title: Alterations in Plasmodium falciparum genetic structure two years after increased malaria control efforts in western Kenya.
abstract: The impact of malaria intervention measures (insecticide-treated net use and artemisinin combination therapy) on malaria genetics was investigated at two sites in western Kenya: an endemic lowland and an epidemic highland. The genetic structure of the parasite population was assessed by using microsatellites, and the prevalence of drug-resistant mutations was examined by using the polymerase chain reaction-restriction fragment length polymorphism method. Two years after intervention, genetic diversity remained high in both populations. A significant decrease in the prevalence of quintuple mutations conferring resistance to sulfadoxine-pyrimethamine was detected in both populations, but the mutation prevalence at codon 1246 of the Plasmodium falciparum multidrug resistance 1 gene had increased in the highland population. The decrease in sulfadoxine-pyrimethamine-resistant mutants is encouraging, but the increase in P. falciparum multidrug resistance 1 gene mutations is worrisome because these mutations are linked to resistance to other antimalarial drugs. In addition, the high level of genetic diversity observed after intervention suggests transmission is still high in each population.
authors.affiliation: Program in Public Health, College of Health Sciences, University of California Irvine, Irvine, California, USA. amv12@psu.edu
authors.forename: Anne M
authors.initials: AM
authors.lastname: Vardo-Zalik
authors.forename: Guofa
authors.initials: G
authors.lastname: Zhou
authors.forename: Daibin
authors.initials: D
authors.lastname: Zhong
authors.forename: Yaw A
authors.initials: YA
authors.lastname: Afrane
authors.forename: Andrew K
authors.initials: AK
authors.lastname: Githeko
authors.forename: Guiyun
authors.initials: G
authors.lastname: Yan
mesh_terms: D000962:Antimalarials / Q000627:therapeutic use; D004351:Drug Resistance / Q000235:genetics; D006801:Humans; D007630:Kenya; D015810:Linkage Disequilibrium; D016778:Malaria, Falciparum / Q000188:drug therapy / Q000453:epidemiology*; D009154:Mutation; D010963:Plasmodium falciparum / Q000235:genetics*
chemical_list: D000962:Antimalarials