Malaria is one of the most important causes of morbidity and mortality in the developing world. Most of the deaths are in children infected by Plasmodium falciparum, a mosquito-borne protozoan parasite that invades red blood cells. Much progress has been made to reduce the burden of malaria. However, the remarkable adaptive capabilities of P. falciparum constantly undermine the efficacy of antimalarial drugs.
Next-generation whole-genome sequencing (WGS) has made it possible to sequence large numbers of P. falciparum genomes. Through significant advances in sample processing, it has now become possible to conduct large-scale population genetics studies using WGS data from dried blood spots collected in the most basic endemic settings. The MalariaGEN P. falciparum Community Project collaborates with dozens of clinical research groups and national malaria control programmes to maintain the world’s largest repository of malaria genetic data. Presently, our global studies use WGS data from nearly 7,000 clinical cases from 4 continents, and this number is rapidly increasing with falling sequencing costs. This dataset has enabled a number of significant advances in P. falciparum genetic epidemiology including the identification of genetic factors associated with resistance to artemisinin and piperaquine.Genomic data is gradually becoming incorporated in surveillance, control and elimination interventions, but this is not without challenges. It will be important for all public health and research partners to understand which capacities are to be developed in the country, and which to be acquired through partnerships.
Dr Olivo Miotto
Senior Informatics Fellow
Mahidol-Oxford Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok;
Centre for Genomics and Global Health, Oxford University, Oxford.
After graduating as a physicist at Imperial College London, Olivo worked for two decades in software engineering, first as a software developer and later as a lecturer at the National University of Singapore. In the wake of the publication of the first human genome, he thought his computing skills would be best employed to fight disease, and completed a PhD in bioinformatics. In 2008, he joined the University of Oxford, where he has led large-scale analyses of malaria genomes. Being located at the Mahidol-Oxford Research Unit in Bangkok, Olivo has been able to collaborate in key clinical studies across Southeast Asia, focussing on the emergence and spread of drug resistance. His work has been published on several respected biomedical journals, including Nature, Science, NEJM, Nature Genetics, PNAS, Lancet ID. He is currently funded by the Bill and Melinda Gates Foundation to implement a genetic surveillance platforms to inform elimination strategies in endemic countries in the region, a project that brings together public health and research partners from eight countries.