Further evidence of increasing diversity of Plasmodium vivax in the Republic of Korea in recent years

<p><strong>Background</strong> Vivax malaria was successfully eliminated from the Republic of Korea (ROK) in the late 1970s but re-emerged in 1993. Two decades later as the ROK enters the final stages of malaria elimination, dedicated surveillance of the local P. vivax population i...

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Main Authors: Kim, J, Goo, Y, Zo, Y, Ji, S, Trimarsanto, H, To, S, Clark, T, Price, R, Auburn, S
Format: Journal article
Language:English
Published: Public Library of Science 2016
Subjects:
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author Kim, J
Goo, Y
Zo, Y
Ji, S
Trimarsanto, H
To, S
Clark, T
Price, R
Auburn, S
author_facet Kim, J
Goo, Y
Zo, Y
Ji, S
Trimarsanto, H
To, S
Clark, T
Price, R
Auburn, S
author_sort Kim, J
collection OXFORD
description <p><strong>Background</strong> Vivax malaria was successfully eliminated from the Republic of Korea (ROK) in the late 1970s but re-emerged in 1993. Two decades later as the ROK enters the final stages of malaria elimination, dedicated surveillance of the local P. vivax population is critical. We apply a population genetic approach to gauge P. vivax transmission dynamics in the ROK between 2010 and 2012.</p> <p><strong>Methodology/Principal Findings</strong> P. vivax positive blood samples from 98 autochthonous cases were collected from patients attending health centers in the ROK in 2010 (n = 27), 2011 (n = 48) and 2012 (n = 23). Parasite genotyping was undertaken at 9 tandem repeat markers. Although not reaching significance, a trend of increasing population diversity was observed from 2010 (HE = 0.50 ± 0.11) to 2011 (HE = 0.56 ± 0.08) and 2012 (HE = 0.60 ± 0.06). Conversely, linkage disequilibrium declined during the same period: IAS = 0.15 in 2010 (P = 0.010), 0.09 in 2011 (P = 0.010) and 0.05 in 2012 (P = 0.010). In combination with data from other ROK studies undertaken between 1994 and 2007, our results are consistent with increasing parasite divergence since re-emergence. Polyclonal infections were rare (3% infections) suggesting that local out-crossing alone was unlikely to explain the increased divergence. Cases introduced from an external reservoir may therefore have contributed to the increased diversity. Aside from one isolate, all infections carried a short MS20 allele (142 or 149 bp), not observed in other studies in tropical endemic countries despite high diversity, inferring that these regions are unlikely reservoirs.</p> <p><strong>Conclusions</strong> Whilst a number of factors may explain the observed population genetic trends, the available evidence suggests that an external geographic reservoir with moderate diversity sustains the majority of P. vivax infection in the ROK, with important implications for malaria elimination.</p>
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spelling oxford-uuid:afe9eae4-f2da-449c-b10c-c63cd23235892022-03-27T03:52:40ZFurther evidence of increasing diversity of Plasmodium vivax in the Republic of Korea in recent yearsJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:afe9eae4-f2da-449c-b10c-c63cd2323589MalariaGenotypingPlasmodiumMalarial parasitesGentic lociPopulation geneticsNorth KoreaParasitic diseasesEnglishSymplectic Elements at OxfordPublic Library of Science2016Kim, JGoo, YZo, YJi, STrimarsanto, HTo, SClark, TPrice, RAuburn, S<p><strong>Background</strong> Vivax malaria was successfully eliminated from the Republic of Korea (ROK) in the late 1970s but re-emerged in 1993. Two decades later as the ROK enters the final stages of malaria elimination, dedicated surveillance of the local P. vivax population is critical. We apply a population genetic approach to gauge P. vivax transmission dynamics in the ROK between 2010 and 2012.</p> <p><strong>Methodology/Principal Findings</strong> P. vivax positive blood samples from 98 autochthonous cases were collected from patients attending health centers in the ROK in 2010 (n = 27), 2011 (n = 48) and 2012 (n = 23). Parasite genotyping was undertaken at 9 tandem repeat markers. Although not reaching significance, a trend of increasing population diversity was observed from 2010 (HE = 0.50 ± 0.11) to 2011 (HE = 0.56 ± 0.08) and 2012 (HE = 0.60 ± 0.06). Conversely, linkage disequilibrium declined during the same period: IAS = 0.15 in 2010 (P = 0.010), 0.09 in 2011 (P = 0.010) and 0.05 in 2012 (P = 0.010). In combination with data from other ROK studies undertaken between 1994 and 2007, our results are consistent with increasing parasite divergence since re-emergence. Polyclonal infections were rare (3% infections) suggesting that local out-crossing alone was unlikely to explain the increased divergence. Cases introduced from an external reservoir may therefore have contributed to the increased diversity. Aside from one isolate, all infections carried a short MS20 allele (142 or 149 bp), not observed in other studies in tropical endemic countries despite high diversity, inferring that these regions are unlikely reservoirs.</p> <p><strong>Conclusions</strong> Whilst a number of factors may explain the observed population genetic trends, the available evidence suggests that an external geographic reservoir with moderate diversity sustains the majority of P. vivax infection in the ROK, with important implications for malaria elimination.</p>
spellingShingle Malaria
Genotyping
Plasmodium
Malarial parasites
Gentic loci
Population genetics
North Korea
Parasitic diseases
Kim, J
Goo, Y
Zo, Y
Ji, S
Trimarsanto, H
To, S
Clark, T
Price, R
Auburn, S
Further evidence of increasing diversity of Plasmodium vivax in the Republic of Korea in recent years
title Further evidence of increasing diversity of Plasmodium vivax in the Republic of Korea in recent years
title_full Further evidence of increasing diversity of Plasmodium vivax in the Republic of Korea in recent years
title_fullStr Further evidence of increasing diversity of Plasmodium vivax in the Republic of Korea in recent years
title_full_unstemmed Further evidence of increasing diversity of Plasmodium vivax in the Republic of Korea in recent years
title_short Further evidence of increasing diversity of Plasmodium vivax in the Republic of Korea in recent years
title_sort further evidence of increasing diversity of plasmodium vivax in the republic of korea in recent years
topic Malaria
Genotyping
Plasmodium
Malarial parasites
Gentic loci
Population genetics
North Korea
Parasitic diseases
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