Abstract

Panama and all nations within the Mesoamerican region have committed to eliminate malaria within this decade. With more than 90% of the malaria cases in this region caused by Plasmodium vivax, an efficient national/regional elimination plan must include a comprehensive study of this parasite’s genetic diversity. Here, we retrospectively analyzed P. vivax genetic diversity in autochthonous and imported field isolates collected in different endemic regions in Panama from 2007 to 2020, using highly polymorphic markers (csp, msp-1, and msp-3α). We did the analysis using molecular techniques that are cost-effective for malaria molecular surveillance within Mesoamerica. Thus, we used molecular analyses that are feasible for malaria molecular surveillance within the region, and that can provide useful information for policy and decision making about malaria elimination. We also evaluated if haplotypes established by combining the genotypes found in these genes were associated with relevant epidemiological variables and showed structure across the transmission foci that have been observed in Panama. Ten different haplotypes were identified, some of them strongly associated with geographical origin, age, and collection year. Phylogenetic analysis of csp (central repeat domain) revealed that both major variant types (vk210 and vk247) were circulating in Panama. Variant vk247 was restricted to the eastern endemic regions, while vk210 was predominant (77.3%) and widespread, displaying higher diversity (14 alleles) and geographically biased alleles. The regional implications of these molecular findings for the control of P. vivax malaria to achieve elimination across Mesoamerica are discussed.

Highlights

  • Given the relatively low number of malaria cases and deaths, and its strategic geographical position as a corridor connecting South and North America (Figure 1); Mesoamerica has been recently targeted by the World Health Organization (WHO) as a tactical subregion with malaria elimination potential in the short term [1,2]

  • From the nine countries comprising Mesoamerica (Figure 1), El Salvador was the first country in Central America to be recently certified malaria-free by WHO, and three other countries (Mexico, Belize, and Costa Rica) were identified with the potential to achieve zero indigenous cases of malaria by 2021 [4,5]

  • We evaluated if haplotypes established by combining the genotypes found in these genes were associated with demographic, epidemiological, and geographical parameters relevant to malaria infection

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Summary

Introduction

Given the relatively low number of malaria cases and deaths, and its strategic geographical position as a corridor connecting South and North America (Figure 1); Mesoamerica has been recently targeted by the World Health Organization (WHO) as a tactical subregion with malaria elimination potential in the short term [1,2]. From the nine countries comprising Mesoamerica (southeastern Mexico and the countries of Central America, including Panama) (Figure 1), El Salvador was the first country in Central America to be recently certified malaria-free by WHO, and three other countries (Mexico, Belize, and Costa Rica) were identified with the potential to achieve zero indigenous cases of malaria by 2021 [4,5]. Despite the Pathogens 2021, 10, 989 ure 1), El Salvador was the first country in Central America to be recently certified ma- 2 of 18 laria-free by WHO, and three other countries (Mexico, Belize, and Costa Rica) were identified with the potential to achieve zero indigenous cases of malaria by 2021 [4,5].

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