Genomic malaria surveillance of antenatal care users detects reduced transmission following elimination interventions in Mozambique

Nanna Brokhattingen, Glória Matambisso, Clemente da Silva, Eric Neubauer Vickers, Arnau Pujol, Henriques Mbeve, Pau Cisteró, Sónia Maculuve, Boaventura Cuna, Cardoso Melembe, Nelo Ndimande, Brian Palmer, Manuel García-Ulloa, Humberto Munguambe, Júlia Montaña-Lopez, Lidia Nhamussua, Wilson Simone, Arlindo Chidimatembue, Beatriz Galatas, Caterina Guinovart, Eduard Rovira-Vallbona, Francisco Saúte, Pedro Aide, Andrés Aranda-Díaz, Bryan Greenhouse, Eusébio Macete and Alfredo Mayor ()
Additional contact information
Nanna Brokhattingen: Hospital Clínic – Universitat de Barcelona
Glória Matambisso: Centro de Investigação em Saúde de Manhiça (CISM)
Clemente da Silva: Centro de Investigação em Saúde de Manhiça (CISM)
Eric Neubauer Vickers: San Francisco
Arnau Pujol: Hospital Clínic – Universitat de Barcelona
Henriques Mbeve: Centro de Investigação em Saúde de Manhiça (CISM)
Pau Cisteró: Hospital Clínic – Universitat de Barcelona
Sónia Maculuve: Centro de Investigação em Saúde de Manhiça (CISM)
Boaventura Cuna: Centro de Investigação em Saúde de Manhiça (CISM)
Cardoso Melembe: Centro de Investigação em Saúde de Manhiça (CISM)
Nelo Ndimande: Centro de Investigação em Saúde de Manhiça (CISM)
Brian Palmer: San Francisco
Manuel García-Ulloa: Hospital Clínic – Universitat de Barcelona
Humberto Munguambe: Centro de Investigação em Saúde de Manhiça (CISM)
Júlia Montaña-Lopez: Hospital Clínic – Universitat de Barcelona
Lidia Nhamussua: Centro de Investigação em Saúde de Manhiça (CISM)
Wilson Simone: Centro de Investigação em Saúde de Manhiça (CISM)
Arlindo Chidimatembue: Centro de Investigação em Saúde de Manhiça (CISM)
Beatriz Galatas: Hospital Clínic – Universitat de Barcelona
Caterina Guinovart: Hospital Clínic – Universitat de Barcelona
Eduard Rovira-Vallbona: Hospital Clínic – Universitat de Barcelona
Francisco Saúte: Centro de Investigação em Saúde de Manhiça (CISM)
Pedro Aide: Centro de Investigação em Saúde de Manhiça (CISM)
Andrés Aranda-Díaz: San Francisco
Bryan Greenhouse: San Francisco
Eusébio Macete: Centro de Investigação em Saúde de Manhiça (CISM)
Alfredo Mayor: Hospital Clínic – Universitat de Barcelona

Nature Communications, 2024, vol. 15, issue 1, 1-12

Abstract: Abstract Routine sampling of pregnant women at first antenatal care (ANC) visits could make Plasmodium falciparum genomic surveillance more cost-efficient and convenient in sub-Saharan Africa. We compare the genetic structure of parasite populations sampled from 289 first ANC users and 93 children from the community in Mozambique between 2015 and 2019. Samples are amplicon sequenced targeting 165 microhaplotypes and 15 drug resistance genes. Metrics of genetic diversity and relatedness, as well as the prevalence of drug resistance markers, are consistent between the two populations. In an area targeted for elimination, intra-host genetic diversity declines in both populations (p = 0.002-0.007), while for the ANC population, population genetic diversity is also lower (p = 0.0004), and genetic relatedness between infections is higher (p = 0.002) than control areas, indicating a recent reduction in the parasite population size. These results highlight the added value of genomic surveillance at ANC clinics to inform about changes in transmission beyond epidemiological data.

Date: 2024
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DOI: 10.1038/s41467-024-46535-x

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