Accès ouvert

Imported malaria predominates in near-elimination settings in Southwestern Uganda

Article scientifique 2026 Anglais

Résumé

Background: Malaria transmission in southwestern Uganda is low, but persists despite ongoing control efforts. Identifying whether infections are locally sustained or imported by travelers is critical for guiding interventions. We integrated epidemiologic surveillance with parasite genomics to characterize imported malaria episodes at three health facilities in southwestern Uganda. Methods: HatTeR, a highly sensitive multiplex amplicon sequencing panel targeting 165 diversity markers and 38 drug resistance loci. Complexity of infection and pairwise relatedness were estimated using MOIRE and Dcifer, respectively. Plasmotrack, a Bayesian transmission network framework, was used to infer network structure, transmission directionality, reproduction numbers, and importation rates. Results: Amongst malaria cases, recent overnight travel was common in Maziba (87%) and Muko (96%) but infrequent in Kamwezi (12%). Most travel in cases from Maziba and Muko was from high-transmission regions in northern and eastern Uganda. Parasites in Maziba and Muko cases exhibited higher within-host diversity and lower within-site relatedness compared to those in Kamwezi cases. Transmission network inference identified most infections in Maziba and Muko as imported, with the majority of inferred secondary transmission linked to recent travelers. In contrast, Kamwezi showed multiple highly related clusters, indicating sustained local transmission. Validated and candidate markers of artemisinin partial resistance (K13 P441L and R561H) were more prevalent in Kamwezi. Conclusion: Malaria in Maziba and Muko was driven largely by importation from other parts of Uganda, while local transmission played a larger role in Kamwezi . Tailored interventions addressing travel-associated risks and local transmission, supported by travel histories and parasite genetic data will be valuable to advance malaria elimination in this region.

Citer ce document

Mbabazi, M., Kiyaga, S., Katairo, T., Kabbale, K., Asua, V., Kagurusi, B., Wiringilimaana, I., Nsengimaana, B., Semakuba, F., Nakasaanya, J., Ayitewala, A., Watyekele, E., Nabende, I., Kayondo, T., Arinaitwe, E., Mulondo, J., Tukwasibwe, S., Nsobya, S., Agaba, B., Maiteki‐Sebuguzi, C., Jjingo, D., Kateete, D., Kamya, M., Ssewanyana, I., Aranda-Diaz, A., Conrad, M., Murphy, M., Gerlovina, I., Epstein, A., Rodríguez-Barraquer, I., Rosenthal, P., Dorsey, G., Greenhouse, B., Briggs, J. (2026). Imported malaria predominates in near-elimination settings in Southwestern Uganda. https://doi.org/10.1371/journal.pgph.0005951

Accès au document

Texte intégral en lecture en ligne, réservé aux abonnés SPHAERO et aux membres de l'institution. Se connecter

Voir l'article sur le site de la revue

Auteur(s)

Monica Mbabazi Shahiid Kiyaga Thomas Katairo Kisakye Diana Kabbale Victor Asua Brian A. Kagurusi Innocent Wiringilimaana Bienvenu Nsengimaana Francis D Semakuba Jackie Nakasaanya Alisen Ayitewala Eric Watyekele Isaiah Nabende Tonny Max Kayondo Emmanuel Arinaitwe Jerry Mulondo Stephen Tukwasibwe Samuel L. Nsobya Bosco Agaba Catherine Maiteki‐Sebuguzi Daudi Jjingo David Patrick Kateete Moses R. Kamya Isaac Ssewanyana Andres Aranda-Diaz Melissa D. Conrad Maxwell Murphy Inna Gerlovina Adrienne Epstein Isabel Rodríguez-Barraquer Philip J. Rosenthal Grant Dorsey Bryan Greenhouse Jessica Briggs

Statistiques

Consultations : 1

Téléchargements : 0