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Genetic surveillance of Plasmodium falciparum populations following treatment policy revisions in the Greater Mekong Subregion

Title: Genetic surveillance of Plasmodium falciparum populations following treatment policy revisions in the Greater Mekong Subregion
Authors: Wasakul, V; Verschuuren, TD; Thuy-Nhien, N; Booth, E; Quang, HH; Thang, ND; Chindavongsa, K; Sovannaroth, S; Banouvong, V; Sengsavath, V; Mayxay, M; Tuyen, NTK; Phuong, VNL; Duc Trung, P; Gonçalves, S; Chen, S; Phalivong, S; Xayvanghang, S; Mahaphontrakoon, S; Pearson, RD; Newton, PN; Maude, RJ; Ashley, EA; Ariani, CV; Day, NP; Dondorp, AM; Miotto, O
Publisher Information: Nature Research
Publication Year: 2025
Collection: Oxford University Research Archive (ORA)
Description: Genetic surveillance of Plasmodium falciparum (Pf) can track antimalarial-resistant strains, to inform decision-making by National Malaria Control Programmes (NMCPs). The GenRe-Mekong project prospectively collected 5982 samples in the Greater Mekong Subregion (GMS) between 2017 and 2022, genotyping drug resistance markers, and barcodes that recapitulate genetic variation. Genotypes were analyzed with the grcMalaria R package, first described in this paper, to translate genetic epidemiology data into actionable visual information. Since 2020, Pf incidences decreased rapidly, accompanied by a decline of dihydroartemisinin-piperaquine (DHA-PPQ) resistant lineages, previously dominant in the eastern GMS. The frequency of plasmepsin2/3 amplifications, conferring piperaquine resistance, dropped from 62% in 2017-2019 to 2% in 2022, coinciding with a switch in frontline therapy in Cambodia, Thailand, and Vietnam. While regional artemisinin resistance levels remained high, no evidence of emerging mefloquine resistance was found. Routine genetic surveillance proved valuable in monitoring rapid parasite population changes in response to public health interventions, providing actionable information for NMCPs.
Document Type: article in journal/newspaper
Language: English
DOI: 10.1038/s41467-025-59946-1
Availability: https://doi.org/10.1038/s41467-025-59946-1; https://ora.ox.ac.uk/objects/uuid:f11e9c51-1c2b-4dd5-9e53-a9ebf3aa4d32
Rights: info:eu-repo/semantics/openAccess ; CC Attribution (CC BY)
Accession Number: edsbas.EF3881A9
Database: BASE