Lo Eugenia, Hemming-Schroeder Elizabeth, Yewhalaw Delenasaw, Nguyen Jennifer, Kebede Estifanos, Zemene Endalew, Getachew Sisay, Tushune Kora, Zhong Daibin, Zhou Guofa, Petros Beyene, Yan Guiyun
Department of Biological Sciences, University of North Carolina at Charlotte, Charlotte, North Carolina, United States of America.
Program in Public Health, University of California, Irvine, California, United States of America.
PLoS Negl Trop Dis. 2017 Jul 26;11(7):e0005806. doi: 10.1371/journal.pntd.0005806. eCollection 2017 Jul.
Ethiopia is one of the few African countries where Plasmodium vivax is co-endemic with P. falciparum. Malaria transmission is seasonal and transmission intensity varies mainly by landscape and climate. Although the recent emergence of drug resistant parasites presents a major issue to malaria control in Ethiopia, little is known about the transmission pathways of parasite species and prevalence of resistant markers. This study used microsatellites to determine population diversity and gene flow patterns of P. falciparum (N = 226) and P. vivax (N = 205), as well as prevalence of drug resistant markers to infer the impact of gene flow and existing malaria treatment regimes. Plasmodium falciparum indicated a higher rate of polyclonal infections than P. vivax. Both species revealed moderate genetic diversity and similar population structure. Populations in the northern highlands were closely related to the eastern Rift Valley, but slightly distinct from the southern basin area. Gene flow via human migrations between the northern and eastern populations were frequent and mostly bidirectional. Landscape genetic analyses indicated that environmental heterogeneity and geographical distance did not constrain parasite gene flow. This may partly explain similar patterns of resistant marker prevalence. In P. falciparum, a high prevalence of mutant alleles was detected in codons related to chloroquine (pfcrt and pfmdr1) and sulfadoxine-pyrimethamine (pfdhps and pfdhfr) resistance. Over 60% of the samples showed pfmdr1 duplications. Nevertheless, no mutation was detected in pfK13 that relates to artemisinin resistance. In P. vivax, while sequences of pvcrt-o were highly conserved and less than 5% of the samples showed pvmdr duplications, over 50% of the samples had pvmdr1 976F mutation. It remains to be tested if this mutation relates to chloroquine resistance. Monitoring the extent of malaria spread and markers of drug resistance is imperative to inform policy for evidence-based antimalarial choice and interventions. To effectively reduce malaria burden in Ethiopia, control efforts should focus on seasonal migrant populations.
埃塞俄比亚是少数间日疟原虫与恶性疟原虫共同流行的非洲国家之一。疟疾传播具有季节性,传播强度主要因地形和气候而异。尽管近期出现的耐药寄生虫对埃塞俄比亚的疟疾控制构成了重大问题,但对于寄生虫物种的传播途径和耐药标志物的流行情况却知之甚少。本研究使用微卫星来确定恶性疟原虫(N = 226)和间日疟原虫(N = 205)的种群多样性和基因流动模式,以及耐药标志物的流行情况,以推断基因流动和现有疟疾治疗方案的影响。恶性疟原虫的多克隆感染率高于间日疟原虫。两个物种均显示出中等程度的遗传多样性和相似的种群结构。北部高地的种群与东部裂谷密切相关,但与南部盆地地区略有不同。北部和东部种群之间通过人类迁移的基因流动频繁,且大多是双向的。景观遗传学分析表明,环境异质性和地理距离并未限制寄生虫的基因流动。这可能部分解释了耐药标志物流行情况的相似模式。在恶性疟原虫中,在与氯喹(pfcrt和pfmdr1)以及磺胺多辛 - 乙胺嘧啶(pfdhps和pfdhfr)耐药相关的密码子中检测到高比例的突变等位基因。超过60%的样本显示pfmdr1重复。然而,在与青蒿素耐药相关的pfK13中未检测到突变。在间日疟原虫中,虽然pvcrt - o的序列高度保守,且不到5%的样本显示pvmdr重复,但超过50%的样本具有pvmdr1 976F突变。该突变是否与氯喹耐药相关仍有待测试。监测疟疾传播范围和耐药标志物对于为基于证据的抗疟药物选择和干预政策提供信息至关重要。为有效减轻埃塞俄比亚的疟疾负担,防控工作应聚焦于季节性流动人口。