Further evidence of increasing diversity of Plasmodium vivax in the Republic of Korea in recent years

Jung-Yeon Kim, Youn-Kyoung Goo, Young Gun Zo, So-Young Ji, Hidayat Trimarsanto, Sheren To, Taane Clark, Ric Price, Sarah Auburn

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    Abstract

    Background: Vivax malaria was successfully eliminated from the Republic of Korea (ROK) in the late 1970s but re-emerged in 1993. Two decades later as the ROK enters the final stages of malaria elimination, dedicated surveillance of the local P. vivax population is critical. We apply a population genetic approach to gauge P. vivax transmission dynamics in the ROK between 2010 and 2012.

    Methodology/Principal Findings:
    P. vivax positive blood samples from 98 autochthonous cases were collected from patients attending health centers in the ROK in 2010 (n = 27), 2011 (n = 48) and 2012 (n = 23). Parasite genotyping was undertaken at 9 tandem repeat markers. Although not reaching significance, a trend of increasing population diversity was observed from 2010 (HE = 0.50 ± 0.11) to 2011 (HE = 0.56 ± 0.08) and 2012 (HE = 0.60 ± 0.06). Conversely, linkage disequilibrium declined during the same period: IAS = 0.15 in 2010 (P = 0.010), 0.09 in 2011 (P = 0.010) and 0.05 in 2012 (P = 0.010). In combination with data from other ROK studies undertaken between 1994 and 2007, our results are consistent with increasing parasite divergence since re-emergence. Polyclonal infections were rare (3% infections) suggesting that local out-crossing alone was unlikely to explain the increased divergence. Cases introduced from an external reservoir may therefore have contributed to the increased diversity. Aside from one isolate, all infections carried a short MS20 allele (142 or 149 bp), not observed in other studies in tropical endemic countries despite high diversity, inferring that these regions are unlikely reservoirs.

    Conclusions: Whilst a number of factors may explain the observed population genetic trends, the available evidence suggests that an external geographic reservoir with moderate diversity sustains the majority of P. vivax infection in the ROK, with important implications for malaria elimination.
    Original languageEnglish
    Article numbere0151514
    Pages (from-to)1-16
    Number of pages16
    JournalPLoS One
    Volume11
    Issue number3
    DOIs
    Publication statusPublished - 2016

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    Plasmodium vivax
    Republic of Korea
    South Korea
    Tandem Repeat Sequences
    malaria
    Malaria
    Gages
    Blood
    Health
    Population Genetics
    infection
    population genetics
    Parasites
    Infection
    Vivax Malaria
    parasites
    genetic trend
    tandem repeat sequences
    Linkage Disequilibrium
    outcrossing

    Cite this

    Kim, Jung-Yeon ; Goo, Youn-Kyoung ; Zo, Young Gun ; Ji, So-Young ; Trimarsanto, Hidayat ; To, Sheren ; Clark, Taane ; Price, Ric ; Auburn, Sarah. / Further evidence of increasing diversity of Plasmodium vivax in the Republic of Korea in recent years. In: PLoS One. 2016 ; Vol. 11, No. 3. pp. 1-16.
    @article{3a7b3fdd47f44b1f8f60a0028c257fa3,
    title = "Further evidence of increasing diversity of Plasmodium vivax in the Republic of Korea in recent years",
    abstract = "Background: Vivax malaria was successfully eliminated from the Republic of Korea (ROK) in the late 1970s but re-emerged in 1993. Two decades later as the ROK enters the final stages of malaria elimination, dedicated surveillance of the local P. vivax population is critical. We apply a population genetic approach to gauge P. vivax transmission dynamics in the ROK between 2010 and 2012.Methodology/Principal Findings: P. vivax positive blood samples from 98 autochthonous cases were collected from patients attending health centers in the ROK in 2010 (n = 27), 2011 (n = 48) and 2012 (n = 23). Parasite genotyping was undertaken at 9 tandem repeat markers. Although not reaching significance, a trend of increasing population diversity was observed from 2010 (HE = 0.50 ± 0.11) to 2011 (HE = 0.56 ± 0.08) and 2012 (HE = 0.60 ± 0.06). Conversely, linkage disequilibrium declined during the same period: IAS = 0.15 in 2010 (P = 0.010), 0.09 in 2011 (P = 0.010) and 0.05 in 2012 (P = 0.010). In combination with data from other ROK studies undertaken between 1994 and 2007, our results are consistent with increasing parasite divergence since re-emergence. Polyclonal infections were rare (3{\%} infections) suggesting that local out-crossing alone was unlikely to explain the increased divergence. Cases introduced from an external reservoir may therefore have contributed to the increased diversity. Aside from one isolate, all infections carried a short MS20 allele (142 or 149 bp), not observed in other studies in tropical endemic countries despite high diversity, inferring that these regions are unlikely reservoirs.Conclusions: Whilst a number of factors may explain the observed population genetic trends, the available evidence suggests that an external geographic reservoir with moderate diversity sustains the majority of P. vivax infection in the ROK, with important implications for malaria elimination.",
    author = "Jung-Yeon Kim and Youn-Kyoung Goo and Zo, {Young Gun} and So-Young Ji and Hidayat Trimarsanto and Sheren To and Taane Clark and Ric Price and Sarah Auburn",
    year = "2016",
    doi = "10.1371/journal.pone.0151514",
    language = "English",
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    Kim, J-Y, Goo, Y-K, Zo, YG, Ji, S-Y, Trimarsanto, H, To, S, Clark, T, Price, R & Auburn, S 2016, 'Further evidence of increasing diversity of Plasmodium vivax in the Republic of Korea in recent years', PLoS One, vol. 11, no. 3, e0151514, pp. 1-16. https://doi.org/10.1371/journal.pone.0151514

