The impact of antimalarial resistance on the genetic structure of Plasmodium falciparum in the DRC

Nat Commun. 2020 Apr 30;11(1):2107. doi: 10.1038/s41467-020-15779-8.

Abstract

The Democratic Republic of the Congo (DRC) harbors 11% of global malaria cases, yet little is known about the spatial and genetic structure of the parasite population in that country. We sequence 2537 Plasmodium falciparum infections, including a nationally representative population sample from DRC and samples from surrounding countries, using molecular inversion probes - a high-throughput genotyping tool. We identify an east-west divide in haplotypes known to confer resistance to chloroquine and sulfadoxine-pyrimethamine. Furthermore, we identify highly related parasites over large geographic distances, indicative of gene flow and migration. Our results are consistent with a background of isolation by distance combined with the effects of selection for antimalarial drug resistance. This study provides a high-resolution view of parasite genetic structure across a large country in Africa and provides a baseline to study how implementation programs may impact parasite populations.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antimalarials / pharmacology*
  • Chloroquine / pharmacology
  • Democratic Republic of the Congo
  • Drug Combinations
  • Drug Resistance / genetics*
  • Genome, Protozoan
  • Genotype
  • Geography
  • Haplotypes
  • Humans
  • Malaria, Falciparum / parasitology
  • Malaria, Falciparum / prevention & control
  • Mutation
  • Plasmodium falciparum / drug effects*
  • Plasmodium falciparum / genetics*
  • Polymorphism, Single Nucleotide
  • Principal Component Analysis
  • Pyrimethamine / pharmacology
  • Sulfadoxine / pharmacology

Substances

  • Antimalarials
  • Drug Combinations
  • fanasil, pyrimethamine drug combination
  • Sulfadoxine
  • Chloroquine
  • Pyrimethamine