Hapuarachchige Chanditha Hapuarachchi
Current Organizations / Institutes
The organizations/institutes from the scholar's latest article
Research Subjects
Hapuarachchige Chanditha Hapuarachchi has a total of 337 co-authors. Here are the top co-authors by number of shared publications:
- Lee Ching Ng
Environmental Health Institute, National Environment Agency, Singapore, Singapore
24 shared publications Carmen Koo
Environmental Health Institute, National Environment Agency, Singapore 138667, Singapore
11 shared publicationsLee Ching Ng
Environmental Health Institute, National Environment Agency, Singapore, Singapore
9 shared publicationsLee-Ching Ng
Environmental Health Institute, National Environment Agency, 11, Biopolis Way, #06-05-08, Singapore 138667; School of Biological Sciences, Nanyang Technological University, 60 Nanyang Drive, Singapore 637551
9 shared publications- Carmen Koo
Environmental Health Institute, National Environment Agency, Singapore, Singapore
6 shared publications Grace Yap
Environmental Health Institute, National Environment Agency, Singapore, Singapore
6 shared publications
Latest Publications
- Open Access
- 1 December 2025
- Published by IOP Publishing in Machine Learning: Health
- Vol. 1 (1) , 015015
Inferring the hidden and long-range dengue transmission routes in Singapore
The dengue virus, a major global health problem, is transmitted via a vector-host epidemic model (i.e. mosquito to human). Even though mosquitoes have a limited flight range, dengue spreads much further, suggesting that human movement plays a significant role in its transmission. To model this, we developed a host–host space-time transmission framework by simplifying the traditional host–vector-host model. Using simulated infection cascades based on residential locations and report times, we demonstrated that it is possible to infer hidden transmission routes between infected locations. Applying our method to Singapore’s dengue data from 2008 to 2022, we found that the inferred transmission networks captured informative patterns and shifts annually. While our model could reasonably predict future infections, its precision was limited by the stochastic nature of real-world outbreaks and incomplete case reporting. We improved prediction accuracy by incorporating historical hotspot patterns and virus genetic fingerprinting data. Our main contribution is demonstrating that hidden long-range dengue transmission routes, likely driven by human mobility, can be inferred directly from infection surveillance data at a fine spatial resolution of 1 km2, without requiring explicit human mobility datasets. Our framework allows weekly forecasts of new infections at a 1 km2 resolution and can be applied to other diseases with spatial and temporal tagging. The observed shifts of transmission networks highlight the limitations of static mobility-based models. This work shows that surveillance and genomic data can be leveraged to guide dynamic, data-driven disease control strategies.
- 1 December 2025
- Published by IOP Publishing in Machine Learning: Health
- Vol. 1 (1) , 015015
Open AccessInferring the hidden and long-range dengue transmission routes in Singapore
The dengue virus, a major global health problem, is transmitted via a vector-host epidemic model (i.e. mosquito to human). Even though mosquitoes have a limited flight range, dengue spreads much further, suggesting that human movement plays a significant role in its transmission. To model this, we developed a host–host space-time transmission framework by simplifying the traditional host–vector-host model. Using simulated infection cascades based on residential locations and report times, we demonstrated that it is possible to infer hidden transmission routes between infected locations. Applying our method to Singapore’s dengue data from 2008 to 2022, we found that the inferred transmission networks captured informative patterns and shifts annually. While our model could reasonably predict future infections, its precision was limited by the stochastic nature of real-world outbreaks and incomplete case reporting. We improved prediction accuracy by incorporating historical hotspot patterns and virus genetic fingerprinting data. Our main contribution is demonstrating that hidden long-range dengue transmission routes, likely driven by human mobility, can be inferred directly from infection surveillance data at a fine spatial resolution of 1 km2, without requiring explicit human mobility datasets. Our framework allows weekly forecasts of new infections at a 1 km2 resolution and can be applied to other diseases with spatial and temporal tagging. The observed shifts of transmission networks highlight the limitations of static mobility-based models. This work shows that surveillance and genomic data can be leveraged to guide dynamic, data-driven disease control strategies.
