Abstract
Imported malaria threatens control and elimination efforts in countries that have low rates of transmission. In 2010, an outbreak of Plasmodium falciparum malaria was reported among United Nations peacekeeping soldiers from Guatemala who had recently returned from the Democratic Republic of the Congo (DRC). Epidemiologic evidence suggested that the soldiers were infected in the DRC, but local transmission could not be ruled out in all cases. We used population genetic analyses of neutral microsatellites to determine the outbreak source. Genetic relatedness was compared among parasites found in samples from the soldiers and parasite populations collected in the DRC and Guatemala; parasites identified in the soldiers were more closely related to those from the DRC. A phylogenetic clustering analysis confirms this identification with >99.9% confidence. Thus, results support the hypothesis that the soldiers likely imported malaria from the DRC. This study demonstrates the utility of molecular genotyping in outbreak investigations.
Highlights
Imported malaria threatens control and elimination efforts in countries that report low malaria transmission rates [1,2,3]
In 2010, an outbreak of malaria was reported among 12 soldiers from Guatemala shortly after they returned from a United Nations (UN) peacekeeping mission in the Democratic Republic of the Congo (DRC)
This study, which was based on the use of population genetic analyses of microsatellite data, supports previous epidemiologic findings that an outbreak of P. falciparum malaria in soldiers from Guatemala, who returned after their peacekeeping mission in the DRC in 2010, was caused by an imported parasite population from the DRC [9]
Summary
Imported malaria threatens control and elimination efforts in countries that report low malaria transmission rates [1,2,3]. If the soldiers acquired P. falciparum in the DRC during their stay, the genotypes of the parasites isolated from the soldiers’ samples would be more closely related to parasites from the DRC than to parasites from Guatemala. To test this hypothesis, we used molecular methods from the field of population genetics to determine the source of the malaria outbreak among the soldiers who returned to Guatemala after being stationed in the DRC
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