Making data map-worthy—enhancing routine malaria data to support surveillance and mapping of Plasmodium falciparum anti-malarial resistance in a pre-elimination sub-Saharan African setting: a molecular and spatiotemporal epidemiology study

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dc.contributor.authorKagoro, Frank M.
dc.contributor.authorAllen, Elizabeth
dc.contributor.authorMabuza, Aaron
dc.contributor.authorWorkman, Lesley
dc.contributor.authorMagagula, Ray
dc.contributor.authorKok, Gerdalize
dc.contributor.authorDavies, Craig
dc.contributor.authorMalatje, Gillian
dc.contributor.authorGuérin, Philippe J
dc.contributor.authorDhorda, Mehul
dc.contributor.authorMaude, Richard J
dc.contributor.authorRaman, Jaishree
dc.contributor.authorBarnes, Karen I
dc.date.accessioned2022-07-08T06:45:32Z
dc.date.available2022-07-08T06:45:32Z
dc.date.issued2022-06-29
dc.date.updated2022-07-03T03:11:15Z
dc.description.abstractBackground Independent emergence and spread of artemisinin-resistant Plasmodium falciparum malaria have recently been confirmed in Africa, with molecular markers associated with artemisinin resistance increasingly detected. Surveillance to promptly detect and effectively respond to anti-malarial resistance is generally suboptimal in Africa, especially in low transmission settings where therapeutic efficacy studies are often not feasible due to recruitment challenges. However, these communities may be at higher risk of anti-malarial resistance. Methods From March 2018 to February 2020, a sequential mixed-methods study was conducted to evaluate the feasibility of the near-real-time linkage of individual patient anti-malarial resistance profiles with their case notifications and treatment response reports, and map these to fine scales in Nkomazi sub-district, Mpumalanga, a pre-elimination area in South Africa. Results Plasmodium falciparum molecular marker resistance profiles were linked to 55.1% (2636/4787) of notified malaria cases, 85% (2240/2636) of which were mapped to healthcare facility, ward and locality levels. Over time, linkage of individual malaria case demographic and molecular data increased to 75.1%. No artemisinin resistant validated/associated  Kelch-13 mutations were detected in the 2385 PCR positive samples. Almost all 2812 samples assessed for lumefantrine susceptibility carried the wildtype mdr86ASN and crt76LYS alleles, potentially associated with decreased lumefantrine susceptibility. Conclusion Routine near-real-time mapping of molecular markers associated with anti-malarial drug resistance on a fine spatial scale provides a rapid and efficient early warning system for emerging resistance. The lessons learnt here could inform scale-up to provincial, national and regional malaria elimination programmes, and may be relevant for other antimicrobial resistance surveillance.en_US
dc.identifier.apacitationKagoro, Frank M., Allen, E., Mabuza, A., Workman, L., Magagula, R., Kok, G., ... Barnes, K. I. (2022). Making data map-worthy—enhancing routine malaria data to support surveillance and mapping of Plasmodium falciparum anti-malarial resistance in a pre-elimination sub-Saharan African setting: a molecular and spatiotemporal epidemiology study. <i>Malaria Journal</i>, 21(1), 207. http://hdl.handle.net/11427/36629en_ZA
dc.identifier.chicagocitationKagoro, Frank M., Elizabeth Allen, Aaron Mabuza, Lesley Workman, Ray Magagula, Gerdalize Kok, Craig Davies, et al "Making data map-worthy—enhancing routine malaria data to support surveillance and mapping of Plasmodium falciparum anti-malarial resistance in a pre-elimination sub-Saharan African setting: a molecular and spatiotemporal epidemiology study." <i>Malaria Journal</i> 21, 1. (2022): 207. http://hdl.handle.net/11427/36629en_ZA
dc.identifier.citationKagoro, Frank M., Allen, E., Mabuza, A., Workman, L., Magagula, R., Kok, G., Davies, C. & Malatje, G. et al. 2022. Making data map-worthy—enhancing routine malaria data to support surveillance and mapping of Plasmodium falciparum anti-malarial resistance in a pre-elimination sub-Saharan African setting: a molecular and spatiotemporal epidemiology study. <i>Malaria Journal.</i> 21(1):207. http://hdl.handle.net/11427/36629en_ZA
