Genetic surveillance in the Greater Mekong Subregion and South Asia to support malaria control and elimination
Jacob CG., Thuy-Nhien N., Mayxay M., Maude RJ., Quang HH., Hongvanthong B., Vanisaveth V., Duc TN., Rekol H., van der Pluijm RW., Von Seidlein L., Fairhurst RM., Nosten FH., Hossain MA., Park N., Goodwin S., Ringwald P., Chindavongsa K., Newton PN., Ashley EA., Phalivong S., Maude RR., Leang R., Huch C., Dong LT., Nguyen K-T., Nhat TM., Hien TT., Nguyen H., Zdrojewski N., Canavati SE., Sayeed AA., Uddin D., Buckee C., Fanello CI., Onyamboko M., Peto T., Tripura R., Amaratunga C., Thu AM., Delmas G., Landier J., Parker DM., Chau NH., Lek D., Suon S., Callery JJ., Jittamala P., Hanboonkunupakarn B., Pukrittayakamee S., Phyo AP., Smithuis F., Lin K., Thant M., Hlaing TM., Satpathi P., Satpathi S., Behera PK., Tripura A., Baidya S., Valecha N., Anvikar AR., Islam AU., Faiz A., Kunasol C., Drury E., Kekre M., Ali M., Love K., Rajatileka S., Jeffreys AE., Rowlands K., Hubbart CS., Dhorda M., Vongpromek R., Kotanan N., Wongnak P., Garcia JA., Pearson RD., Ariani CV., Chookajorn T., Malangone C., Nguyen T., Stalker J., Jeffery B., Keatley J., Johnson KJ., Muddyman D., Chan XHS., Sillitoe J., Amato R., Simpson V., Gonçalves S., Rockett K., Day NP., Dondorp AM., Kwiatkowski DP., Miotto O.
ABSTRACTNational 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. Samples are processed by high-throughput technologies to genotype several drug resistance markers, species markers and a genomic barcode, delivering reports of genotypes and phenotype predictions, used to map prevalence of resistance to multiple drugs. GenRe-Mekong has worked with NMCPs and research projects in eight countries, processing 9,623 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. GenRe-Mekong facilitates data sharing by aggregating results from different countries, enabling cross-border resistance monitoring.Impact StatementLarge-scale genetic surveillance of malaria implemented by National Malaria Control Programmes informs public health decision makers about the spread of strains resistant to antimalarials.FundingBill & Melinda Gates Foundation, Wellcome Trust, UK Medical Research Council, UK Department for International Development, NIAID