ArticleCommunications biology2023
Targeted and whole-genome sequencing reveal a north-south divide in P. falciparum drug resistance markers and genetic structure in Mozambique.
Article in Communications biology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 of them syntheses that pooled it.
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Who cites it
17 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Efficacy of artemether-lumefantrine for uncomplicated plasmodium falciparum malaria treatment in mozambique: a systematic review and meta-analysis.Malaria journal · 2026Pooled it
- Mapping Antimalarial Drug Resistance in Mozambique: A Systematic Review ofInternational journal of molecular sciences · 2024Pooled it
- Trial
- Global-scale population genetic analysis of Plasmodium falciparum identifies region-specific patterns of malaria parasite adaptation.Nature communications · 2026Article
- Prevalence ofPathogens (Basel, Switzerland) · 2026Article
- Antimalarial drug resistance and population structure of Plasmodium falciparum in Mozambique using genomic surveillance at health facilities in 2021 and 2022.Scientific reports · 2025Article
- A NovelmedRxiv : the preprint server for health sciences · 2025Article
- Impact of dhps mutations on sulfadoxine-pyrimethamine protective efficacy and implications for malaria chemoprevention.Nature communications · 2025Article
- Sensitive and modular amplicon sequencing ofbioRxiv : the preprint server for biology · 2025Article
- Highly multiplexed molecular inversion probe panel inFrontiers in genetics · 2025Article
- Geo-classification of drug-resistant travel-associatedAntimicrobial agents and chemotherapy · 2024Article
- Observational
- Molecular tools are crucial for malaria elimination.Molecular biology reports · 2024Review
- Genomic malaria surveillance of antenatal care users detects reduced transmission following elimination interventions in Mozambique.Nature communications · 2024Article
- Analysis of Mutations inInfection and drug resistance · 2024Article
- Genomic malaria surveillance of antenatal care users detects reduced transmission following elimination interventions in Mozambique.Research square · 2023Article
- Sampling for malaria molecular surveillance.Trends in parasitology · 2023Review
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Authors and funding
29 authors.
Funding
Abstract
Mozambique is one of the four African countries which account for over half of all malaria deaths worldwide, yet little is known about the parasite genetic structure in that country. We performed P. falciparum amplicon and whole genome sequencing on 2251 malaria-infected blood samples collected in 2015 and 2018 in seven provinces of Mozambique to genotype antimalarial resistance markers and interrogate parasite population structure using genome-wide microhaplotyes. Here we show that the only resistance-associated markers observed at frequencies above 5% were pfmdr1-184F (59%), pfdhfr-51I/59 R/108 N (99%) and pfdhps-437G/540E (89%). The frequency of pfdhfr/pfdhps quintuple mutants associated with sulfadoxine-pyrimethamine resistance increased from 80% in 2015 to 89% in 2018 (p < 0.001), with a lower expected heterozygosity and higher relatedness of microhaplotypes surrounding pfdhps mutants than wild-type parasites suggestive of recent selection. pfdhfr/pfdhps quintuple mutants also increased from 72% in the north to 95% in the south (2018; p < 0.001). This resistance gradient was accompanied by a concentration of mutations at pfdhps-436 (17%) in the north, a south-to-north increase in the genetic complexity of P. falciparum infections (p = 0.001) and a microhaplotype signature of regional differentiation. The parasite population structure identified here offers insights to guide antimalarial interventions and epidemiological surveys.
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