dc.identifier.ris TY - Journal Article AU - Kagoro, Frank M. AU - Allen, Elizabeth AU - Mabuza, Aaron AU - Workman, Lesley AU - Magagula, Ray AU - Kok, Gerdalize AU - Davies, Craig AU - Malatje, Gillian AU - Guérin, Philippe J AU - Dhorda, Mehul AU - Maude, Richard J AU - Raman, Jaishree AU - Barnes, Karen I AB - Background Independent emergence and spread of artemisinin-resistant Plasmodium falciparum malaria have recently been confirmed in Africa, with molecular markers associated with artemisinin resistance increasingly detected. Surveillance to promptly detect and effectively respond to anti-malarial resistance is generally suboptimal in Africa, especially in low transmission settings where therapeutic efficacy studies are often not feasible due to recruitment challenges. However, these communities may be at higher risk of anti-malarial resistance. Methods From March 2018 to February 2020, a sequential mixed-methods study was conducted to evaluate the feasibility of the near-real-time linkage of individual patient anti-malarial resistance profiles with their case notifications and treatment response reports, and map these to fine scales in Nkomazi sub-district, Mpumalanga, a pre-elimination area in South Africa. Results Plasmodium falciparum molecular marker resistance profiles were linked to 55.1% (2636/4787) of notified malaria cases, 85% (2240/2636) of which were mapped to healthcare facility, ward and locality levels. Over time, linkage of individual malaria case demographic and molecular data increased to 75.1%. No artemisinin resistant validated/associated  Kelch-13 mutations were detected in the 2385 PCR positive samples. Almost all 2812 samples assessed for lumefantrine susceptibility carried the wildtype mdr86ASN and crt76LYS alleles, potentially associated with decreased lumefantrine susceptibility. Conclusion Routine near-real-time mapping of molecular markers associated with anti-malarial drug resistance on a fine spatial scale provides a rapid and efficient early warning system for emerging resistance. The lessons learnt here could inform scale-up to provincial, national and regional malaria elimination programmes, and may be relevant for other antimicrobial resistance surveillance. DA - 2022-06-29 DB - OpenUCT DP - University of Cape Town IS - 1 J1 - Malaria Journal KW - Artemisinin resistance KW - Kelch 13, k13 KW - Lumefantrine KW - Plasmodium falciparum KW - Africa KW - Spatiotemporal model KW - Malaria LK - https://open.uct.ac.za PY - 2022 T1 - Making data map-worthy—enhancing routine malaria data to support surveillance and mapping of Plasmodium falciparum anti-malarial resistance in a pre-elimination sub-Saharan African setting: a molecular and spatiotemporal epidemiology study TI - Making data map-worthy—enhancing routine malaria data to support surveillance and mapping of Plasmodium falciparum anti-malarial resistance in a pre-elimination sub-Saharan African setting: a molecular and spatiotemporal epidemiology study UR - http://hdl.handle.net/11427/36629 ER - en_ZA
dc.identifier.urihttps://doi.org/10.1186/s12936-022-04224-4
dc.identifier.urihttp://hdl.handle.net/11427/36629
dc.identifier.vancouvercitationKagoro Frank M, Allen E, Mabuza A, Workman L, Magagula R, Kok G, et al. Making data map-worthy—enhancing routine malaria data to support surveillance and mapping of Plasmodium falciparum anti-malarial resistance in a pre-elimination sub-Saharan African setting: a molecular and spatiotemporal epidemiology study. Malaria Journal. 2022;21(1):207. http://hdl.handle.net/11427/36629.en_ZA
dc.language.isoenen_US
dc.language.rfc3066en
dc.publisher.departmentDivision of Clinical Pharmacologyen_US
dc.publisher.facultyFaculty of Health Sciencesen_US
dc.rights.holderThe Author(s)
dc.sourceMalaria Journalen_US
dc.source.journalissue1en_US
dc.source.journalvolume21en_US
dc.source.pagination207en_US
dc.source.urihttps://malariajournal.biomedcentral.com/
dc.subjectArtemisinin resistanceen_US
dc.subjectKelch 13, k13en_US
dc.subjectLumefantrineen_US
dc.subjectPlasmodium falciparumen_US
dc.subjectAfricaen_US
dc.subjectSpatiotemporal modelen_US
dc.subjectMalariaen_US
dc.titleMaking data map-worthy—enhancing routine malaria data to support surveillance and mapping of Plasmodium falciparum anti-malarial resistance in a pre-elimination sub-Saharan African setting: a molecular and spatiotemporal epidemiology studyen_US
dc.typeJournal Articleen_US
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