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Drug Resistance and Population Structure of Plasmodium Falciparum across the Democratic Republic of Congo using high-throughput Molecular Inversion Probes
Authors: Aydemir O, Janko M, Hathaway NJ, Verity R, Mwandagalirwa MK, Tshefu AK, Tessema SK, Marsh PW, Tran A, Reimonn T, Ghani AC, Ghansah A, Juliano JJ, Greenhouse BR, Emch M, Meshnick SR, and Bailey JA
Source: Journal of Infectious Diseases , jiy223; DOI: 10.1093/infdis/jiy223
Topic(s): Malaria
Country: Africa
  Democratic Republic of the Congo (DRC)
Published: APR 2018
Abstract: A better understanding of the drivers of the spread of malaria parasites and drug resistance across space and time is needed. These drivers can be elucidated using genetic tools. Here, a novel molecular inversion probe (MIP) panel targeting all major drug resistance mutations and a set of microsatellites was used to genotype Plasmodium falciparum infections of 552 children from the 2013-14 Demographic and Health Survey conducted in the Democratic Republic of the Congo (DRC). Microsatellite-based analysis of population structure suggests that parasites within the DRC form a homogeneous population. In contrast, sulfadoxine resistance markers in dihydropteroate synthase show marked spatial structure with ongoing spread of double and triple mutants compared to 2007. These findings suggest that parasites in DRC remain panmictic despite rapidly spreading antimalarial resistance mutations. Moreover, highly-multiplexed targeted sequencing using MIPs emerges as a cost effective method for elucidating pathogen genetics in complex infections in large cohorts.