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      On the road to eliminate malaria in Sri Lanka: lessons from history, challenges, gaps in knowledge and research needs

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          Abstract

          Malaria is one of the most important tropical diseases that has caused devastation throughout the history of mankind. Malaria eradication programmes in the past have had many positive effects but failed to wipe out malaria from most tropical countries, including Sri Lanka. Encouraged by the impressive levels of reduction in malaria case numbers during the past decade, Sri Lanka has launched a programme to eliminate malaria by year 2014. This article reviews the historical milestones associated with the malaria eradication programme that failed subsequently and the events that led to the launch of the ongoing malaria elimination plans at national-level and its strategies that are operational across the entire country. The existing gaps in knowledge are also discussed together with the priority areas for research to fill in these gaps that are posing as challenges to the envisaged goal of wiping out malaria from this island nation.

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          Microsatellite markers reveal a spectrum of population structures in the malaria parasite Plasmodium falciparum.

          T. J. Anderson, B Haubold, J T Williams … (2000)
          Multilocus genotyping of microbial pathogens has revealed a range of population structures, with some bacteria showing extensive recombination and others showing almost complete clonality. The population structure of the protozoan parasite Plasmodium falciparum has been harder to evaluate, since most studies have used a limited number of antigen-encoding loci that are known to be under strong selection. We describe length variation at 12 microsatellite loci in 465 infections collected from 9 locations worldwide. These data reveal dramatic differences in parasite population structure in different locations. Strong linkage disequilibrium (LD) was observed in six of nine populations. Significant LD occurred in all locations with prevalence <1% and in only two of five of the populations from regions with higher transmission intensities. Where present, LD results largely from the presence of identical multilocus genotypes within populations, suggesting high levels of self-fertilization in populations with low levels of transmission. We also observed dramatic variation in diversity and geographical differentiation in different regions. Mean heterozygosities in South American countries (0.3-0.4) were less than half those observed in African locations (0. 76-0.8), with intermediate heterozygosities in the Southeast Asia/Pacific samples (0.51-0.65). Furthermore, variation was distributed among locations in South America (F:(ST) = 0.364) and within locations in Africa (F:(ST) = 0.007). The intraspecific patterns of diversity and genetic differentiation observed in P. falciparum are strikingly similar to those seen in interspecific comparisons of plants and animals with differing levels of outcrossing, suggesting that similar processes may be involved. The differences observed may also reflect the recent colonization of non-African populations from an African source, and the relative influences of epidemiology and population history are difficult to disentangle. These data reveal a range of population structures within a single pathogen species and suggest intimate links between patterns of epidemiology and genetic structure in this organism.
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            Serology: a robust indicator of malaria transmission intensity?

            Patrick Corran, Paul A. Coleman, Eleanor M. Riley … (2007)
            To estimate the burden of malarial disease, and evaluate the likely effects of control strategies, requires reliable predictions of malaria transmission intensity. It has long been suggested that antimalarial antibody prevalences could provide a more accurate estimate of transmission intensity than traditional measures such as parasite prevalence or entomological inoculation rates, but there has been no systematic evaluation of this approach. Now, the availability of well characterized malarial antigens allows us to test whether serological measurements provide a practical method for estimating transmission. Here we present a suggested methodology, highlight the advantages and shortcomings of serological measurements of malaria transmission and identify areas in which further work is desirable.
            Article 0 comments Cited 181 times – based on 0 reviews     Review now
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              A general SNP-based molecular barcode for Plasmodium falciparum identification and tracking

              Caroline Daniels, Sarah K Volkman, Danny A. Milner … (2008)
              Background Single nucleotide polymorphism (SNP) genotyping provides the means to develop a practical, rapid, inexpensive assay that will uniquely identify any Plasmodium falciparum parasite using a small amount of DNA. Such an assay could be used to distinguish recrudescence from re-infection in drug trials, to monitor the frequency and distribution of specific parasites in a patient population undergoing drug treatment or vaccine challenge, or for tracking samples and determining purity of isolates in the laboratory during culture adaptation and sub-cloning, as well as routine passage. Methods A panel of twenty-four SNP markers has been identified that exhibit a high minor allele frequency (average MAF > 35%), for which robust TaqMan genotyping assays were constructed. All SNPs were identified through whole genome sequencing and MAF was estimated through Affymetrix array-based genotyping of a worldwide collection of parasites. These assays create a "molecular barcode" to uniquely identify a parasite genome. Results Using 24 such markers no two parasites known to be of independent origin have yet been found to have the same allele signature. The TaqMan genotyping assays can be performed on a variety of samples including cultured parasites, frozen whole blood, or whole blood spotted onto filter paper with a success rate > 99%. Less than 5 ng of parasite DNA is needed to complete a panel of 24 markers. The ability of this SNP panel to detect and identify parasites was compared to the standard molecular methods, MSP-1 and MSP-2 typing. Conclusion This work provides a facile field-deployable genotyping tool that can be used without special skills with standard lab equipment, and at reasonable cost that will unambiguously identify and track P. falciparum parasites both from patient samples and in the laboratory.
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                Author and article information

                Contributors
                Nadira D Karunaweera
                Gawrie NL Galappaththy
                Dyann F Wirth
                Journal
                Journal ID (nlm-ta): Malar J
                Journal ID (iso-abbrev): Malar. J
                Title: Malaria Journal
                Publisher: BioMed Central
                ISSN (Electronic): 1475-2875
                Publication date Collection: 2014
                Publication date (Electronic): 18 February 2014
                Volume: 13
                Page: 59
                Affiliations
                [1 ]Department of Parasitology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
                [2 ]Antimalaria Campaign, Ministry of Health, Colombo, Sri Lanka
                [3 ]Department of Immunology and Infectious Diseases, School of Public Health, Harvard University, Boston, USA
                Article
                Publisher ID: 1475-2875-13-59
                DOI: 10.1186/1475-2875-13-59
                PMC ID: 3943480
                PubMed ID: 24548783
                SO-VID: 824adce9-c912-4543-9f39-12b5d099d3bd
                Copyright © Copyright © 2014 Karunaweera et al.; licensee BioMed Central Ltd.
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                Date received : 31 October 2013
                Date accepted : 14 February 2014
                Categories
                Subject: Review

                ScienceOpen disciplines: Infectious disease & Microbiology
                Keywords: plasmodium,p. vivax,p. falciparum,anopheles,eradication,control,tropical disease,vector-borne,mosquito,asia
                Data availability:
                ScienceOpen disciplines: Infectious disease & Microbiology
                Keywords: plasmodium, p. vivax, p. falciparum, anopheles, eradication, control, tropical disease, vector-borne, mosquito, asia

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