Migrants in transit across Central America and the potential spread of chloroquine resistant malaria–a call for action

Higuita, Nelson Iván Agudelo; Franco‐Paredes, Carlos; Henao‐Martínez, Andrés F.; Rojas, Bomar Mendez; Suárez, José Antonio; Naranjo, Laura; Alger, Jackeline

doi:10.1016/j.lana.2023.100505

Cited by 2 publications

(1 citation statement)

References 24 publications

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“…The majority of migrants moving northward originate from regions where Plasmodium spp. exhibit resistance to chloroquine, potentially serving as the reservoir for the introduction and subsequent dissemination of drug-resistant parasites to currently deployed antimalarial medications in the area [ 32 ]. For instance, local cases of P. vivax malaria recently identified in the Southern United States may be linked to this migratory influx [ 33 ].…”

Section: Discussionmentioning

confidence: 99%

Spatiotemporal Analysis of Malaria Transmission in the Autonomous Indigenous Regions of Panama, Central America, 2015–2022

Cumbrera,

Calzada,

Chaves

et al. 2024

TropicalMed

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Despite ongoing efforts for elimination, malaria continues to be a major public health problem in the Republic of Panama. For effective elimination, it is key that malaria foci and areas of high transmission are identified in a timely manner. Here, we study malaria transmission records for the 2015–2022 period, a time when cases have increased by a factor of ten. Using several methods to study spatial and spatiotemporal malaria confirmed case clusters at the level of localities, including LISA and scan, we found that cases are clustered across indigenous villages located within the autonomous indigenous regions of Ngäbe–Buglé, Guna Yala, and Embera, with the latter on the eastern border of Panama (with Colombia). We discuss the different factors that might be shaping the marked increase in malaria transmission associated with these clusters, which include an inflow of malaria-exposed migrating populations hoping to reach the USA, insufficient health services, and the lack of culturally sensitive actionable tools to reduce malaria exposure among the ethnically diverse and impoverished indigenous populations of Panama.

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Section: Discussionmentioning

confidence: 99%

Spatiotemporal Analysis of Malaria Transmission in the Autonomous Indigenous Regions of Panama, Central America, 2015–2022

Cumbrera,

Calzada,

Chaves

et al. 2024

TropicalMed

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Geo-classification of drug-resistant travel-associated Plasmodium falciparum using Pfs47 and Pfcpmp gene sequences (USA, 2018–2021)

Pierre-Louis,

Kelley,

Patel

et al. 2024

Antimicrob Agents Chemother

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Travel-related malaria is regularly encountered in the United States, and the U.S. Centers for Disease Control and Prevention (CDC) characterizes Plasmodium falciparum drug-resistance genotypes routinely for travel-related cases. An important aspect of antimalarial drug resistance is understanding its geographic distribution. However, specimens submitted to CDC laboratories may have missing, incomplete, or inaccurate travel data. To complement genotyping for drug-resistance markers Pfcrt , Pfmdr1 , Pfk13 , Pfdhps , Pfdhfr , and PfcytB at CDC, amplicons of Pfs47 and Pfcpmp are also sequenced as markers of geographic origin. Here, a bi-allele likelihood (BALK) classifier was trained using Pfs47 and Pfcpmp sequences from published P. falciparum genomes of known geographic origin to classify clinical genotypes to a continent. Among P. falciparum -positive blood samples received at CDC for drug-resistance genotyping from 2018 to 2021 ( n = 380), 240 included a travel history with the submission materials, though 6 were excluded due to low sequence quality. Classifications obtained for the remaining 234 were compared to their travel histories. Classification results were over 96% congruent with reported travel for clinical samples, and with collection sites for field isolates. Among travel-related samples, only two incongruent results occurred; a specimen submitted citing Costa Rican travel classified to Africa, and a specimen with travel referencing Sierra Leone classified to Asia. Subsequently, the classifier was applied to specimens with unreported travel histories ( n = 140; 5 were excluded due to low sequence quality). For the remaining 135 samples, geographic classification data were paired with results generated using CDC’s Malaria Resistance Surveillance (MaRS) protocol, which detects single-nucleotide polymorphisms in and generates haplotypes for Pfcrt , Pfmdr1 , Pfk13 , Pfdhps , Pfdhfr , and PfcytB . Given the importance of understanding the geographic distribution of antimalarial drug resistance, this work will complement domestic surveillance efforts by expanding knowledge on the geographic origin of drug-resistant P. falciparum entering the USA.

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Migrants in transit across Central America and the potential spread of chloroquine resistant malaria–a call for action

Cited by 2 publications

References 24 publications

Spatiotemporal Analysis of Malaria Transmission in the Autonomous Indigenous Regions of Panama, Central America, 2015–2022

Spatiotemporal Analysis of Malaria Transmission in the Autonomous Indigenous Regions of Panama, Central America, 2015–2022

Geo-classification of drug-resistant travel-associated Plasmodium falciparum using Pfs47 and Pfcpmp gene sequences (USA, 2018–2021)

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