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. 2013 Apr 4;8(4):e60780.
doi: 10.1371/journal.pone.0060780. Print 2013.

Genetic surveillance detects both clonal and epidemic transmission of malaria following enhanced intervention in Senegal

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Genetic surveillance detects both clonal and epidemic transmission of malaria following enhanced intervention in Senegal

Rachel Daniels et al. PLoS One. .

Abstract

Using parasite genotyping tools, we screened patients with mild uncomplicated malaria seeking treatment at a clinic in Thiès, Senegal, from 2006 to 2011. We identified a growing frequency of infections caused by genetically identical parasite strains, coincident with increased deployment of malaria control interventions and decreased malaria deaths. Parasite genotypes in some cases persisted clonally across dry seasons. The increase in frequency of genetically identical parasite strains corresponded with decrease in the probability of multiple infections. Further, these observations support evidence of both clonal and epidemic population structures. These data provide the first evidence of a temporal correlation between the appearance of identical parasite types and increased malaria control efforts in Africa, which here included distribution of insecticide treated nets (ITNs), use of rapid diagnostic tests (RDTs) for malaria detection, and deployment of artemisinin combination therapy (ACT). Our results imply that genetic surveillance can be used to evaluate the effectiveness of disease control strategies and assist a rational global malaria eradication campaign.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Temporal changes in population characteristics.
A. Decreasing prevalence of unique parasite barcode profiles. For every collection season, the number of samples with unique barcodes (grey) and the number of samples in each shared-barcode cluster (blue) are shown. B. Ratio of shared vs. unique barcode profiles. The proportion of samples residing outside of shared-barcode clusters is shown per year. The error bars show 95% confidence interval of mean (±1.96 SE).
Figure 2
Figure 2. Mixedness over time.
Proportion of mixed infections decreased between 2007 and 2008. The error bars show 95% confidence interval of mean (±1.96 SE).
Figure 3
Figure 3. Clonal transmission of parasites across transmission seasons.
Size and distribution of same parasite types across collection years.

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