Genomic epidemiology of artemisinin resistant malaria
Journal Title
Elife
Publication Type
Journal Article
Abstract
The current epidemic of artemisinin resistant Plasmodium falciparum in Southeast Asia is the result of a soft selective sweep involving at least 20 independent kelch13 mutations. In a large global survey, we find that kelchl3 mutations which cause resistance in Southeast Asia are present at low frequency in Africa. We show that African kelch13 mutations have originated locally, and that kelch13 shows a normal variation pattern relative to other genes in Africa, whereas in Southeast Asia there is a great excess of non-synonymous mutations, many of which cause radical amino-acid changes. Thus, kelch13 is not currently undergoing strong selection in Africa, despite a deep reservoir of variations that could potentially allow resistance to emerge rapidly. The practical implications are that public health surveillance for artemisinin resistance should not rely on kelchl3 data alone, and interventions to prevent resistance must account for local evolutionary conditions, shown by genomic epidemiology to differ greatly between geographical regions.
Publisher
elife Sciences
Research Division(s)
Population Health And Immunity
Open Access at Publisher's Site
https://elifesciences.org/content/5/e08714
Terms of Use/Rights Notice
Refer to copyright notice on published article.


Creation Date: 2016-06-15 08:51:07
Last Modified: 2016-06-15 08:57:41
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