Molecular markers of antimalarial resistance

Principal Investigator:       Assoc Prof Michael Alifrangis (Denmark)

Co-Investigators:              Dr Julie Gutman (USA), Dr Daniel Minja (Tanzania), 

PhD Student:                    Queen Saidi Naumanga (Tanzania)


Main objective:

To assess impact of sub-microscopic infections and molecular markers of antimalarial drug resistance on efficiency of IPTp with either standard SP or DP.

Specific objectives

  • To measure the prevalence and incidence of P. falciparum infections by PCR.
  • To measure the prevalence of molecular markers associated with SP and DP resistance in P. falciparum cross study sites and their effect on the protective efficacy of IPTp-SP and IPTp-DP.
  • To measure the impact of the IPTp strategy using either SP or DP on the possible selection of molecular markers
We will address two central research questions by applying molecular tools, the first to determine the prevalence and incidence of P. falciparum infections throughout the duration of the trial using a highly sensitive qPCR method, and the second to examine the selection and impact of molecular markers of drug resistance on the efficacy of the IPTp interventions using next generation sequencing platform. In the first study, the PCR prevalence of P. falciparum infections will be measured retrospectively in all women at enrolment in the trial (baseline) and at delivery (to measure impact). Women with clinical symptoms attending scheduled ANC and women seeking care between scheduled visits will also be examined to identify symptoms-causing infections that are not cleared by the drug interventions. In a third study, the impact of each intervention on incidence of infections will be measured retrospectively in a sub-sample of women at each ANC visit. In the second study, all P. falciparum PCR positive samples identified will be used to identify the selection and impact of molecular markers of drug resistance.