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<jats:sec id="sec001"> <jats:title>Background</jats:title> <jats:p><jats:italic>Plasmodium vivax</jats:italic> has been recently discovered as a significant cause of malaria in Mauritania, although very rare elsewhere in West Africa. It has not been known if this is a recently introduced or locally remnant parasite population, nor whether the genetic structure reflects epidemic or endemic transmission.</jats:p> </jats:sec> <jats:sec id="sec002"> <jats:title>Methodology/Principal findings</jats:title> <jats:p>To investigate the <jats:italic>P</jats:italic>. <jats:italic>vivax</jats:italic> population genetic structure in Mauritania and compare with populations previously analysed elsewhere, multi-locus genotyping was undertaken on 100 clinical isolates, using a genome-wide panel of 38 single nucleotide polymorphisms (SNPs), plus seven SNPs in drug resistance genes. The Mauritanian <jats:italic>P</jats:italic>. <jats:italic>vivax</jats:italic> population is shown to be genetically diverse and divergent from populations elsewhere, indicated consistently by genetic distance matrix analysis, principal components analyses, and fixation indices. Only one isolate had a genotype clearly indicating recent importation, from a southeast Asian source. There was no linkage disequilibrium in the local parasite population, and only a small number of infections appeared to be closely genetically related, indicating that there is ongoing genetic recombination consistent with endemic transmission. The <jats:italic>P</jats:italic>. <jats:italic>vivax</jats:italic> diversity in a remote mining town was similar to that in the capital Nouakchott, with no indication of local substructure or of epidemic population structure. Drug resistance alleles were virtually absent in Mauritania, in contrast with <jats:italic>P</jats:italic>. <jats:italic>vivax</jats:italic> in other areas of the world.</jats:p> </jats:sec> <jats:sec id="sec003"> <jats:title>Conclusions/Significance</jats:title> <jats:p>The molecular epidemiology indicates that there is long-standing endemic transmission that will be very challenging to eliminate. The virtual absence of drug resistance alleles suggests that most infections have been untreated, and that this endemic infection has been more neglected in comparison to <jats:italic>P</jats:italic>. <jats:italic>vivax</jats:italic> elsewhere.</jats:p> </jats:sec>

Original publication

DOI

10.1371/journal.pntd.0008945

Type

Journal

PLOS Neglected Tropical Diseases

Publisher

Public Library of Science (PLoS)

Publication Date

16/12/2020

Volume

14

Pages

e0008945 - e0008945