Molecular assays for antimalarial drug resistance surveillance: A target product profile

Christian Nsanzabana (1) , Frederic Ariey (2, 3) , Hans-Peter Beck (4, 5) , Xavier Ding (1) , Edwin Kamau (6, 7) , Sanjeev Krishna (8) , Eric Legrand (9) , Naomi Lucchi (10) , Olivo Miotto (11, 12, 13) , Sidsel Nag (14, 15) , Harald Noedl (16) , Cally Roper (17) , Philip Rosenthal (18) , Henk Schallig (19) , Steve Taylor (20) , Sarah Volkman (21, 22, 23) , Iveth Gonzalez (1)

1 FIND - Foundation for Innovative New Diagnostics
2 IC UM3 (UMR 8104 / U1016) - Institut Cochin
3 Service de parasitologie-mycologie [CHU Cochin]
4 MPI - Medical Parasitology and Infection Biology [Basel, Suisse]
5 Unibas - University of Basel
6 Walter Reed Army Institute of Research
7 USAMRD-K - United States Army Medical Research Directorate [Kenya]
8 Institute for Infection and Immunity [Londres, UK]
9 Génétique du paludisme et résistance - Malaria Genetics and Resistance
10 DPDM - Division of Parasitic Diseases and Malaria [Atlanta, GA, États-Unis]
11 Mahidol Oxford Tropical Medicine Research Unit
12 The Wellcome Trust Sanger Institute [Cambridge]
13 Big Data Institute
14 Centre for Medical Parasitology [Copenhagen]
15 Department of Infectious Disease [Copenhague, Danemark]
16 Institute of Specific Prophylaxis and Tropical Medicine = Institut für Spezifische Prophylaxe und Tropenmedizin [Vienne, Autriche]
17 LSHTM - London School of Hygiene and Tropical Medicine
18 Department of Medicine [San Francisco]
19 Experimental parasitology [Amsterdam, Pays-Bas]
20 Duke University Medical Center
21 IID - Department of Immunology and Infectious Diseases
22 BROAD INSTITUTE - Broad Institute of MIT and Harvard
23 Simmons University [Boston, USA]

Antimalarial drug resistance is a major constraint for malaria control and elimination efforts. Artemisinin-based combination therapy is now the mainstay for malaria treatment. However, delayed parasite clearance following treatment with artemisinin derivatives has now spread in the Greater Mekong Sub region and may emerge or spread to other malaria endemic regions. This spread is of great concern for malaria control programmes, as no alternatives to artemisinin-based combination therapies are expected to be available in the near future. There is a need to strengthen surveillance systems for early detection and response to the antimalarial drug resistance threat. Current surveillance is mainly done through therapeutic efficacy studies; however these studies are complex and both time- and resource-intensive. For multiple common antimalarials, parasite drug resistance has been correlated with specific genetic mutations, and the molecular markers associated with antimalarial drug resistance offer a simple and powerful tool to monitor the emergence and spread of resistant parasites. Different techniques to analyse molecular markers associated with antimalarial drug resistance are available, each with advantages and disadvantages. However, procedures are not adequately harmonized to facilitate comparisons between sites. Here we describe the target product profiles for tests to analyse molecular markers associated with antimalarial drug resistance, discuss how use of current techniques can be standardised, and identify the requirements for an ideal product that would allow malaria endemic countries to provide useful spatial and temporal information on the spread of resistance.

Domains: Life Sciences [q-bio]; Microbiology and Parasitology; Parasitology

Christian Nsanzabana, Frederic Ariey, Hans-Peter Beck, Xavier Ding, Edwin Kamau, et al.. Molecular assays for antimalarial drug resistance surveillance: A target product profile. PLoS ONE, 2018, 13 (9), pp.e0204347. ⟨10.1371/journal.pone.0204347⟩. ⟨pasteur-02735465⟩