# Malaria parasite migration and emergence and spread of drug resistance

> **NIH NIH U19** · DUKE UNIVERSITY · 2020 · $68,141

## Abstract

Myanmar, the Southeast Asian country with the heaviest malaria burden, has been a historical gateway for the
dissemination of drug-resistant malaria to India and the rest of the world. The emergence of artemisinin
resistant falciparum malaria in western Cambodia and its subsequent appearance in Vietnam, Laos, China and
Myanmar has raised the specter of losing the efficacy of first-line malaria treatments in the region and
worldwide and poses a serious threat to renewed hopes for malaria eradication. Averting this grim scenario
requires aggressive measures to eliminate malaria in areas where resistance is present and in areas at high
risk of acquiring resistance through spreading or de novo mutations, and tools to identify such areas. The
previous failed attempt to eradicate malaria in the 1950s and 1960s taught us that ongoing research and
evidence-based, locally tailored public health interventions are essential for successful malaria elimination.
Tools that can help distinguish locally transmitted versus imported malaria and identify sources and sinks of
malaria transmission will also help National Malaria Control Programs target malaria elimination interventions
effectively. Using samples collected as part of Project 1 from sites within Myanmar and bordering regions of
China and Bangladesh, we propose to identify patterns of malaria parasite population structure and migration
to facilitate malaria elimination efforts and track the emergence and spread of drug-resistant parasites. The
work will be accomplished in two aims. In the first aim, we will estimate P. falciparum and P. vivax genetic
diversity and population structure over time in sites within Myanmar and bordering regions of China and
Bangladesh. This will be done by generating whole genome sequence data from both species and estimating
genetic diversity, multiplicity of infection, and population structure over multiple years. Using these data, we will
identify a minimum set of markers needed to detect population structure and to differentiate parasites from
different geographic areas at an increasingly fine scale, and we will develop an assay that can be used in-
country to track parasites in time and space. In the second aim, we will use the whole genome sequence data
from Aim 1 to estimate parasite migration rates using coalescent-based methods and methods based on
shared haplotypes that are identical-by-descent. Molecular markers of antimalarial drug resistance and flanking
loci in linkage disequilibrium with drug resistance genes will be called from whole genome sequences to
determine the prevalence and origins of drug resistance mutations. Rates of parasite migration will be
compared to estimates of human mobility determined in Project 3 and between regions with evidence of
spreading drug resistance. If successful, this project will generate actionable evidence about the structure and
movement of parasite populations that can be used to guide targeted elimination interventions an...

## Key facts

- **NIH application ID:** 9912076
- **Project number:** 5U19AI129386-04
- **Recipient organization:** DUKE UNIVERSITY
- **Principal Investigator:** CHRISTOPHER V. PLOWE
- **Activity code:** U19 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $68,141
- **Award type:** 5
- **Project period:** — → 2021-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9912076

## Citation

> US National Institutes of Health, RePORTER application 9912076, Malaria parasite migration and emergence and spread of drug resistance (5U19AI129386-04). Retrieved via AI Analytics 2026-06-14 from https://api.ai-analytics.org/grant/nih/9912076. Licensed CC0.

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