Alterations in Plasmodium falciparum Genetic Structure Two Years after Increased Malaria Control Efforts in Western Kenya

Anne M. Vardo-Zalik Program in Public Health, College of Health Sciences, University of California Irvine, Irvine, California; Climate and Human Health Research Unit, Kenya Medical Research Institute, Kisumu, Kenya

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Guofa Zhou Program in Public Health, College of Health Sciences, University of California Irvine, Irvine, California; Climate and Human Health Research Unit, Kenya Medical Research Institute, Kisumu, Kenya

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Daibin Zhong Program in Public Health, College of Health Sciences, University of California Irvine, Irvine, California; Climate and Human Health Research Unit, Kenya Medical Research Institute, Kisumu, Kenya

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Yaw A. Afrane Program in Public Health, College of Health Sciences, University of California Irvine, Irvine, California; Climate and Human Health Research Unit, Kenya Medical Research Institute, Kisumu, Kenya

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Andrew K. Githeko Program in Public Health, College of Health Sciences, University of California Irvine, Irvine, California; Climate and Human Health Research Unit, Kenya Medical Research Institute, Kisumu, Kenya

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Guiyun Yan Program in Public Health, College of Health Sciences, University of California Irvine, Irvine, California; Climate and Human Health Research Unit, Kenya Medical Research Institute, Kisumu, Kenya

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The impact of malaria intervention measures (insecticide-treated net use and artemisinin combination therapy) on malaria genetics was investigated at two sites in western Kenya: an endemic lowland and an epidemic highland. The genetic structure of the parasite population was assessed by using microsatellites, and the prevalence of drug-resistant mutations was examined by using the polymerase chain reaction–restriction fragment length polymorphism method. Two years after intervention, genetic diversity remained high in both populations. A significant decrease in the prevalence of quintuple mutations conferring resistance to sulfadoxine-pyrimethamine was detected in both populations, but the mutation prevalence at codon 1246 of the Plasmodium falciparum multidrug resistance 1 gene had increased in the highland population. The decrease in sulfadoxine-pyrimethamine–resistant mutants is encouraging, but the increase in P. falciparum multidrug resistance 1 gene mutations is worrisome because these mutations are linked to resistance to other antimalarial drugs. In addition, the high level of genetic diversity observed after intervention suggests transmission is still high in each population.

Author Notes

* Address correspondence to Anne M. Vardo-Zalik, The Pennsylvania State University, 1031 Edgecomb Avenue, York, PA 17403. E-mail: amv12@psu.edu

Financial support: This study was supported by the National Institute of Health grants R01 AI050243 and D43 TW001505 to Guiyun Yan.

Authors' addresses: Anne M. Vardo-Zalik, The Pennsylvania State University, York, PA, E-mail: amv12@psu.edu. Guofa Zhou, Daibin Zhong, and Guiyun Yan, Program in Public Health, College of Health Sciences, University of California Irvine, Irvine, CA, E-mails: zhoug@uci.edu, dzhong@uci.edu, and guiyuny@uci.edu. Yaw A. Afrane and Andrew K. Githeko, Climate and Human Health Research Unit, Kenya Medical Research Institute, Kisumu, Kenya, E-mails: yaw_afrane@yahoo.com and githeko@yahoo.com.

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