# Exploring the parasite genomics of severe falciparum malaria in Mozambique

> **NIH NIH R21** · UNIVERSITY OF CALIFORNIA, SAN DIEGO · 2020 · $237,100

## Abstract

PROJECT SUMMARY/ABSTRACT
Plasmodium falciparum malaria is a devastating infection that caused 210 million symptomatic cases and
435,000 deaths in 2017, with 93% of all malaria cases occurring in the WHO African Region. Mozambique is a
country in southeastern Africa with the third highest number of malaria cases in the world. The country also
has a high prevalence of human immunodeficiency virus (HIV) infection with approximately 12.3% of persons
aged 15-49 living with HIV. HIV and malaria co-infection is associated with more frequent clinical episodes of
malaria, higher parasitemia and an impaired response to treatment. In this study, we will perform whole
genome sequencing (WGS) of P. falciparum parasites from subjects who are admitted to the hospital with
severe malaria at Maputo Central Hospital (MCH), the principal teaching hospital in Mozambique. This project
takes advantage of the strong research and educational partnership between UC San Diego and Universidade
Eduardo Mondlane in Mozambique. This study presents a unique opportunity to apply our expertise in P.
falciparum whole genome analysis to a deep exploration of drug resistance and malaria transmission in
Mozambique. Parasites from these vulnerable subjects are more susceptible to the development of
antimalarial resistance due to prior antibiotic exposure and higher parasitemia. We will evaluate the parasite
genomes for known and novel molecular markers of antimalarial resistance and determine genomic regions
under selection pressure to assess evolutionary forces on this population of parasites. Of particular
importance will be the assessment of known genetic markers of artemisinin resistance and identifying genomic
regions under selective pressure in subjects with prior treatment with artesunate derivatives or persistent
parasitemia despite treatment. Although there is no substantial evidence of resistance to artemisinin
derivatives in Africa yet, resistance is rapidly spreading in Southeast Asia and presents a major threat to global
public health. Assessing the current genomic landscape of antimalarial resistance in Africa is of vital
importance. We will compare antimalarial resistance markers and genomic pressures between parasite
sequences from HIV-infected and HIV-uninfected subjects. We will also assess the overall parasite population
structure to better understand malaria transmission in the region and identify any transmission clusters. This
study will reveal the evolutionary forces currently influencing severe malaria infection in Mozambique and help
identify key genes of interest that can serve as molecular markers for monitoring antimalarial resistance.

## Key facts

- **NIH application ID:** 9998697
- **Project number:** 1R21AI152511-01
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN DIEGO
- **Principal Investigator:** Elizabeth A Winzeler
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $237,100
- **Award type:** 1
- **Project period:** 2020-03-05 → 2022-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9998697

## Citation

> US National Institutes of Health, RePORTER application 9998697, Exploring the parasite genomics of severe falciparum malaria in Mozambique (1R21AI152511-01). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9998697. Licensed CC0.

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