Bibliographic citations
Ramirez, R., (2024). Micro-epidemiología molecular de las infecciones que contribuyen a mantener la transmisión de Plasmodium vivax en comunidades en vías de eliminación de la malaria en la Región Loreto [Universidad Peruana Cayetano Heredia]. https://hdl.handle.net/20.500.12866/16534
Ramirez, R., Micro-epidemiología molecular de las infecciones que contribuyen a mantener la transmisión de Plasmodium vivax en comunidades en vías de eliminación de la malaria en la Región Loreto []. PE: Universidad Peruana Cayetano Heredia; 2024. https://hdl.handle.net/20.500.12866/16534
@phdthesis{renati/1281935,
title = "Micro-epidemiología molecular de las infecciones que contribuyen a mantener la transmisión de Plasmodium vivax en comunidades en vías de eliminación de la malaria en la Región Loreto",
author = "Ramirez Saavedra, Roberson",
publisher = "Universidad Peruana Cayetano Heredia",
year = "2024"
}
Malaria transmission is a persistent public health problem in the Peruvian Amazon. This persistence is reflected in the increased morbidity of cases caused by P. vivax in a micro-epidemiological context of residual malaria within the Peruvian Amazon. For this reason, there is an urgent need to use tools such as population genetics and genomics to help explain the maintenance of residual malaria transmission at the micro- epidemiological level. The overall objective of this study was to molecularly characterize the micro-epidemiology of P. vivax infections that contribute to the maintenance of transmission in remote communities undergoing malaria elimination. The results in Chapter 1 of this thesis highlight the presence of 40% submicroscopic infections, with high genetic diversity (He=0.70 ± 0.10) with no significant changes (p-value>0.05) between 2013 and 2015-2016 and the other metrics of genetic diversity. Clonal parasites and lineages with different origins were also found, plus the presence of gene flow (Fst>0.5) evidenced by the entry of new genetically unrelated parasites. Due to this last finding, Chapter 2 of this thesis was developed, where the infected travelers were evaluated and the mobilization and human mobilization were characterized, and the population genomic diversity and genetic relationships of the parasites collected in Libertad and Urcomiraño were also evaluated. We found 21.0% of Plasmodium spp. infections in travelers, 89% of these infections were submicroscopic. Human mobilization was heterogeneous with frequent trips to Mazan, Iquitos and creeks. Finally, the parasites collected showed low genomic diversity, with clonal populations (IBD=90%), presence of gene flow (Fst=0.15-0.25) between Libertad and Urcomiraño, plus clonal lineages that have been maintained according to the time of collection and the geographic proximity to the collection site. In conclusion, submicroscopic infections as well as human mobilization are having a role in maintaining residual malaria transmission, at level of parasite genetics, that contributes with the malaria micro-epidemiology in the communities included in this study.
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