    Further evidence of increasing diversity of Plasmodium vivax in the Republic of Korea in recent years. / Kim, Jung-Yeon; Goo, Youn-Kyoung; Zo, Young Gun; Ji, So-Young; Trimarsanto, Hidayat; To, Sheren; Clark, Taane; Price, Ric; Auburn, Sarah.

    In: PLoS One, Vol. 11, No. 3, e0151514, 2016, p. 1-16.

    Research output: Contribution to journalArticleResearchpeer-review

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    T1 - Further evidence of increasing diversity of Plasmodium vivax in the Republic of Korea in recent years

    AU - Kim, Jung-Yeon

    AU - Goo, Youn-Kyoung

    AU - Zo, Young Gun

    AU - Ji, So-Young

    AU - Trimarsanto, Hidayat

    AU - To, Sheren

    AU - Clark, Taane

    AU - Price, Ric

    AU - Auburn, Sarah

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    N2 - Background: Vivax malaria was successfully eliminated from the Republic of Korea (ROK) in the late 1970s but re-emerged in 1993. Two decades later as the ROK enters the final stages of malaria elimination, dedicated surveillance of the local P. vivax population is critical. We apply a population genetic approach to gauge P. vivax transmission dynamics in the ROK between 2010 and 2012.Methodology/Principal Findings: P. vivax positive blood samples from 98 autochthonous cases were collected from patients attending health centers in the ROK in 2010 (n = 27), 2011 (n = 48) and 2012 (n = 23). Parasite genotyping was undertaken at 9 tandem repeat markers. Although not reaching significance, a trend of increasing population diversity was observed from 2010 (HE = 0.50 ± 0.11) to 2011 (HE = 0.56 ± 0.08) and 2012 (HE = 0.60 ± 0.06). Conversely, linkage disequilibrium declined during the same period: IAS = 0.15 in 2010 (P = 0.010), 0.09 in 2011 (P = 0.010) and 0.05 in 2012 (P = 0.010). In combination with data from other ROK studies undertaken between 1994 and 2007, our results are consistent with increasing parasite divergence since re-emergence. Polyclonal infections were rare (3% infections) suggesting that local out-crossing alone was unlikely to explain the increased divergence. Cases introduced from an external reservoir may therefore have contributed to the increased diversity. Aside from one isolate, all infections carried a short MS20 allele (142 or 149 bp), not observed in other studies in tropical endemic countries despite high diversity, inferring that these regions are unlikely reservoirs.Conclusions: Whilst a number of factors may explain the observed population genetic trends, the available evidence suggests that an external geographic reservoir with moderate diversity sustains the majority of P. vivax infection in the ROK, with important implications for malaria elimination.

    AB - Background: Vivax malaria was successfully eliminated from the Republic of Korea (ROK) in the late 1970s but re-emerged in 1993. Two decades later as the ROK enters the final stages of malaria elimination, dedicated surveillance of the local P. vivax population is critical. We apply a population genetic approach to gauge P. vivax transmission dynamics in the ROK between 2010 and 2012.Methodology/Principal Findings: P. vivax positive blood samples from 98 autochthonous cases were collected from patients attending health centers in the ROK in 2010 (n = 27), 2011 (n = 48) and 2012 (n = 23). Parasite genotyping was undertaken at 9 tandem repeat markers. Although not reaching significance, a trend of increasing population diversity was observed from 2010 (HE = 0.50 ± 0.11) to 2011 (HE = 0.56 ± 0.08) and 2012 (HE = 0.60 ± 0.06). Conversely, linkage disequilibrium declined during the same period: IAS = 0.15 in 2010 (P = 0.010), 0.09 in 2011 (P = 0.010) and 0.05 in 2012 (P = 0.010). In combination with data from other ROK studies undertaken between 1994 and 2007, our results are consistent with increasing parasite divergence since re-emergence. Polyclonal infections were rare (3% infections) suggesting that local out-crossing alone was unlikely to explain the increased divergence. Cases introduced from an external reservoir may therefore have contributed to the increased diversity. Aside from one isolate, all infections carried a short MS20 allele (142 or 149 bp), not observed in other studies in tropical endemic countries despite high diversity, inferring that these regions are unlikely reservoirs.Conclusions: Whilst a number of factors may explain the observed population genetic trends, the available evidence suggests that an external geographic reservoir with moderate diversity sustains the majority of P. vivax infection in the ROK, with important implications for malaria elimination.

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