TY - JOUR
T1 - Regular Plasmodium falciparum importation onto Bioko Island, Equatorial Guinea, hampers malaria elimination from the island
AU - Stabler, Thomas C.
AU - Dwivedi, Ankit
AU - Guo, Bing
AU - Shrestha, Biraj
AU - Joshi, Sudhaunshu
AU - Rivas, Matilde Riloha
AU - Donfack, Olivier Tresor
AU - Guerra, Carlos A.
AU - García, Guillermo A.
AU - Daubenberger, Claudia
AU - Silva, Joana C.
N1 - Funding Information:
Work related to the BIMEP activities was funded by a private sector consortium led by Marathon Oil Corporation and the Government of Equatorial Guinea. The funders had no role in study design, data collection, data analysis, data interpretation, the decision to publish, or preparation of the manuscript. Work related to the generation of WGS data was funded by the National Institutes of Health (NIH) awards R01 AI141900 to JCS. This work was supported by the National Malaria Control Programme and the Ministry of Health and Social Welfare of Equatorial Guinea, and MCD Global Health through the Bioko Island Malaria Elimination Project (BIMEP). Specifically, we would like to thank the entire BIMEP team for their efforts conducting the 2019 MIS. Ultimately, we would like to thank Marathon Oil, Noble Energy, AMPCO (Atlantic Methanol Production Company), and the Ministry of Mines and Energy of Equatorial Guinea for their continued efforts and support for malaria control on Bioko Island. We thank the staff of the IGS\u2019s Maryland Genomics for genomic DNA library construction and sequencing.
Publisher Copyright:
© 2025 Stabler et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2025/8/19
Y1 - 2025/8/19
N2 - The Bioko Island Malaria Elimination Project (BIMEP) has made significant progress in reducing the prevalence of Plasmodium falciparum on Bioko Island, Equatorial Guinea. However, like other malaria endemic islands like São Tomé and Principe and Zanzibar, Tanzania, elimination efforts are hampered by imported infections. In an effort to understand the local transmission dynamics and the influence of importation on Bioko Island’s P. falciparum population, whole-genome sequences were generated from field samples collected during the BIMEP’s 2019 Malaria Indicator Survey (MIS). Within the sub-Saharan African context, we observed Bioko Island parasites did not significantly differentiate from nearby continental neighbors. Among Bioko infections, within-host diversity and the quantity of polyclonal infections appear similar to an area of moderate malaria transmission. However, we observed higher than expected genetic diversity among Bioko parasites, similar to high transmission areas, suggesting imported strains are contributing to transmission on the island. Among Bioko’s closest geographical neighbors, the flow of parasites with Bioko appeared more pronounced with the Gabonese parasite population, implying more importation may be coming from this region than others. Overall, despite significant investment in malaria control, results illustrate the challenges of eliminating malaria without both interrupting local transmission and accounting for importation from higher transmission areas, likely due to human migration. For there to be sustained progress towards elimination, the BIMEP needs, if feasible, to conduct targeted interventions of outgoing/incoming travelers, expand malaria control interventions to the continental region of Equatorial Guinea, and ideally conduct cross-border interventions in collaboration with the malaria control program in Gabon.
AB - The Bioko Island Malaria Elimination Project (BIMEP) has made significant progress in reducing the prevalence of Plasmodium falciparum on Bioko Island, Equatorial Guinea. However, like other malaria endemic islands like São Tomé and Principe and Zanzibar, Tanzania, elimination efforts are hampered by imported infections. In an effort to understand the local transmission dynamics and the influence of importation on Bioko Island’s P. falciparum population, whole-genome sequences were generated from field samples collected during the BIMEP’s 2019 Malaria Indicator Survey (MIS). Within the sub-Saharan African context, we observed Bioko Island parasites did not significantly differentiate from nearby continental neighbors. Among Bioko infections, within-host diversity and the quantity of polyclonal infections appear similar to an area of moderate malaria transmission. However, we observed higher than expected genetic diversity among Bioko parasites, similar to high transmission areas, suggesting imported strains are contributing to transmission on the island. Among Bioko’s closest geographical neighbors, the flow of parasites with Bioko appeared more pronounced with the Gabonese parasite population, implying more importation may be coming from this region than others. Overall, despite significant investment in malaria control, results illustrate the challenges of eliminating malaria without both interrupting local transmission and accounting for importation from higher transmission areas, likely due to human migration. For there to be sustained progress towards elimination, the BIMEP needs, if feasible, to conduct targeted interventions of outgoing/incoming travelers, expand malaria control interventions to the continental region of Equatorial Guinea, and ideally conduct cross-border interventions in collaboration with the malaria control program in Gabon.
UR - https://www.scopus.com/pages/publications/105013565559
U2 - 10.1371/journal.pgph.0004999
DO - 10.1371/journal.pgph.0004999
M3 - Article
C2 - 40828792
AN - SCOPUS:105013565559
SN - 2767-3375
VL - 5
JO - PLoS Global Public Health
JF - PLoS Global Public Health
IS - 8
M1 - e0004999
ER -
SDG 3 Good Health and Well-being