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Landier, J.

Publications and source records attributed to Landier, J..

3 recordsLinked to original sources
bioRxiv2026

Characterising recent antimalarial resistance in West Africa: Insights from amplicon sequencing of 17,384 Plasmodium falciparum infection samples

Plasmodium falciparum (P. falciparum) infection remains a significant public health threat in West Africa, where chemoprevention and first-line therapies are key interventions against malaria. However, the development and spread of resistance to commonly used antimalarials poses a growing threat to the efficacy of these strategies. This study characterises the recent landscape of antimalarial resistance in West Africa by analysing targeted amplicon sequences from 17,384 P. falciparum infection samples. Across countries, the prevalence of the pyrimethamine resistance-associated dhfr triple mutant allele (51I/59R/108N) exceeded 80%, while its combination with the sulphadoxine resistance-associated dhps 437G exceeded 60% of infections. Unlike the parasite genotypes in East Africa, the prevalence of the dhps 540E mutant was low (1.5%), whereas dhps 436A was common (43.8%). The chloroquine resistance marker crt 76T showed greatest geographic heterogeneity, ranging from low prevalence in Ghana (1.3%) to very common in The Gambia (64.9%). Non-synonymous mutants of kelch13 were uncommon, most with unknown relevance to artemisinin resistance and observed for the first time in Africa. However, mutants that are artemisinin resistance-associated elsewhere were detected in three infection samples from Ghana (574L, 561H, 469Y), and one in Cameroon (538V). This large-scale genomic surveillance of P. falciparum infections highlights the need for ongoing monitoring of drug resistance and for data integration throughout the region.

genomics↗
bioRxiv2025

Malaria parasite population genomics during an elimination program in Eastern Myanmar

BackgroundWe investigated parasite population genomics during an intensive malaria elimination program in Kayin State (Myanmar), in which malaria posts were used for rapid detection and treatment of malaria cases, while mass drug administration (MDA) was used in villages with high submicroscopic reservoirs. MethodsWe collected 5014 dried blood spots from Plasmodium falciparum infected patients from 413 malaria posts, over 58-months (November 2015 - August 2020), and sequenced 2270 parasite genomes, each with geographic references (latitude and longitude). We used identity-by-descent (IBD) relationships to examine how control efforts impact parasite population structure. FindingsParasites were genetically depauperate: 1726 single-genotype infections comprised 166 unique genomes ([≥]90% IBD), while nine families ([≥]45% IBD) accounted for 62{middle dot}5% of parasites sampled. We observed localized, temporally stable transmission of unique parasite genotypes, identifying transmission chains. Parasite relatedness was positively correlated up to approximately 20 km revealing the scale of parasite subpopulations. Kelch13 diversity was stable from 2016-2019, but only one predominant clonal genotype (kelch13-R561H) remained in 2020. MDA resulted in parasite founder effects, providing genomic evidence for the efficacy of this malaria control tool. InterpretationOur genomic data show that parasite population size decreased over the study period, and we observed regional distribution of parasite genotypes, which can define operational units for parasite control. One parasite genotype (kelch13-R561H) from the north rose to high frequency in 2020, because transmission was halted elsewhere in the control area. Future surveillance will reveal whether this genotype spreads to neighboring regions. Genetic drift may have a stronger impact on parasite population structure than selection in low-transmission elimination settings. FundingNational Institutes of Health; Wellcome Trust; Global Fund to Fight against AIDS, Tuberculosis and Malaria; The Bill and Melinda Gates Foundation. Research in contextO_ST_ABSEvidence before this studyC_ST_ABSThis study describes the genomic analysis of malaria parasites collected during a malaria elimination program targeting four townships (Myawaddy, Kawkareik, Hlaingbwe, and Hpapun) in Kayin State, eastern Myanmar. We searched PubMed on May 10, 2025, using the terms: "malaria", "transmission", "drug resistance", "southeast Asia" and "genetic surveillance" without any date or language restrictions. Our search yielded 58 publications, including reports on declined immunity to malaria and increased drug resistance in southeast Asia; genetic diversity and population structure shaped by mass drug administration, transmission intensity, human movement and mosquito ecology; and the spread of kelch13 and pfcrt mutations conferring dihydroartemimsinin-piperaquine resistance in east southeast Asia countries. Added value of this studyWe sequenced and analyzed 2270 Plasmodium falciparum whole genomes (each with geographic location) collected between November 2015 and August 2020 in Kayin State. We described fine-scale molecular epidemiology changes during intense malaria elimination interventions. We observed localized, temporally stable transmission of parasite genotypes, with different parasite families and kelch13 haplotypes predominating in different subregions over the 5-year period. We found kelch13 haplotypes with local or regional origin, but none originating from eastern southeast Asia. The genomic data indicated decreasing parasite population size, but we observed no selection towards drug-resistance parasites. In 2020, only one predominant lineage (kelch13-R561H) remained in our studying region, consistent with genetic drift in a pre-elimination setting. Implications of all the available evidenceThe parasite population was genetically depauperate, with a spatially localized and temporally stable distribution of parasite lineages, and declining population size. In this situation genetic drift may play a heightened role in parasite epidemiology. Consistent with this, parasites carrying kelch13-R561H rose to high frequency in 2020, because transmission was eliminated in all regions except the north of Kayin State, where parasites bearing this kelch13 genotype have predominated since 2017. Future surveillance will determine whether this parasite genotype is transmitted to neighboring regions, and thus related to changes in P. falciparum drug resistance dynamics on the Thailand Myanmar border. These data illustrate how genetic drift in small populations can result in instantaneous changes in the resistance status of parasite populations in near elimination settings.

