Genomic Epidemiology in Filarial Nematodes: Transforming the Basis for Elimination Program Decisions
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Date
2020-01-09
Journal Title
Journal ISSN
Volume Title
Publisher
Frontiers in Genetics
Abstract
Onchocerciasis and lymphatic filariasis are targeted for elimination, primarily using mass
drug administration at the country and community levels. Elimination of transmission is the
onchocerciasis target and global elimination as a public health problem is the end point for
lymphatic filariasis. Where program duration, treatment coverage, and compliance are
sufficiently high, elimination is achievable for both parasites within defined geographic
areas. However, transmission has re-emerged after apparent elimination in some areas,
and in others has continued despite years of mass drug treatment. A critical question is
whether this re-emergence and/or persistence of transmission is due to persistence of
local parasites—i.e., the result of insufficient duration or drug coverage, poor parasite
response to the drugs, or inadequate methods of assessment and/or criteria for
determining when to stop treatment—or due to re-introduction of parasites via human
or vector movement from another endemic area. We review recent genetics-based
research exploring these questions in Onchocerca volvulus, the filarial nematode that
causes onchocerciasis, and Wuchereria bancrofti, the major pathogen for lymphatic
filariasis. We focus in particular on the combination of genomic epidemiology and
genome-wide associations to delineate transmission zones and distinguish between
local and introduced parasites as the source of resurgence or continuing transmission,
and to identify genetic markers associated with parasite response to chemotherapy. Our
ultimate goal is to assist elimination efforts by developing easy-to-use tools that
incorporate genetic information about transmission and drug response for more
effective mass drug distribution, surveillance strategies, and decisions on when to stop
interventions to improve sustainability of elimination
Description
Research Article
Keywords
population genomics, onchocerciasis, lymphatic filariasis, transmission, parasite elimination, drug resistance, epidemiology
Citation
Hedtke SM, Kuesel AC, Crawford KE, Graves PM, Boussinesq M, Lau CL, Boakye DA and Grant WN (2020) Genomic Epidemiology in Filarial Nematodes: Transforming the Basis for Elimination Program Decisions. Front. Genet. 10:1282. doi: 10.3389/fgene.2019.01282