Microsatellite analysis reveals connectivity among geographically distant transmission zones of Plasmodium vivax in the Peruvian Amazon: A critical barrier to regional malaria elimination

Despite efforts made over decades by the Peruvian government to eliminate malaria, Plasmodium vivax remains a challenge for public health decision-makers in the country. The uneven distribution of its incidence, plus its complex pattern of dispersion, has made ineffective control measures based on g...

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Bibliographic Details
Published in:PLoS neglected tropical diseases 2019-11, Vol.13 (11), p.e0007876-e0007876
Main Authors: Manrique, Paulo, Miranda-Alban, Julio, Alarcon-Baldeon, Jhonatan, Ramirez, Roberson, Carrasco-Escobar, Gabriel, Herrera, Henry, Guzman-Guzman, Mitchel, Rosas-Aguirre, Angel, Llanos-Cuentas, Alejandro, Vinetz, Joseph M, Escalante, Ananias A, Gamboa, Dionicia
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Analysis
Biodiversity
Biology and Life Sciences
Child
Child, Preschool
Decision making
Disease eradication
Disease transmission
Disease Transmission, Infectious
Earth Sciences
Ecology and Environmental Sciences
Female
Gene flow
Genes
Genetic diversity
Genetic variation
Genotype
Genotyping Techniques
Geographical distribution
Health aspects
Human diseases
Human motion
Humans
Humboldt, Alexander von (1769-1859)
Incidence
Infant
Infant, Newborn
Infections
Longitudinal Studies
Maintenance
Malaria
Malaria, Vivax - epidemiology
Malaria, Vivax - parasitology
Malaria, Vivax - transmission
Male
Medicine and Health Sciences
Microsatellite Repeats
Microsatellites
Middle Aged
Molecular Epidemiology
Parasites
Persistence
Peru - epidemiology
Plasmodium falciparum
Plasmodium vivax
Plasmodium vivax - classification
Plasmodium vivax - genetics
Plasmodium vivax - isolation & purification
Population
Population genetics
Population structure
Population studies
Populations
Public health
Public health movements
Rivers
Transmission
Travel
Tropical diseases
Vector-borne diseases
Young Adult
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Summary:Despite efforts made over decades by the Peruvian government to eliminate malaria, Plasmodium vivax remains a challenge for public health decision-makers in the country. The uneven distribution of its incidence, plus its complex pattern of dispersion, has made ineffective control measures based on global information that lack the necessary detail to understand transmission fully. In this sense, population genetic tools can complement current surveillance. This study describes the genetic diversity and population structure from September 2012 to March 2015 in three geographically distant settlements, Cahuide (CAH), Lupuna (LUP) and Santa Emilia (STE), located in the Peruvian Amazon. A total 777 P. vivax mono-infections, out of 3264, were genotyped. Among study areas, LUP showed 19.7% of polyclonal infections, and its genetic diversity (Hexp) was 0.544. Temporal analysis showed a significant increment of polyclonal infections and Hexp, and the introduction and persistence of a new parasite population since March 2013. In STE, 40.1% of infections were polyclonal, with Hexp = 0.596. The presence of four genetic clusters without signals of clonal expansion and infections with lower parasite densities compared against the other two areas were also found. At least four parasite populations were present in CAH in 2012, where, after June 2014, malaria cases decreased from 213 to 61, concomitant with a decrease in polyclonal infections (from 0.286 to 0.18), and expectedly variable Hexp. Strong signals of gene flow were present in the study areas and wide geographic distribution of highly diverse parasite populations were found. This study suggests that movement of malaria parasites by human reservoirs connects geographically distant malaria transmission areas in the Peruvian Amazon. The maintenance of high levels of parasite genetic diversity through human mobility is a critical barrier to malaria elimination in this region.
ISSN:1935-2735
1935-2727
1935-2735
DOI:10.1371/journal.pntd.0007876