genomics↗
bioRxiv2018

Herd protection against Plasmodium falciparum infections conferred by mass antimalarial drug administrations and the implications for malaria elimination

IntroductionAll nations of the Greater Mekong Subregion have committed to elimination of malaria by the year 2030. Elimination efforts rely on increasing access to diagnosis and treatment. However, asymptomatic infections pose a major challenge for these efforts. One approach towards eliminating asymptomatic reservoirs is targeted mass antimalarial drug administration (MDA). Here we present a fine scale spatiotemporal analysis of malaria incidence and prevalence in villages undergoing MDA.\n\nMethodsFour villages along the Myanmar-Thailand border were selected for a MDA pilot study based on clinical records and prevalence surveys. Passive detection of clinical episodes was facilitated through community based malaria clinics in each village. All villagers were screened using venous blood and ultra-sensitive qPCR (uPCR) for detection of parasites at baseline and every subsequent 3 months until month 18 (M18). A final screening was done at M24. MDAs were conducted on M0, M1 and M2 in two villages and on M9, M10, M11 in the remaining two villages. Which villages received early or deferred MDA was decided using restricted randomization. MDA participation, clinical episodes and uPCR detected infections were mapped to participant houses. Scan statistics were used to test for clusters of malaria episodes, malaria infections and non-adherence to MDA. Mixed effects regressions were used to test for risk factors for clinical episodes after MDA.\n\nResultsNeighborhood level MDA adherence was a major predictor for clinical episodes of malaria post-MDA, suggesting a strong herd effect. Each village had a cluster of P. falciparum infections at M0. After M0, there were no clusters of uPCR detectable P. falciparum infections. Clinical episodes of P. falciparum occurred in one village only which had a cluster of non-adherence to MDA and a high mosquito vector human biting rate. Individuals with subclinical P.falciparum infections were more likely to have subsequent clinical episodes than individuals who had no subclinical infections. Individuals who lived in a house with someone who had a clinical episode were more likely to also have a clinical episode subsequently than individuals residing in a house free of P.falciparum infections.\n\nConclusionTo our knowledge this is the first study to show a herd effect from MDA for malaria. These data and results have significance for spatial targeting of interventions for malaria elimination. Clusters of non-adherence to MDA participation can lead to failed elimination if they occur among individuals with asymptomatic infections and given sufficient mosquito vector exposure. Community participation, which can be facilitated through community engagement, is key to MDA success.

epidemiology↗