ArticleThe Journal of infectious diseases2019
High Genetic Diversity of Plasmodium falciparum in the Low-Transmission Setting of the Kingdom of Eswatini.
Article in The Journal of infectious diseases, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 50 papers, 1 of them a synthesis that pooled it.
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50 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Plasmodium falciparum genetic diversity and multiplicity of infection based on msp-1, msp-2, glurp and microsatellite genetic markers in sub-Saharan Africa: a systematic review and meta-analysis.Malaria journal · 2024Pooled it
- Estimating probabilities of malaria importation in southern Mozambique through modellingeLife · 2026Article
- Genetic metrics decodeFrontiers in genetics · 2026Article
- Genetic Diversity ofTropical medicine and infectious disease · 2025Article
- Comprehensive genomic study of Plasmodium falciparum in Sierra leone: genetic variation and resistance patterns.BMC genomics · 2025Article
- Genetic surveillance reveals low but sustained malaria transmission with clonal replacement in Sao Tome and Principe.Communications medicine · 2025Article
- Assessing Microsatellite Variations in Plasmodium falciparum Following a Decade-Long Antimalaria Campaign in Kenya.Molecular ecology · 2025Article
- Genetic diversity and population structure of Plasmodium falciparum across areas of varied malaria transmission intensities in Uganda.Malaria journal · 2025Article
- Assessment of different genotyping markers and algorithms for distinguishing Plasmodium falciparum recrudescence from reinfection in Uganda.Scientific reports · 2025Article
- Detecting imported malaria infections in endemic settings using molecular surveillance: current state and challenges.Frontiers in epidemiology · 2025Review
- Regular Plasmodium falciparum importation onto Bioko Island, Equatorial Guinea, hampers malaria elimination from the island.PLOS global public health · 2025Article
- Temporal changes in Plasmodium falciparum genetic diversity and multiplicity of infection across three areas of varying malaria transmission intensities in Uganda.Tropical medicine and health · 2024Article
- The evolutionary history of Plasmodium falciparum from mitochondrial and apicoplast genomes of China-Myanmar border isolates.Parasites & vectors · 2024Article
- MOIRE: a software package for the estimation of allele frequencies and effective multiplicity of infection from polyallelic data.Bioinformatics (Oxford, England) · 2024Article
- Article
- Genotyping Plasmodium falciparum gametocytes using amplicon deep sequencing.Malaria journal · 2024Article
- Genomics reveals heterogeneous Plasmodium falciparum transmission and selection signals in Zambia.Communications medicine · 2024Article
- Genomic malaria surveillance of antenatal care users detects reduced transmission following elimination interventions in Mozambique.Nature communications · 2024Article
- Genetic complexity alters drug susceptibility of asexual and gametocyte stages ofAntimicrobial agents and chemotherapy · 2024Article
- Strong isolation by distance and evidence of population microstructure reflect ongoingmedRxiv : the preprint server for health sciences · 2024Article
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16 authors.
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Abstract
backgroundTo better understand transmission dynamics, we characterized Plasmodium falciparum genetic diversity in Eswatini, where transmission is low and sustained by importation.
methodsTwenty-six P. falciparum microsatellites were genotyped in 66% of confirmed cases (2014-2016; N = 582). Population and within-host diversity were used to characterize differences between imported and locally acquired infections. Logistic regression was used to assess the added value of diversity metrics to classify imported and local infections beyond epidemiology data alone.
resultsParasite population in Eswatini was highly diverse (expected heterozygosity [HE] = 0.75) and complex: 67% polyclonal infections, mean multiplicity of infection (MOI) 2.2, and mean within-host infection fixation index (FWS) 0.84. Imported cases had comparable diversity to local cases but exhibited higher MOI (2.4 vs 2.0; P = .004) and lower mean FWS (0.82 vs 0.85; P = .03). Addition of MOI and FWS to multivariate analyses did not increase discrimination between imported and local infections.
conclusionsIn contrast to the common perception that P. falciparum diversity declines with decreasing transmission intensity, Eswatini isolates exhibited high parasite diversity consistent with high rates of malaria importation and limited local transmission. Estimates of malaria transmission intensity from genetic data need to consider the effect of importation, especially as countries near elimination.
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