Partner Study Description

As countries decrease malaria transmission and come closer to elimination, transmission becomes more fragmented and focal, and human population movement becomes an important factor in the spread of infection. Proper targeting of interventions to these focal areas of transmission therefore requires an understanding of the scales and patterns of the malaria parasite. Since 2015, the Manhiça Health Research Center (CISM) in Mozambique, in collaboration with the Barcelona Institute of Global Health (ISGlobal) in Spain, has been conducting a malaria elimination pilot program in the district of Magude (Southern Mozambique) which involved four rounds of mass drug administration (MDA) with DHAp in the 2015-16 and 2016-17 transmission seasons, followed by reactive case detection consisting of following up all passively-detected cases and administering focal MDA at the level of their household.

The ancillary project presented here proposes to evaluate the ability of parasite genetic data to inform malaria epidemiology in the path towards elimination. Dried blood samples collected from the community and febrile cases attending health clinics in Southern Mozambique will be used for genetic characterisation. The study also includes parasite samples collected from pregnant women at antenatal clinics, given their potential as surrogate of the parasite population in the community. Parasite samples collected from sentinel sites in the country will be included to identify genetic markers that can inform about geographic origin, with the aim of identifying imported cases in malaria elimination settings. Findings of this study will inform the GenMoz project (P. falciparum genomic intelligence in Mozambique; https://www.isglobal.org/en/-/genmoz), which aims to build malaria genomic capacities in Mozambique in order to increase the actionable intelligence for making programmatic decisions on the optimal mix of control and elimination measures in Mozambique.

Publications

• Targeted and whole-genome sequencing reveal a north-south divide in P. falciparum drug resistance markers and genetic structure in Mozambique
  da Silva et al
  Nature Communications Biology, 2023; 6 619
  10.1038/s42003-023-04997-7