Daniel N Hupalo 1 , Zunping Luo 1 , Alexandre Melnikov 2 , Patrick L Sutton 1 , Peter Rogov 2 , Ananias Escalante 3 , Andrés F Vallejo 4 , Sócrates Herrera 4 , Myriam Arévalo-Herrera 4 , 5 , Qi Fan 6 , Ying Wang 7 , Liwang Cui 8 , Carmen M Lucas 9 , Salomon Durand 9 , Juan F Sanchez 9 , G Christian Baldeviano 9 , Andres G Lescano 9 , Moses Laman 10 , Celine Barnadas 11 , 12 , Alyssa Barry 13 , 14 , Ivo Mueller 13 , 14 , 15 , James W Kazura 16 , Alex Eapen 17 , Deena Kanagaraj 17 , Neena Valecha 18 , Marcelo U Ferreira 19 , Wanlapa Roobsoong 20 , Wang Nguitragool 21 , Jetsumon Sattabonkot 20 , Dionicia Gamboa 22 , 23 , Margaret Kosek 24 , Joseph M Vinetz 22 , 23 , 25 , Lilia González-Cerón 26 , Bruce W Birren 2 , Daniel E Neafsey 2 , Jane M Carlton 1
Plasmodium vivax is a major public health burden, responsible for the majority of malaria infections outside Africa. 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.