Tiedje Kathryn E, Zhan Qi, Ruybal-Pesantez Shazia, Tonkin-Hill Gerry, He Qixin, Tan Mun Hua, Argyropoulos Dionne C, Deed Samantha L, Ghansah Anita, Bangre Oscar, Oduro Abraham R, Koram Kwadwo A, Pascual Mercedes, Day Karen P
medRxiv. 2024 Jul 31:2023.05.18.23290210. doi: 10.1101/2023.05.18.23290210.
Here we introduce a new endpoint ″census population size″ to evaluate the epidemiology and control of infections, where the parasite, rather than the infected human host, is the unit of measurement. To calculate census population size, we rely on a definition of parasite variation known as multiplicity of infection (MOI ), based on the hyper-diversity of the multigene family. We present a Bayesian approach to estimate MOI from sequencing and counting the number of unique DBLα tags (or DBLα types) of genes, and derive from it census population size by summation of MOI in the human population. We track changes in this parasite population size and structure through sequential malaria interventions by indoor residual spraying (IRS) and seasonal malaria chemoprevention (SMC) from 2012 to 2017 in an area of high-seasonal malaria transmission in northern Ghana. Following IRS, which reduced transmission intensity by > 90% and decreased parasite prevalence by ~40-50%, significant reductions in diversity, MOI , and population size were observed in ~2,000 humans across all ages. These changes, consistent with the loss of diverse parasite genomes, were short lived and 32-months after IRS was discontinued and SMC was introduced, diversity and population size rebounded in all age groups except for the younger children (1-5 years) targeted by SMC. Despite major perturbations from IRS and SMC interventions, the parasite population remained very large and retained the population genetic characteristics of a high-transmission system (high diversity; low repertoire similarity) demonstrating the resilience of to short-term interventions in high-burden countries of sub-Saharan Africa.
在此,我们引入一个新的终点指标“普查种群大小”,以评估感染的流行病学和控制情况,其中寄生虫而非受感染的人类宿主是测量单位。为了计算普查种群大小,我们依据一种称为感染复数(MOI)的寄生虫变异定义,该定义基于多基因家族的高度多样性。我们提出一种贝叶斯方法,通过对基因的独特DBLα标签(或DBLα类型)进行测序和计数来估计MOI,并通过对人群中MOI求和从中推导出普查种群大小。我们在加纳北部季节性疟疾传播高发地区,通过2012年至2017年的室内滞留喷洒(IRS)和季节性疟疾化学预防(SMC)等连续疟疾干预措施,追踪这种寄生虫种群大小和结构的变化。在IRS使传播强度降低>90%且寄生虫流行率降低约40 - 50%之后,在所有年龄段的约2000人中观察到多样性、MOI和种群大小显著降低。这些与多种寄生虫基因组丢失一致的变化是短暂的,在IRS停止且引入SMC 32个月后,除了SMC针对的幼儿(1 - 5岁)外,所有年龄组的多样性和种群大小都出现了反弹。尽管受到IRS和SMC干预的重大干扰,但寄生虫种群仍然非常庞大,并保留了高传播系统的种群遗传特征(高多样性;低基因库相似性),这表明在撒哈拉以南非洲的高负担国家,寄生虫对短期干预具有恢复力。
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