Abstract

BackgroundInsecticide-treated bed nets (ITNs) reduce malaria transmission and are an important prevention tool. However, there are still information gaps on how the reduction in malaria transmission by ITNs affects parasite genetics population structure. This study examined the relationship between transmission reduction from ITN use and the population genetic diversity of Plasmodium falciparum in an area of high ITN coverage in western Kenya.MethodsParasite genetic diversity was assessed by scoring eight single copy neutral multilocus microsatellite (MS) markers in samples collected from P. falciparum-infected children (< five years) before introduction of ITNs (1996, baseline, n = 69) and five years after intervention (2001, follow-up, n = 74).ResultsThere were no significant changes in overall high mixed infections and unbiased expected heterozygosity between baseline (%MA = 94% and He = 0.75) and follow up (%MA = 95% and He = 0.79) years. However, locus specific analysis detected significant differences for some individual loci between the two time points. Pfg377 loci, a gametocyte-specific MS marker showed significant increase in mixed infections and He in the follow up survey (%MA = 53% and He = 0.57) compared to the baseline (%MA = 30% and He = 0.29). An opposite trend was observed in the erythrocyte binding protein (EBP) MS marker. There was moderate genetic differentiation at the Pfg377 and TAA60 loci (FST = 0.117 and 0.137 respectively) between the baseline and post-ITN parasite populations. Further analysis revealed linkage disequilibrium (LD) of the microsatellites in the baseline (14 significant pair-wise tests and ISA = 0.016) that was broken in the follow up parasite population (6 significant pairs and ISA = 0.0003). The locus specific change in He, the moderate population differentiation and break in LD between the baseline and follow up years suggest an underlying change in population sub-structure despite the stability in the overall genetic diversity and multiple infection levels.ConclusionsThe results from this study suggest that although P. falciparum population maintained an overall stability in genetic diversity after five years of high ITN coverage, there was significant locus specific change associated with gametocytes, marking these for further investigation.

Highlights

  • Insecticide-treated bed nets (ITNs) reduce malaria transmission and are an important prevention tool

  • More than 90% of samples from both baseline and post-ITN surveys had at least two or more alleles detected by any of the microsatellites targets

  • The results from this study are consistent with those of an earlier study conducted in areas with entomological inoculation rate (EIR) ranging from 0.4 to 31.8 in western Kenya, which recorded over 80% mixed infections in both low and high malaria transmission areas [44]

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Summary

Introduction

Insecticide-treated bed nets (ITNs) reduce malaria transmission and are an important prevention tool. Insecticide-treated bed nets (ITNs) have emerged as an efficacious and cost-effective malaria prevention tool. Several previous trials conducted in areas of different malaria transmission patterns have demonstrated that ITNs reduce Plasmodium falciparum malaria transmission by 70-90%. Most importantly, these trials have provided substantial evidence that use of ITNs significantly reduces all-cause mortality and malaria morbidity in children less than five years of age [2]. The World Health Organization (WHO) reported that in countries where ITNs have been effectively scaled up, substantial reductions in malaria cases and deaths have occurred [1]

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