title: Optimal health and disease management using spatial uncertainty: a geographic characterization of emergent artemisinin-resistant Plasmodium falciparum distributions in Southeast Asia.
abstract: Artemisinin-resistant Plasmodium falciparum malaria parasites are now present across much of mainland Southeast Asia, where ongoing surveys are measuring and mapping their spatial distribution. These efforts require substantial resources. Here we propose a generic 'smart surveillance' methodology to identify optimal candidate sites for future sampling and thus map the distribution of artemisinin resistance most efficiently.
  
  
  
  The approach uses the 'uncertainty' map generated iteratively by a geostatistical model to determine optimal locations for subsequent sampling.
  
  
  
  The methodology is illustrated using recent data on the prevalence of the K13-propeller polymorphism (a genetic marker of artemisinin resistance) in the Greater Mekong Subregion.
  
  
  
  This methodology, which has broader application to geostatistical mapping in general, could improve the quality and efficiency of drug resistance mapping and thereby guide practical operations to eliminate malaria in affected areas.
authors: WorldWide Antimalarial Resistance Network (WWARN), Oxford, UK. epmgrist@gmail.com.|Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, OX3 7LJ, UK. epmgrist@gmail.com.
authors: Eric P M
authors: EP
authors: Grist
authors: WorldWide Antimalarial Resistance Network (WWARN), Oxford, UK.|Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, OX3 7LJ, UK.|School of Mathematical Sciences, Monash University, Melbourne, Australia.
authors: Jennifer A
authors: JA
authors: Flegg
authors: WorldWide Antimalarial Resistance Network (WWARN), Oxford, UK.|Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, OX3 7LJ, UK.
authors: Georgina
authors: G
authors: Humphreys
authors: WorldWide Antimalarial Resistance Network (WWARN), Oxford, UK.|Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, OX3 7LJ, UK.
authors: Ignacio Suay
authors: IS
authors: Mas
authors: Department of Genetics, Texas Biomedical Research Institute, San Antonio, TX, USA.
authors: Tim J C
authors: TJ
authors: Anderson
authors: Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, OX3 7LJ, UK.|Mahidol-Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand.
authors: Elizabeth A
authors: EA
authors: Ashley
authors: Mahidol-Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand.
authors: Nicholas P J
authors: NP
authors: Day
authors: WorldWide Antimalarial Resistance Network (WWARN), Oxford, UK.|Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, OX3 7LJ, UK.
authors: Mehul
authors: M
authors: Dhorda
authors: Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, OX3 7LJ, UK.|Mahidol-Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand.
authors: Arjen M
authors: AM
authors: Dondorp
authors: Mahidol-Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand.|Dev Care Foundation and Malaria Research Group, Dhaka, Bangladesh.
authors: M Abul
authors: MA
authors: Faiz
authors: Spatial Epidemiology and Ecology Group, Department of Zoology, University of Oxford, Oxford, UK.
authors: Peter W
authors: PW
authors: Gething
authors: Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, OX3 7LJ, UK.|Hospital for Tropical Disease, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam.
authors: Tran T
authors: TT
authors: Hien
authors: Defence Services Medical Research Centre, Naypyitaw, Myanmar.
authors: Tin M
authors: TM
authors: Hlaing
authors: Department of Molecular Tropical Medicine and Genetics, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
authors: Mallika
authors: M
authors: Imwong
authors: Médecins Sans Frontières, Brussels, Belgium.
authors: Jean-Marie
authors: JM
authors: Kindermans
authors: Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, OX3 7LJ, UK.|Mahidol-Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand.|Harvard TH Chan School of Public Health, Harvard University, Boston, USA.
authors: Richard J
authors: RJ
authors: Maude
authors: Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, OX3 7LJ, UK.|Microbiology Laboratory, Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Mahosot Hospital, Vientiane, Lao People's Democratic Republic.
authors: Mayfong
authors: M
authors: Mayxay
authors: Department of Genetics, Texas Biomedical Research Institute, San Antonio, TX, USA.
authors: Marina
authors: M
authors: McDew-White
authors: Malaria Molecular Epidemiology Unit, Institute Pasteur in Cambodia, Phnom Penh, Cambodia.
authors: Didier
authors: D
authors: Menard
authors: Department of Genetics, Texas Biomedical Research Institute, San Antonio, TX, USA.
authors: Shalini
authors: S
authors: Nair
authors: Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, OX3 7LJ, UK.|Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand.
authors: Francois
authors: F
authors: Nosten
authors: WorldWide Antimalarial Resistance Network (WWARN), Oxford, UK.|Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, OX3 7LJ, UK.|Microbiology Laboratory, Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Mahosot Hospital, Vientiane, Lao People's Democratic Republic.
authors: Paul N
authors: PN
authors: Newton
authors: WorldWide Antimalarial Resistance Network (WWARN), Oxford, UK.|Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, OX3 7LJ, UK.|Menzies School of Health Research, Charles Darwin University, Darwin, Australia.
authors: Ric N
authors: RN
authors: Price
authors: Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
authors: Sasithon
authors: S
authors: Pukrittayakamee
authors: Institute for Global Health, University of Maryland School of Medicine, Baltimore, MD, USA.
authors: Shannon
authors: S
authors: Takala-Harrison
authors: Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, OX3 7LJ, UK.|Myanmar Oxford Clinical Research Unit, Yangon, Myanmar.
authors: Frank
authors: F
authors: Smithuis
authors: Hospital for Tropical Disease, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam.
authors: Nhien T
authors: NT
authors: Nguyen
authors: Defence Services Medical Research Centre, Naypyitaw, Myanmar.|Myanmar Oxford Clinical Research Unit, Yangon, Myanmar.
authors: Kyaw M
authors: KM
authors: Tun
authors: Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, OX3 7LJ, UK.|Mahidol-Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand.
authors: Nicholas J
authors: NJ
authors: White
authors: WorldWide Antimalarial Resistance Network (WWARN), Oxford, UK.|Malaria Molecular Epidemiology Unit, Institute Pasteur in Cambodia, Phnom Penh, Cambodia.
authors: Benoit
authors: B
authors: Witkowski
authors: Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, OX3 7LJ, UK.|Mahidol-Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand.
authors: Charles J
authors: CJ
authors: Woodrow
authors: Laboratory of Malaria and Vector Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, MD, USA.
authors: Rick M
authors: RM
authors: Fairhurst
authors: WorldWide Antimalarial Resistance Network (WWARN), Oxford, UK.|Department of Genome Sciences, University of Washington, Seattle, WA, USA.
authors: Carol Hopkins
authors: CH
authors: Sibley
authors: WorldWide Antimalarial Resistance Network (WWARN), Oxford, UK.|Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, OX3 7LJ, UK.
authors: Philippe J
authors: PJ
authors: Guerin
mesh_terms: D000890:Anti-Infective Agents / Q000494:pharmacology* / Q000627:therapeutic use; D037621:Artemisinins / Q000494:pharmacology* / Q000627:therapeutic use; D001210:Asia, Southeastern; D021821:Communicable Diseases, Emerging; D019468:Disease Management; D004351:Drug Resistance; D005843:Geography; D006304:Health Status; D006801:Humans; D016778:Malaria, Falciparum / Q000188:drug therapy* / Q000453:epidemiology; D010963:Plasmodium falciparum / Q000187:drug effects*; D011159:Population Surveillance / Q000379:methods*
chemical_list: D000890:Anti-Infective Agents; D037621:Artemisinins; C031327:artemisinin
keywords: Artemisinin; Drug resistance; Greater Mekong Subregion; Malaria; Surveillance