https://stacks.cdc.gov/view/cdc/132366/cdc_132366_DS1.pdf
• File Type:
  [PDF - 738.60 KB ]