Malaria molecular surveillance in Angola, 2021
To evaluate genetic susceptibility of P. falciparum malaria parasites to current diagnostics and treatment in Angola’s healthcare setting, using samples from the 2021 therapeutic efficacy study (TES) and health facility survey (HFS).
- Differentiate recrudescence from new infections in recurrent episodes of P. falciparum parasitemia detected in TES.
- Characterize molecular markers of P. falciparum antimalarial drug resistance (pfkelch13 and pfmdr1) in treatment failures from TES.
- Assess if TES sampling is representative of province-level prevalence of drug resistance markers by comparing prevalence of pfmdr1, pfdhfr and pfdhps mutations in a random selection of P.falciparum infections from TES and HFS from the same province.
- Determine the geographical heterogeneity in pfkelch13, pfmdr1 and pfdhfr/pfdhps markers by comparing the prevalence of mutations between the different provinces sampled.
- Determine the prevalence of non-falciparum malaria infections among outpatients in the HFS.
- Determine the presence of pfhrp2/3 gene deletions in samples with discordant RDT result.
Genome science has the potential to inform about key drivers of P. falciparum transmission and guide actions towards malaria control and elimination. For this reason, several initiatives are pursuing the development of molecular capacities in countries where malaria is endemic. As part of this efforts, collaborations between countries can increase the power and sustainability of next generation sequencing platforms to track the emergence and spread of P. falciparum parasites resistant to currently used antimalarials and rapid diagnostic tests. This project aims to establish a collaboration between Angola and Mozambique to analyze samples from an upcoming therapeutic efficacy study (TES) and a health facility survey (HFS) in Angola, using molecular and serological tools for early detection of antimalarial drug resistance and pfhrp2/3 deletion. Data generated from the study will be of direct benefit to the Angolan National Malaria Control Program by providing early detection of antimalarial drug and diagnostics resistance and inform on which treatment and RDT are the best for the country.