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Liked by Patrick L. Sutton, PhD
Experience & Education
Publications
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The burden of submicroscopic and asymptomatic malaria in India revealed from epidemiology studies at three varied transmission sites in India
Scientific Reports
Malaria in India, while decreasing, remains a serious public health problem, and the contribution of submicroscopic and asymptomatic infections to its persistence is poorly understood. We conducted community surveys and clinic studies at three sites in India differing in their eco-epidemiologies: Chennai (Tamil Nadu), Nadiad (Gujarat), and Rourkela (Odisha), during 2012–2015. A total of 6,645 subject blood samples were collected for Plasmodium diagnosis by microscopy and PCR, and an extensive…
Malaria in India, while decreasing, remains a serious public health problem, and the contribution of submicroscopic and asymptomatic infections to its persistence is poorly understood. We conducted community surveys and clinic studies at three sites in India differing in their eco-epidemiologies: Chennai (Tamil Nadu), Nadiad (Gujarat), and Rourkela (Odisha), during 2012–2015. A total of 6,645 subject blood samples were collected for Plasmodium diagnosis by microscopy and PCR, and an extensive clinical questionnaire completed. Malaria prevalence ranged from 3–8% by PCR in community surveys (24 infections in Chennai, 56 in Nadiad, 101 in Rourkela), with Plasmodium vivax dominating in Chennai (70.8%) and Nadiad (67.9%), and Plasmodium falciparum in Rourkela (77.3%). A proportional high burden of asymptomatic and submicroscopic infections was detected in community surveys in Chennai (71% and 71%, respectively, 17 infections for both) and Rourkela (64% and 31%, 65 and 31 infections, respectively). In clinic studies, a proportional high burden of infections was identified as submicroscopic in Rourkela (45%, 42 infections) and Chennai (19%, 42 infections). In the community surveys, anemia and fever were significantly more common among microscopic than submicroscopic infections. Exploratory spatial analysis identified a number of potential malaria hotspots at all three sites. There is a considerable burden of submicroscopic and asymptomatic malaria in malarious regions in India, which may act as a reservoir with implications for malaria elimination strategies.
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Characterizing antibody responses to Plasmodium vivax and Plasmodium falciparum antigens in India using genome-scale protein microarrays
PLOS Neglected Tropical Disease (NTD)
Understanding naturally acquired immune responses to Plasmodium in India is key to improving malaria surveillance and diagnostic tools. Here we describe serological profiling of immune responses at three sites in India by probing protein microarrays consisting of 515 Plasmodium vivax and 500 Plasmodium falciparum proteins with 353 plasma samples. A total of 236 malaria-positive (symptomatic and asymptomatic) plasma samples and 117 malaria-negative samples were collected at three field sites in…
Understanding naturally acquired immune responses to Plasmodium in India is key to improving malaria surveillance and diagnostic tools. Here we describe serological profiling of immune responses at three sites in India by probing protein microarrays consisting of 515 Plasmodium vivax and 500 Plasmodium falciparum proteins with 353 plasma samples. A total of 236 malaria-positive (symptomatic and asymptomatic) plasma samples and 117 malaria-negative samples were collected at three field sites in Raurkela, Nadiad, and Chennai. Indian samples showed significant seroreactivity to 265 P. vivax and 373 P. falciparum antigens, but overall seroreactivity to P. vivax antigens was lower compared to P. falciparum antigens. We identified the most immunogenic antigens of both Plasmodium species that were recognized at all three sites in India, as well as P. falciparum antigens that were associated with asymptomatic malaria. This is the first genome-scale analysis of serological responses to the two major species of malaria parasite in India. The range of immune responses characterized in different endemic settings argues for targeted surveillance approaches tailored to the diverse epidemiology of malaria across the world.
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The use of mosquito repellents at three sites in India with declining malaria transmission: surveys in the community and clinic
Parasites & Vectors
The use of repellents was examined at the household level during a census, and at the individual level in cross-sectional surveys and among patients visiting a clinic with fever or other symptoms. Factors associated with their use were examined in a multivariate analysis, and the association between malaria and the use of repellents was assessed among survey- and clinic participants. Repellents are widely used in India. Their use is influenced by the level of education and socio-economic…
The use of repellents was examined at the household level during a census, and at the individual level in cross-sectional surveys and among patients visiting a clinic with fever or other symptoms. Factors associated with their use were examined in a multivariate analysis, and the association between malaria and the use of repellents was assessed among survey- and clinic participants. Repellents are widely used in India. Their use is influenced by the level of education and socio-economic status. Information on effectiveness and guidance on choices may improve rational use.
