TY - JOUR
T1 - Plasmodium falciparum population structure in Sudan post artemisinin-based combination therapy
AU - Bakhiet, Amani M.A.
AU - Abdel-Muhsin, Abdel Muhsin A.
AU - Elzaki, Salah Eldin G.
AU - Al-Hashami, Zainab
AU - Albarwani, Hamida S.
AU - AlQamashoui, Badar A.
AU - Al-Hamidhi, Salama
AU - Idris, Mohamed A.
AU - Elagib, Atif A.
AU - Beja-Pereira, Albano
AU - Babiker, Hamza A.
N1 - Funding Information:
We thank the malaria patients and health workers in Sudan who participated in this work, and gratefully acknowledge the funding from Third World Organization for Women in Science (TWOWS) (No. 32402193S4 ). Furthermore, we would like to thank staff of Biochemistry Department—College of Medicine in Sultan Qaboos University (SQU)—Oman for providing the lab to complete the task. We also thank Prof. Intisar Alhaj—Tropical Medicine Research Institute—Sudan, Prof. Abdellah H. Noor, Dr. Siham M. Ahmed, College of Medicine—Alzaeam Alazhari University—Sudan, Dr. Moawia A. Hassan, College of Medicine—Jazan University—KSA for their tremendous support.
Publisher Copyright:
© 2015 Elsevier B.V.
PY - 2015/8/1
Y1 - 2015/8/1
N2 - Over the past decade, Sudan has stepped up malaria control backed by WHO, and this has resulted in significant reduction in parasite rate, malaria morbidity and mortality. The present study analyzed Plasmodium falciparum parasites in four geographical separated areas, to examine whether the success in malaria control following the use of artemisinin-based combination therapy (ACT) has disrupted the population structure and evolution of the parasite.We examined 319 P. falciparum isolates collected between October 2009 and October 2012 in four different areas in Sudan (Jazira [central Sudan], Southern Darfur [western Sudan], Upper Nile [southern Sudan] and Kasala [eastern Sudan]). Twelve microsatellites were analyzed for allelic diversity, multi-locus haplotype and inter-population differentiation. Level of diversity was compared to that detected for three of the above microsatellites among P. falciparum parasites in central and eastern Sudan in 1999, prior to introduction of ACT.Diversity at each locus (unbiased heterozygosity [H]) was high in all areas (Jazira, H=0.67), (Southern Darfur, H=0.71), (Upper Nile, H=0.71), and (Kasala, H=0.63). Microsatellites were distributed widely and private alleles, detected in a single population, were rare. The extent of diversity in the above sites was similar to that seen, in 1999, in central (Khartoum, H=0.73) and eastern Sudan (Gedaref, H=0.75). Significant Linkage disequilibrium (LD) was observed between the microsatellites in all populations. Pairwise FST analysis revealed that parasites in the four areas could be considered as one population. However, the parasites in Sudan clustered away from parasites in West Africa and the Arabian Peninsula.Despite marked reduction in malaria risk in Sudan, the extent of diversity and parasite genetic structure are indicative of a large population size. Further considerable reduction in transmission would be needed before fragmented sub-population can be seen. In addition, the large divergence of P. falciparum in Sudan from West Africa and Arabian Peninsula populations may result from differential evolutionary pressures acting at the population level, which shall be considered in eradication plans.
AB - Over the past decade, Sudan has stepped up malaria control backed by WHO, and this has resulted in significant reduction in parasite rate, malaria morbidity and mortality. The present study analyzed Plasmodium falciparum parasites in four geographical separated areas, to examine whether the success in malaria control following the use of artemisinin-based combination therapy (ACT) has disrupted the population structure and evolution of the parasite.We examined 319 P. falciparum isolates collected between October 2009 and October 2012 in four different areas in Sudan (Jazira [central Sudan], Southern Darfur [western Sudan], Upper Nile [southern Sudan] and Kasala [eastern Sudan]). Twelve microsatellites were analyzed for allelic diversity, multi-locus haplotype and inter-population differentiation. Level of diversity was compared to that detected for three of the above microsatellites among P. falciparum parasites in central and eastern Sudan in 1999, prior to introduction of ACT.Diversity at each locus (unbiased heterozygosity [H]) was high in all areas (Jazira, H=0.67), (Southern Darfur, H=0.71), (Upper Nile, H=0.71), and (Kasala, H=0.63). Microsatellites were distributed widely and private alleles, detected in a single population, were rare. The extent of diversity in the above sites was similar to that seen, in 1999, in central (Khartoum, H=0.73) and eastern Sudan (Gedaref, H=0.75). Significant Linkage disequilibrium (LD) was observed between the microsatellites in all populations. Pairwise FST analysis revealed that parasites in the four areas could be considered as one population. However, the parasites in Sudan clustered away from parasites in West Africa and the Arabian Peninsula.Despite marked reduction in malaria risk in Sudan, the extent of diversity and parasite genetic structure are indicative of a large population size. Further considerable reduction in transmission would be needed before fragmented sub-population can be seen. In addition, the large divergence of P. falciparum in Sudan from West Africa and Arabian Peninsula populations may result from differential evolutionary pressures acting at the population level, which shall be considered in eradication plans.
KW - Genetic diversity
KW - Plasmodium falciparum
KW - Population structure
KW - Sudan
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U2 - 10.1016/j.actatropica.2015.04.013
DO - 10.1016/j.actatropica.2015.04.013
M3 - Article
C2 - 25913735
AN - SCOPUS:84929104306
SN - 0001-706X
VL - 148
SP - 97
EP - 104
JO - Acta Tropica
JF - Acta Tropica
ER -