Last Updated: 12/06/2019
Genetic epidemiology of Plasmodium falciparum in Southern Mozambique
Objectives
In this context, this study aims to evaluate whether studying the parasite population may i) offer information on the source of infections in areas close to elimination and ii) serve as a measure of the level of transmission intensity in an area. More specifically, the research team will evaluate the ability of parasite genetic data to measure transmission within southern Mozambique as well as to assess the parasite movements between Mozambique and the neighbouring country of Swaziland.
Specific objectives:
- To determine population structure and genetic relatedness of P. falciparum in three provinces of southern Mozambique.
- To determine cross-border genetic relatedness of parasites between Mozambique, Swaziland and South Africa.
- To accurately classify imported and local parasites from each province using genetic and epidemiologic data.
Malaria is endemic throughout Mozambique, and most of the country has year-round malaria transmission with a seasonal peak from December to April. In a 2015 survey, malaria prevalence varied from 2.2 % in the Maputo city to 68% in Zambézia Province, with point prevalence higher in the northern than the southern provinces. Malaria control measures showed a heterogeneous success in Mozambique, with a 13.8% decline in prevalence from 2007 to 2015. The three southern provinces (Maputo, Gaza and Inhambane) had the lowest point prevalence in 2015 (Mozambique Malaria Indicator Survey 2015).
These provinces are targeted for elimination by the MALTEM, with a goal to eliminate malaria in the Maputo province by 2020 and to make significant progress towards elimination in Gaza and Inhambane provinces. However, a recent study showed an increase in the number of cases of malaria in some provinces of Mozambique,1 highlighting the potentially fragile nature of malaria elimination in a country with heterogeneous transmission.
The major challenges will be the ability to sustain gains in low transmission areas and prevention of continuous replenishment of parasites from the high transmission provinces. Therefore, to fully interrupt transmission in areas close to elimination, parasite movement patterns should be better understood to identify the primary sources of infection, and consequently target those specific areas of transmission. Similarly, the parasite population diversity in areas where transmission is rapidly reduced after the deployment of interventions may also be affected, thus serving as an alternative way to monitor transmission dynamics.
Mar 2018 — Jun 2018
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