Genetic surveillance in the Greater Mekong subregion and South Asia to support malaria control and elimination

Author:

Jacob Christopher G1,Thuy-Nhien Nguyen2,Mayxay Mayfong345,Maude Richard J567ORCID,Quang Huynh Hong8,Hongvanthong Bouasy9,Vanisaveth Viengxay9,Ngo Duc Thang10,Rekol Huy11,van der Pluijm Rob56,von Seidlein Lorenz56,Fairhurst Rick12,Nosten François513ORCID,Hossain Md Amir14,Park Naomi1,Goodwin Scott1,Ringwald Pascal15,Chindavongsa Keobouphaphone9,Newton Paul356,Ashley Elizabeth35,Phalivong Sonexay3,Maude Rapeephan616,Leang Rithea11,Huch Cheah11,Dong Le Thanh17,Nguyen Kim-Tuyen2,Nhat Tran Minh2ORCID,Hien Tran Tinh2,Nguyen Hoa18,Zdrojewski Nicole18,Canavati Sara18,Sayeed Abdullah Abu14,Uddin Didar6,Buckee Caroline7ORCID,Fanello Caterina I56,Onyamboko Marie19,Peto Thomas56,Tripura Rupam56,Amaratunga Chanaki12,Myint Thu Aung513,Delmas Gilles513,Landier Jordi1320ORCID,Parker Daniel M1321,Chau Nguyen Hoang2,Lek Dysoley11,Suon Seila11,Callery James56ORCID,Jittamala Podjanee22,Hanboonkunupakarn Borimas22,Pukrittayakamee Sasithon2223,Phyo Aung Pyae524,Smithuis Frank524ORCID,Lin Khin25,Thant Myo26,Hlaing Tin Maung26,Satpathi Parthasarathi27,Satpathi Sanghamitra28,Behera Prativa K28,Tripura Amar29,Baidya Subrata29,Valecha Neena30,Anvikar Anupkumar R30,Ul Islam Akhter31,Faiz Abul32,Kunasol Chanon6,Drury Eleanor1,Kekre Mihir1,Ali Mozam1,Love Katie1,Rajatileka Shavanthi1,Jeffreys Anna E33,Rowlands Kate33,Hubbart Christina S33ORCID,Dhorda Mehul5634,Vongpromek Ranitha634,Kotanan Namfon22,Wongnak Phrutsamon6,Almagro Garcia Jacob35,Pearson Richard D135ORCID,Ariani Cristina V1,Chookajorn Thanat22,Malangone Cinzia1,Nguyen T1,Stalker Jim1,Jeffery Ben35,Keatley Jonathan1,Johnson Kimberly J135,Muddyman Dawn1,Chan Xin Hui S56,Sillitoe John1,Amato Roberto1,Simpson Victoria135,Gonçalves Sonia1,Rockett Kirk133ORCID,Day Nicholas P56ORCID,Dondorp Arjen M56ORCID,Kwiatkowski Dominic P135,Miotto Olivo1635ORCID

Affiliation:

1. Wellcome Sanger Institute, Hinxton, United Kingdom

2. Oxford University Clinical Research Unit, Ho Chi Minh City, Viet Nam

3. Lao-Oxford-Mahosot Hospital-Wellcome Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao People's Democratic Republic

4. Institute of Research and Education Development (IRED), University of Health Sciences, Ministry of Health, Vientiane, Lao People's Democratic Republic

5. Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom

6. Mahidol-Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand

7. Harvard TH Chan School of Public Health, Harvard University, Boston, United States

8. Institute of Malariology, Parasitology and Entomology (IMPE-QN), Quy Nhon, Viet Nam

9. Centre of Malariology, Parasitology, and Entomology, Vientiane, Lao People's Democratic Republic

10. National Institute of Malariology, Parasitology and Entomology (NIMPE), Hanoi, Viet Nam

11. National Center for Parasitology, Entomology, and Malaria Control, Phnom Penh, Cambodia

12. National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, United States

13. Shoklo Malaria Research Unit, Mae Sot, Thailand

14. Chittagong Medical College Hospital, Chittagong, Bangladesh

15. World Health Organization, Geneva, Switzerland

16. Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand

17. Institute of Malariology, Parasitology and Entomology (IMPEHCM), Ho Chi Minh City, Viet Nam

18. Vysnova Partners Inc, Hanoi, Viet Nam

19. Kinshasa School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of the Congo

20. Aix-Marseille Université, INSERM, IRD, SESSTIM, Aix Marseille Institute of Public Health, ISSPAM, Marseille, France

21. Susan and Henry Samueli College of Health Sciences, University of California, Irvine, Irvine, United States

22. Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand

23. The Royal Society of Thailand, Bangkok, Thailand

24. Myanmar-Oxford Clinical Research Unit, Yangon, Myanmar

25. Department of Medical Research, Pyin Oo Lwin, Myanmar

26. Defence Services Medical Research Centre, Yangon, Myanmar

27. Midnapore Medical College, Midnapur, India

28. Ispat General Hospital, Rourkela, India

29. Agartala Medical College, Agartala, India

30. National Institute of Malaria Research, Indian Council of Medical Research, New Delhi, India

31. Ramu Upazila Health Complex, Cox's Bazar, Bangladesh

32. Malaria Research Group and Dev Care Foundation, Dhaka, Bangladesh

33. Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, United Kingdom

34. Worldwide Antimalarial Resistance Network (WWARN), Asia Regional Centre, Bangkok, Thailand

35. MRC Centre for Genomics and Global Health, Big Data Institute, Oxford University, Oxford, United Kingdom

Abstract

Background:National Malaria Control Programmes (NMCPs) currently make limited use of parasite genetic data. We have developed GenRe-Mekong, a platform for genetic surveillance of malaria in the Greater Mekong Subregion (GMS) that enables NMCPs to implement large-scale surveillance projects by integrating simple sample collection procedures in routine public health procedures.Methods:Samples from symptomatic patients are processed by SpotMalaria, a high-throughput system that produces a comprehensive set of genotypes comprising several drug resistance markers, species markers and a genomic barcode. GenRe-Mekong delivers Genetic Report Cards, a compendium of genotypes and phenotype predictions used to map prevalence of resistance to multiple drugs.Results:GenRe-Mekong has worked with NMCPs and research projects in eight countries, processing 9623 samples from clinical cases. Monitoring resistance markers has been valuable for tracking the rapid spread of parasites resistant to the dihydroartemisinin-piperaquine combination therapy. In Vietnam and Laos, GenRe-Mekong data have provided novel knowledge about the spread of these resistant strains into previously unaffected provinces, informing decision-making by NMCPs.Conclusions:GenRe-Mekong provides detailed knowledge about drug resistance at a local level, and facilitates data sharing at a regional level, enabling cross-border resistance monitoring and providing the public health community with valuable insights. The project provides a rich open data resource to benefit the entire malaria community.Funding:The GenRe-Mekong project is funded by the Bill and Melinda Gates Foundation (OPP11188166, OPP1204268). Genotyping and sequencing were funded by the Wellcome Trust (098051, 206194, 203141, 090770, 204911, 106698/B/14/Z) and Medical Research Council (G0600718). A proportion of samples were collected with the support of the UK Department for International Development (201900, M006212), and Intramural Research Program of the National Institute of Allergy and Infectious Diseases.

Funder

Bill and Melinda Gates Foundation

Wellcome Trust

Medical Research Council

Department for International Development, UK Government

Publisher

eLife Sciences Publications, Ltd

Subject

General Immunology and Microbiology,General Biochemistry, Genetics and Molecular Biology,General Medicine,General Neuroscience

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