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Population genomics studies identify signatures of global dispersal and drug resistance in Plasmodium vivax
Nature Genetics
We explored the impact of demographic history and selective pressures on the P. vivax genome by sequencing 182 clinical isolates sampled from 11 countries across the globe, using hybrid selection to overcome human DNA contamination. We confirmed previous reports of high genomic diversity in P. vivax relative to the more virulent Plasmodium falciparum species; regional populations of P. vivax exhibited greater diversity than the global P. falciparum population, indicating a large and/or stable…
We explored the impact of demographic history and selective pressures on the P. vivax genome by sequencing 182 clinical isolates sampled from 11 countries across the globe, using hybrid selection to overcome human DNA contamination. We confirmed previous reports of high genomic diversity in P. vivax relative to the more virulent Plasmodium falciparum species; regional populations of P. vivax exhibited greater diversity than the global P. falciparum population, indicating a large and/or stable population. Signals of natural selection suggest that P. vivax is evolving in response to antimalarial drugs and is adapting to regional differences in the human host and the mosquito vector. These findings underline the variable epidemiology of this parasite species and highlight the breadth of approaches that may be required to eliminate P. vivax globally.
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Characterizing the genetic diversity of the monkey malaria parasite Plasmodium cynomolgi
Infection, Genetics and Evolution
While genomes of three P. cynomolgi strains have been sequenced, genetic diversity of P. cynomolgi has not been widely investigated. To address this we developed the first panel of P. cynomolgi microsatellite markers to genotype eleven P. cynomolgi laboratory strains and 18 field isolates from Sarawak, Malaysian Borneo. We found diverse genotypes among most of the laboratory strains, though two nominally different strains were found to be genetically identical. We also investigated sequence…
While genomes of three P. cynomolgi strains have been sequenced, genetic diversity of P. cynomolgi has not been widely investigated. To address this we developed the first panel of P. cynomolgi microsatellite markers to genotype eleven P. cynomolgi laboratory strains and 18 field isolates from Sarawak, Malaysian Borneo. We found diverse genotypes among most of the laboratory strains, though two nominally different strains were found to be genetically identical. We also investigated sequence polymorphism in two erythrocyte invasion gene families, the rbp and dbp genes, in these strains. We also observed copy number variation in rbp genes.
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What is the value of reactive case detection in malaria control? A case-study in India and a systematic review
Malaria Journal
Reactive case detection (RCD) for malaria is a strategy to identify additional malaria infections in areas of low malaria transmission and can complement passive surveillance. This study describes experiences with RCD in two Indian sites, and aimed to synthesize experiences with RCD across endemic countries.
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Malaria Diagnosis Across the International Centers of Excellence for Malaria Research: Platforms, Performance, and Standardization
American Journal of Tropical Medicine and Hygiene
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Chloroquine efficacy studies confirm drug susceptibility of Plasmodium vivax in Chennai, India
Malaria Journal
The authors investigated chloroquine sensitivity of Plasmodium vivax among infected patients in Chennai. The study included a longitudinal in vivo efficacy study to monitor the clearance and recurrence of parasite infection, and in vitro drug assays to monitor chloroquine resistance. Microsatellite genotyping also revealed a highly diverse and heterogeneous parasite population. There was no relation between mutations occurring in the P. vivax multidrug resistant gene-1 and IC50 values.
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A call to arms: on refining Plasmodium vivax microsatellite marker panels for comparing global diversity
Malaria Journal
A comprehensive analysis of the different Plasmodium vivax microsatellites used in different studies. It is suggested that the use of a standard set of microsatellites would ease comparisons between different study sites.
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Mutant pfcrt "SVMNT" haplotype and wild type pfmdr1 "N86" are endemic in Plasmodium vivax dominated areas of India under high chloroquine exposure
Malaria Journal
In this study, the distribution of pfcrt haplotypes and the pfmdr-1 mutation (N86Y) has been described across 11 sites in India and evaluated for a correlation between the prevalence of mutations and the clinical outcome of chloroquine treatment.
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Sexual recombination is a signature of a persisting malaria epidemic in Peru
Malaria Journal
A hypothesis that sexual recombination is important to determine the local subpopulation structure, based on the analysis of a longitudinal dataset.
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Plasmodium falciparum genetic diversity maintained and amplified over five years of a low transmission endemic in the Peruvian Amazon.
Molecular Biology and Evolution
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The Plasmodium falciparum merozoite surface protein-1 19 KD antibody response in the Peruvian Amazon predominantly targets the non-allele specific, shared sites of this antigen
Malaria Journal
The authors point out that vaccine development must overcome strain-specific responses and they offer interesting data from the Peruvian Amazon on the development of diversity in an area that had eliminated malaria for 30 years before it re-emerged.
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Multimodal signaling: the relative importance of chemical and visual cues from females to the behaviour of male wolf spiders (Lycosidae)
Animal Behaviour
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Plasmodium falciparum and Plasmodium vivax infections in the Peruvian Amazon: propagation of complex, multiple allele-type infections without superinfection
American Journal of Tropical Medicine and Hygiene
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