title: Molecular analysis of two local falciparum malaria outbreaks on the French Guiana coast confirms the msp1 B-K1/varD genotype association with severe malaria.
abstract: BACKGROUND
  Plasmodium falciparum outbreaks can occur in the coastal area of French Guiana, where the population is essentially non-immune. Two sporadic outbreaks were observed, including one with severe malaria cases. To characterize these outbreaks and verify previous observations of specific genotype characteristics in severe malaria in this area, all cases from each outbreak were studied.
  
  
  METHODS
  P. falciparum genotypes for six genetic loci were determined by PCR amplification from peripheral blood parasites. The msp1/block2 and msp2 genotypes were determined by DNA sequencing. Microsatellite and varD genotyping was based on size polymorphism and locus-specific amplification.
  
  
  RESULTS
  The outbreak including severe malaria cases was associated with a single genotype. The other mild malaria outbreak was due to at least five distinct genotypes.
  
  
  CONCLUSIONS
  Two distinct types of outbreak occurred despite systematic and sustained deployment of malaria control measures, indicating a need for reinforced vigilance. The varD/B-K1 msp1 linkage and its association with severe malaria in this area was confirmed.
authors.affiliation: Centre National de Référence sur la Chimiorésistance du Paludisme dans la région Antilles-Guyane, Institut Pasteur de la Guyane, BP 6010, F-97306 Cayenne-Cedex, France. elegrand@pasteur-cayenne.fr
authors.forename: Eric
authors.initials: E
authors.lastname: Legrand
authors.forename: Beatrice
authors.initials: B
authors.lastname: Volney
authors.forename: Anne
authors.initials: A
authors.lastname: Lavergne
authors.forename: Caroline
authors.initials: C
authors.lastname: Tournegros
authors.forename: Loïc
authors.initials: L
authors.lastname: Florent
authors.forename: Doris
authors.initials: D
authors.lastname: Accrombessi
authors.forename: Micheline
authors.initials: M
authors.lastname: Guillotte
authors.forename: Odile
authors.initials: O
authors.lastname: Mercereau-Puijalon
authors.forename: Philippe
authors.initials: P
authors.lastname: Esterre
mesh_terms: D000595:Amino Acid Sequence; D000818:Animals; D000953:Antigens, Protozoan / Q000737:chemistry / Q000235:genetics; D004196:Disease Outbreaks; D005616:French Guiana / Q000453:epidemiology; D005838:Genotype; D006801:Humans; D016778:Malaria, Falciparum / Q000453:epidemiology* / Q000469:parasitology*; D020066:Merozoite Surface Protein 1 / Q000737:chemistry / Q000235:genetics*; D008969:Molecular Sequence Data; D010641:Phenotype; D010963:Plasmodium falciparum / Q000235:genetics* / Q000472:pathogenicity*; D015800:Protozoan Proteins / Q000737:chemistry / Q000235:genetics
chemical_list: D000953:Antigens, Protozoan; D020066:Merozoite Surface Protein 1; D015800:Protozoan Proteins; C065974:merozoite surface protein 2, Plasmodium