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Validating the  A pplicability of Malaria Rapid Diagnostic Tests and Next Validating the  A pplicability of Malaria Rapid Diagnostic Tests and Next

Validating the A pplicability of Malaria Rapid Diagnostic Tests and Next - PowerPoint Presentation

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Validating the A pplicability of Malaria Rapid Diagnostic Tests and Next - PPT Presentation

G eneration S equencing as Platform E lements in Molecular S urveillance of P falciparum Malaria E pidemiology and Epidemic R isks Sidsel Nag Center for Medical Parasitology University of Copenhagen ID: 787520

data malaria transmission rdts malaria data rdts transmission sequencing trends falciparum sampling copenhagen countries diversity 2012 mapping evolutionary surveillance

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Slide1

Validating the Applicability of Malaria Rapid Diagnostic Tests and Next Generation Sequencing as Platform Elements in Molecular Surveillance of P. falciparum Malaria Epidemiology and Epidemic Risks

Sidsel Nag Center for Medical ParasitologyUniversity of Copenhagen

The 2

nd Kilimanjaro International PhD symposium November 27th-29th 2013

Slide2

Test: Malaria rapid diagnostic test (RDTs):Malaria cases confirmed prior to treatment

20052011

Globally68 %

77 %WHO Africa region20 %

47 %

Treat: Artemisinin combination therapies (ACTs):

Track: ….

Efficacy = >95 % in SSA

According to WHO Malaria Report 2012

WHO guidelines

Slide3

Guidelines for Malaria surveillance WHO Malaria Report 2012 Countries in control phase Identify hotspots and

hotpops for targeted intervention Identify trends (epidemics, decreasing malaria or lack thereof…) Assess if control measures are effective

Countries in elimination phase Detect all malaria cases

Reactive case detection (assess the geographical origin of the infection) Focus on local areas with transmission

Slide4

WHO Malaria Report 2012 Only ~10 % of all malaria cases globally are reported

41 out of 99 countries were unable to submit sufficient data in 2011

to evaluate malaria trends

41 out of 99 countries are estimated to represent 85 % of global malaria burden

Estimates from WHO 2012

Slide5

Molecular surveillance Transmission data Parasite genetics

Resistance markers Evolutionary trends

Geographical mapping of parasite haplotypes

Human serum, antibodies

Slide6

Malaria Rapid Diagnostic Tests(RDTs) Antibodies for transmission data

Resistance markers Optimizing non-targeted sequencing based on DNA material extracted from RDTs

Slide7

Next generation sequencing(NGS) Burkina Faso and Mali

KenyaThailand

Cambodia

Papua New GuineaFrom Science, June 13th 2012Analysis of Plasmodium falciparum diversity in natural infections by deep sequencing. Magnus Manske

et al.

Genetic diversity of P. falciparum from chosen areas

Can mapping be

done on

a regional level??

Evolutionary development of P. falciparum from chosen locations across malaria seasons

 What role does transmission intensity and transmission fluctuations play?

Time

Transmission

intensity

Differences in diversity?

Detectable evolutionary trends?

Slide8

Bandim

Cacheu

Gabu

Mwanza

Tanga

Magu

Sengerema

Misungwi

Korogwe

Magoda

Teule

Mukuzi

Guinea-Bissau

Tanzania

Sampling sites

(tentative)

Slide9

Sampling procedures (tentative)

Febrile patient

Diagnosis

RDT

dries

Storage

Collection

Strips

are

packed

individually

Copenhagen

RDTs

All study sites

All

used RDTs

Monthly basis

18 months

Slide10

Sampling procedures (tentative)Blood samples

Positive malaria

diagnosis

Blood

sample

Centrifugation

Separation of

buffy

coat

Storage

Copenhagen

Only major study sites (one from each area)

100

infections per season (high and low if applicable)

18 months

Slide11

Objective: Concept developmentMaximum RDT potential

Sampling, storage procedures Cost-effective methodology

Applicable NGS data

Evolutionary insight

 relevant for approaches for control and elimination

Diversity, mapping

Geographical mapping based on

barcoding

?

Whole-genome sequencing based on RDTs?

Slide12

Data sharingDrugresistancemaps.org

PlasmoDB (and

others)

Open access data, as real time as possible

Slide13

Collaborators: Bandim Health ProjectGuinea Bissau Amabelia Rodriguez NIMR Mwanza and Tanga Alphaxard Manjurano and Tanzania Deus Ishengoma

Acknowledgements

Slide14

Principal supervisor: Michael Alifrangis University of Copenhagen Co-supervisors: Ole Lund and Frank Møller Aarestrup Technical University of Denmark Poul-Erik Kofoed

University of Southern Denmark Johan Ursing Karolinska Institute, Stockholm

Supervisors

Acknowledgements

Slide15

Thank you for listening Ideas, collaboration, criticism: we would appreciate all of itIf you have any samples you would like us to sequence, don’t hesitate to ask!!

sidselnag@sund.ku.dk