title: Clonal population expansion in an outbreak of Plasmodium falciparum on the northwest coast of Ecuador.
abstract: BACKGROUND
  Determining the source of malaria outbreaks in Ecuador and identifying remaining transmission foci will help in malaria elimination efforts. In this study, the genetic signatures of Plasmodium falciparum isolates, obtained from an outbreak that occurred in northwest Ecuador from 2012 to 2013, were characterized.
  
  
  METHODS
  Molecular investigation of the outbreak was performed using neutral microsatellites, drug resistance markers and pfhrp2 and pfhrp3 genotyping.
  
  
  RESULTS
  A majority of parasite isolates (31/32) from this outbreak were of a single clonal type that matched a clonal lineage previously described on the northern coast of Peru and a historical isolate from Ecuador. All but one isolate carried a chloroquine-resistant pfcrt genotype and sulfadoxine- and pyrimethamine-sensitive pfdhps and pfdhfr genotypes. Pfmdr1 mutations were identified in codons 184 and 1042. In addition, most samples (97 %) showed presence of pfhrp2 gene.
  
  
  CONCLUSIONS
  This study indicates that parasites from a single clonal lineage largely contributed to this outbreak and this lineage was found to be genetically related to a lineage previously reported in the Peruvian coast and historical Ecuadorian parasites.
authors.affiliation: Centro de Investigación en Enfermedades Infecciosas y Crónicas, Escuela de Ciencias Biológicas, Pontificia Universidad Católica del Ecuador, Ave. 12 de Octubre 1076 y Roca, Quito, Ecuador. fsaenz213@puce.edu.ec.
authors.forename: Fabián E
authors.initials: FE
authors.lastname: Sáenz
authors.affiliation: Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA. lmorton@umaryland.edu.
authors.forename: Lindsay C
authors.initials: LC
authors.lastname: Morton
authors.affiliation: Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA. jyo3@cdc.gov.|Atlanta Research and Education Foundation, Decatur, GA, USA. jyo3@cdc.gov.
authors.forename: Sheila Akinyi
authors.initials: SA
authors.lastname: Okoth
authors.affiliation: Centro de Investigación en Enfermedades Infecciosas y Crónicas, Escuela de Ciencias Biológicas, Pontificia Universidad Católica del Ecuador, Ave. 12 de Octubre 1076 y Roca, Quito, Ecuador. vgabriela_paola@hotmail.com.
authors.forename: Gabriela
authors.initials: G
authors.lastname: Valenzuela
authors.affiliation: Centro de Investigación en Enfermedades Infecciosas y Crónicas, Escuela de Ciencias Biológicas, Pontificia Universidad Católica del Ecuador, Ave. 12 de Octubre 1076 y Roca, Quito, Ecuador. claudia.vera.arias@gmail.com.
authors.forename: Claudia A
authors.initials: CA
authors.lastname: Vera-Arias
authors.affiliation: Centro de Investigación en Enfermedades Infecciosas y Crónicas, Escuela de Ciencias Biológicas, Pontificia Universidad Católica del Ecuador, Ave. 12 de Octubre 1076 y Roca, Quito, Ecuador. ecvelezalvarez@gmail.com.|Universidad de las Fuerzas Armadas, Quito, Ecuador. ecvelezalvarez@gmail.com.
authors.forename: Eileen
authors.initials: E
authors.lastname: Vélez-Álvarez
authors.affiliation: Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA. frd9@cdc.gov.
authors.forename: Naomi W
authors.initials: NW
authors.lastname: Lucchi
authors.affiliation: Ministerio de Salud Pública, Guayaquil, Ecuador. lenriquecastro56@hotmail.com.
authors.forename: L Enrique
authors.initials: LE
authors.lastname: Castro
authors.affiliation: Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA. vxu0@cdc.gov.
authors.forename: Venkatachalam
authors.initials: V
authors.lastname: Udhayakumar