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Wellcome Sanger Institute enables genomic surveillance of drug resistant malaria parasites in Greater Mekong subregion




In-depth genomic surveillance is being used to track drug resistant malaria parasites in the Greater Mekong subregion of Asia, helping to inform what treatments are delivered by public health agencies in South-East Asia.

Market activity in the early morning by the Mekong river in Can Tho, Vietnam
Market activity in the early morning by the Mekong river in Can Tho, Vietnam

The GenRe-Mekong project, involving researchers from the Wellcome Sanger Institute, the University of Oxford, MalariaGEN and partners in the region, has processed 9,623 blood samples from symptomatic patients across eight countries, with the majority from Vietnam, Laos, Cambodia, Thailand, and Myanmar.

DNA analysis, primarily at the Wellcome Sanger Institute, has extracted large amounts of parasite genetic information, which has enabled areas of parasite resistance to specific drugs to be identified, influencing the choice of frontline therapy and choice of interventions.

Dr Christopher Jacob, first author at the Wellcome Sanger Institute, said: “The technology used in this research was created to make genomic surveillance as accessible as possible, so that information could be gathered from some of the region’s most remote locations. By using a single drop of blood for analysis and developing a technology that has low processing costs, it is possible to undertake these large-scale genetic epidemiology surveys. This method could be used across more countries in different endemic regions to help track malaria cases and inform more public health decisions.”

Market activity in the early morning by the Mekong river in Can Tho, Vietnam
Market activity in the early morning by the Mekong river in Can Tho, Vietnam

Professor Arjen Dondorp, deputy director and head of malaria and critical care at the Mahidol-Oxford Tropical Medicine Research Unit (MORU) in Bangkok, Thailand, said: “Drug resistant P.falciparum malaria is an important threat to malaria control, particularly in the Greater Mekong subregion, where an intense effort for malaria elimination is ongoing, and will hopefully be successful before the parasite becomes close to untreatable.

“The GenRe-Mekong project works closely with local malaria control programmes, so that they have direct access to the data, facilitating informed decisions on antimalarial drug choices, malaria control and elimination strategies.”

Professor Olivo Miotto, principal investigator of GenRe-Mekong at Mahidol-Oxford Tropical Medicine Research Unit (MORU) in Bangkok, Thailand, and associate professor at the University of Oxford, added: “Malaria is still a major killer disease across the world, and it is great to see what an impact genetic surveillance data can have when it is translated into actionable messages that inform public health decisions.

“This is the first time that such detailed malaria genomic surveillance has been implemented across multiple countries, and it is remarkable how National Malaria Control Programmes and other partners in the Greater Mekong Subregion are working together by sharing data across the region, making this project far more than the sum of its parts.”

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