Exploration of relationship between multiplicity of infection and transmission intensity in malarial infections in Ghana Público

Kuehl, Sarah Elizabeth (2015)

Permanent URL: https://etd.library.emory.edu/concern/etds/c247ds274?locale=pt-BR
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Abstract

The malaria parasite Plasmodium falciparum has evolved partial or complete resistance to all available antimalarial drugs. P. falciparum infections often comprise multiple genetically distinct strains that are suggested to compete for resources within a host. Competition may have important effects on the spread of resistance due to the potential fitness cost associated with resistance as well as suppression of resistant parasites by drug-sensitive competitors. Therefore, the average number of clones in an infection, termed the multiplicity of infection (MOI), could be of great significance. Studies have shown a positive correlation between transmission intensity and MOI on a broad geographic scale, which could potentially explain the surprising pattern of antimalarial drug resistance emerging in low-transmission settings and spreading to high-transmission settings. To explore the link between transmission intensity and MOI on a smaller scale, PCR and microsatellite genotyping were used to assess the MOI of four regions in Ghana that differ in transmission intensity, sampled over a ten-year period. The results indicate no consistent differences in MOI distribution between sites but significant change in MOI over time for all but one site. Further investigations are needed to elucidate the important determinants of MOI on various spatial and temporal scales.

Table of Contents

Abstract 1

Introduction 1-5

Methods 5-10

Results 10-13

Discussion 13-19

Figures and Tables 20-28

References 29-35

Supplemental Information 36-44

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