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A sharp decline in piperaquine-resistant strains of P. Falciparum malaria following drug policy revisions across the Greater Mekong Subregion (GMS) highlights how real-time genetic data can support timely, evidence-based responses to shifting malaria threats, say researchers in a study published in Nature Communications.

Genetic surveillance of Plasmodium falciparum populations following treatment policy revisions in the Greater Mekong Subregion. Figure from publication © Nature Communications
Genetic surveillance of Plasmodium falciparum populations following treatment policy revisions in the Greater Mekong Subregion .

The spread of antimalarial drug resistance threatens progress in malaria control and elimination, particularly in the GMS. The GenRe-Mekong project addresses this challenge by implementing genetic surveillance to provide actionable data to support National Malaria Control Programmes (NMCPs)in making timely, evidence-based decisions.

The study, Genetic surveillance of Plasmodium falciparum populations following treatment policy revisions in the Greater Mekong Subregion, reported on a collaborative effort between MORU, OUCRU, Wellcome Sanger Institute and the NMCPs in Cambodia, Laos, and Viet Nam. The GenRe-Mekong project used targeted sequencing to genotype drug resistance markers and population barcodes to analyse 5,982 Plasmodium falciparum samples in the GMS (2017–2022). They found that after policy-driven replacement of dihydroartemisinin-piperaquine (DHA-PPQ) in Cambodia, Thailand, and Viet Nam, resistant parasite lineages declined sharply. The frequency of regional piperaquine resistance markers dropped from 62% to just 2% between 2017–2019 and 2022. Despite persistently high artemisinin resistance, no signs of mefloquine resistance emerged.

These findings demonstrate how real-time genetic surveillance can support timely, evidence-based responses by NMCPs to shifting malaria threats.

Read the publication 'Genetic surveillance of Plasmodium falciparum populations following treatment policy revisions in the Greater Mekong Subregion' on Nature Communications

- With thanks to Varanya Wasakul for text. Image courtesy of Nature Communications.