Making data map-worthy—enhancing routine malaria data to support surveillance and mapping of Plasmodium falciparum anti-malarial resistance in a pre-elimination sub-Saharan African setting: a molecular and spatiotemporal epidemiology study
Issued Date
2022-12-01
Resource Type
eISSN
14752875
Scopus ID
2-s2.0-85133142549
Pubmed ID
35768869
Journal Title
Malaria Journal
Volume
21
Issue
1
Rights Holder(s)
SCOPUS
Bibliographic Citation
Malaria Journal Vol.21 No.1 (2022)
Suggested Citation
Kagoro F.M., Allen E., Mabuza A., Workman L., Magagula R., Kok G., Davies C., Malatje G., Guérin P.J., Dhorda M., Maude R.J., Raman J., Barnes K.I. Making data map-worthy—enhancing routine malaria data to support surveillance and mapping of Plasmodium falciparum anti-malarial resistance in a pre-elimination sub-Saharan African setting: a molecular and spatiotemporal epidemiology study. Malaria Journal Vol.21 No.1 (2022). doi:10.1186/s12936-022-04224-4 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/85288
Title
Making data map-worthy—enhancing routine malaria data to support surveillance and mapping of Plasmodium falciparum anti-malarial resistance in a pre-elimination sub-Saharan African setting: a molecular and spatiotemporal epidemiology study
Author's Affiliation
WorldWide Antimalarial Resistance Network
Faculty of Health Sciences
Faculty of Tropical Medicine, Mahidol University
Clinton Health Access Initiative, Inc.
University of the Witwatersrand Faculty of Health Sciences
Harvard T.H. Chan School of Public Health
The Open University
Nuffield Department of Medicine
University of Cape Town
Mpumalanga Provincial Malaria Elimination Programme
National Institute for Communicable Disease
Faculty of Health Sciences
Faculty of Tropical Medicine, Mahidol University
Clinton Health Access Initiative, Inc.
University of the Witwatersrand Faculty of Health Sciences
Harvard T.H. Chan School of Public Health
The Open University
Nuffield Department of Medicine
University of Cape Town
Mpumalanga Provincial Malaria Elimination Programme
National Institute for Communicable Disease
Other Contributor(s)
Abstract
Background: Independent emergence and spread of artemisinin-resistant Plasmodium falciparum malaria have recently been confirmed in Africa, with molecular markers associated with artemisinin resistance increasingly detected. Surveillance to promptly detect and effectively respond to anti-malarial resistance is generally suboptimal in Africa, especially in low transmission settings where therapeutic efficacy studies are often not feasible due to recruitment challenges. However, these communities may be at higher risk of anti-malarial resistance. Methods: From March 2018 to February 2020, a sequential mixed-methods study was conducted to evaluate the feasibility of the near-real-time linkage of individual patient anti-malarial resistance profiles with their case notifications and treatment response reports, and map these to fine scales in Nkomazi sub-district, Mpumalanga, a pre-elimination area in South Africa. Results: Plasmodium falciparum molecular marker resistance profiles were linked to 55.1% (2636/4787) of notified malaria cases, 85% (2240/2636) of which were mapped to healthcare facility, ward and locality levels. Over time, linkage of individual malaria case demographic and molecular data increased to 75.1%. No artemisinin resistant validated/associated Kelch-13 mutations were detected in the 2385 PCR positive samples. Almost all 2812 samples assessed for lumefantrine susceptibility carried the wildtype mdr86ASN and crt76LYS alleles, potentially associated with decreased lumefantrine susceptibility. Conclusion: Routine near-real-time mapping of molecular markers associated with anti-malarial drug resistance on a fine spatial scale provides a rapid and efficient early warning system for emerging resistance. The lessons learnt here could inform scale-up to provincial, national and regional malaria elimination programmes, and may be relevant for other antimicrobial resistance surveillance.