Genetic surveillance for monitoring the impact of drug use on Plasmodium falciparum populations. (December 2021)

• Record Type: Journal Article
• Authors: Ndiaye, Yaye Die; Hartl, Daniel L.; McGregor, David; Badiane, Aida; Fall, Fatou Ba; Daniels, Rachel F.; Wirth, Dyann F.; Ndiaye, Daouda; Volkman, Sarah K.
• Is Part Of: International journal for parasitology. Volume 17(2021)
• Page Start: 12
• Page End: 22
• Publication Date: 2021-12
• Subjects: Mass drug administration (MDA) -- Seasonal malaria chemoprevention (SMC) -- Therapeutic efficacy study (TES) -- Population genetics -- Selective sweep -- Genetic surveillance; Parasitic diseases -- Chemotherapy -- Periodicals; Drug resistance -- Periodicals; 616.96061
• DOI: 10.1016/j.ijpddr.2021.07.004
• Languages: English
• ISSNs: 2211-3207

Abstract

Abstract: The use of antimalarial drugs is an effective strategy in the fight against malaria. However, selection of drug resistant parasites is a constant threat to the continued use of this approach. Antimalarial drugs are used not only to treat infections but also as part of population-level strategies to reduce malaria transmission toward elimination. While there is strong evidence that the ongoing use of antimalarial drugs increases the risk of the emergence and spread of drug-resistant parasites, it is less clear how population-level use of drug-based interventions like seasonal malaria chemoprevention (SMC) or mass drug administration (MDA) may contribute to drug resistance or loss of drug efficacy. Critical to sustained use of drug-based strategies for reducing the burden of malaria is the surveillance of population-level signals related to transmission reduction and resistance selection. Here we focus on Plasmodium falciparum and discuss the genetic signatures of a parasite population that are correlated with changes in transmission and related to drug pressure and resistance as a result of drug use. We review the evidence for MDA and SMC contributing to malaria burden reduction and drug resistance selection and examine the use and impact of these interventions in Senegal. Throughout we consider best strategies for ongoing surveillance of both population and resistance signals in the context of different parasite population parameters. Finally, we propose a roadmap for ongoing surveillance during population-level drug-based interventions to reduce the global malaria burden. Graphical abstract: Image 1 Highlights: Effective antimalarial drug use decreases Plasmodium falciparum genetic diversity. Population-level use of drug-based interventions can contribute to drug resistance. Calibrate drug surveillance for transmission reduction and resistance selection. Monitor use of seasonal malaria chemoprevention and mass drug administration.