Abstract
The countries of Central America and the island of Hispaniola have set the goal of eliminating malaria in less than a decade. Although efforts to reduce the malaria burden in the region have been successful, there has been an alarming increase in cases in the Nicaraguan Moskitia since 2014. The continuous decrease in cases between 2000 and 2014, followed by a rapid expansion from 2015 to the present, has generated a potential bottleneck effect in the populations of Plasmodium spp. Consequently, this study aimed to evaluate the genetic diversity of P. falciparum and the decrease in allelic richness in this population. The polymorphic regions of the pfmsp-1 and pfmsp-2 genes of patients with falciparum malaria from Honduras and Nicaragua were analyzed using nested PCR and sequencing. Most of the samples were classified into the K1 allelic subfamily of the pfmsp-1 gene and into the 3D7 subfamily of the pfmsp-2 gene. Despite the low genetic diversity found, more than half of the samples presented a polyclonal K1/RO33 haplotype. No sequence polymorphisms were found within each allelic subfamily. This study describes a notable decrease in the genetic diversity of P. falciparum in the Moskitia region after a bottleneck phenomenon. These results will be useful for future epidemiological investigations and the monitoring of malaria transmission in Central America.
Highlights
The incidence of malaria in the Americas has decreased by 53% in the last decade, reaching 0.9 million cases in 2019 [1]
A total of 160 blood samples were collected between 2018 and 2021 with a microscopic diagnosis of P. falciparum malaria confirmed by PCR
Regarding the pfmsp-2 gene, our results reveal a clear predominance of the 3D7 subfamily (92.7%) over FC27 (7.3%)
Summary
The incidence of malaria in the Americas has decreased by 53% in the last decade, reaching 0.9 million cases in 2019 [1]. Progress in malaria elimination is not homogeneous for all countries. In this regard, 86% of malaria cases on the continent are reported by three countries: Brazil, Colombia and Venezuela, and the latter country reported almost half a million cases in 2019, representing a 13-fold increase since 2000 [1]. The Central American isthmus is responsible for only 2.4% of cases in the Americas, there are notable differences in the epidemiology of malaria among the seven Central American countries. Belize and El Salvador have reported zero cases of malaria during the last years [1]
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