- Open Access
- 4 December 2024
- Published by Instituto Nacional de Salud (Peru) in Revista Peruana de Medicina Experimental Y Salud Pública
- Vol. 41 (4) , 375-84
Rapid spread of the emerging cosmopolitan genotype of dengue virus serotype 2, and expansion of dengue virus serotype 1 genotype V in Peru
Objectives. This study aimed to evaluate the prevalence and distribution of dengue virus genotype V serotype 1 (DENV-1) and cosmopolitan genotype serotype 2 (DENV-2) in Peru between 2019 and 2022. Materials and methods. The envelope (E) gene region was amplified from 79 serum samples by polymerase chain reaction (PCR) and sequenced by next-generation sequencing (NGS) technology. The obtained sequences were subsequently analyzed with bioinformatics tools. Results. The study generated envelope gene sequences of DENV-1 and DENV-2 serotypes. Our study revealed a rapid dispersal and wide distribution of the cosmopolitan DENV-2 genotype in several regions of Peru in 2022, as well as the spread of DENV-1 genotype V to new Peruvian regions, along with the cosmopolitan DENV-2 genotype. Conclusions. Our findings suggest the urgent need to strengthen epidemiological and genomic surveillance systems to understand and control the spread of circulating DENV genotypes in Peru. This will allow a more rapid response, as well as the monitoring of its potential dissemination to other countries in the Americas.
- 4 December 2024
- Published by Instituto Nacional de Salud (Peru) in Revista Peruana de Medicina Experimental Y Salud Pública
- Vol. 41 (4) , 375-84
Open AccessRapid spread of the emerging cosmopolitan genotype of dengue virus serotype 2, and expansion of dengue virus serotype 1 genotype V in Peru
Objectives. This study aimed to evaluate the prevalence and distribution of dengue virus genotype V serotype 1 (DENV-1) and cosmopolitan genotype serotype 2 (DENV-2) in Peru between 2019 and 2022. Materials and methods. The envelope (E) gene region was amplified from 79 serum samples by polymerase chain reaction (PCR) and sequenced by next-generation sequencing (NGS) technology. The obtained sequences were subsequently analyzed with bioinformatics tools. Results. The study generated envelope gene sequences of DENV-1 and DENV-2 serotypes. Our study revealed a rapid dispersal and wide distribution of the cosmopolitan DENV-2 genotype in several regions of Peru in 2022, as well as the spread of DENV-1 genotype V to new Peruvian regions, along with the cosmopolitan DENV-2 genotype. Conclusions. Our findings suggest the urgent need to strengthen epidemiological and genomic surveillance systems to understand and control the spread of circulating DENV genotypes in Peru. This will allow a more rapid response, as well as the monitoring of its potential dissemination to other countries in the Americas.
- Open Access
- 28 May 2024
- Published by Frontiers Media SA in Frontiers in Genetics
- Vol. 15, 1368843
Molecular epidemiology of dengue in Malaysia: 2015–2021
Dengue has been one of the major public health problems in Malaysia for decades. Over 600,000 dengue cases and 1,200 associated fatalities have been reported in Malaysia from 2015 to 2021, which was 100% increase from the cumulative total of dengue cases reported during the preceding 07-year period from 2008 to 2014. However, studies that describe the molecular epidemiology of dengue in Malaysia in recent years are limited. In the present study, we describe the genetic composition and dispersal patterns of Dengue virus (DENV) by using 4,004 complete envelope gene sequences of all four serotypes (DENV-1 = 1,567, DENV-2 = 1,417, DENV-3 = 762 and DENV-4 = 258) collected across Malaysia from 2015 to 2021. The findings revealed that DENV populations in Malaysia were highly diverse, and the overall heterogeneity was maintained through repetitive turnover of genotypes. Phylogeography analyses suggested that DENV dispersal occurred through an extensive network, mainly among countries in South and East Asia and Malaysian states, as well as among different states, especially within Peninsular Malaysia. The results further suggested Selangor and Johor as major hubs of DENV emergence and spread in Malaysia.
- 28 May 2024
- Published by Frontiers Media SA in Frontiers in Genetics
- Vol. 15, 1368843
Open AccessMolecular epidemiology of dengue in Malaysia: 2015–2021
Dengue has been one of the major public health problems in Malaysia for decades. Over 600,000 dengue cases and 1,200 associated fatalities have been reported in Malaysia from 2015 to 2021, which was 100% increase from the cumulative total of dengue cases reported during the preceding 07-year period from 2008 to 2014. However, studies that describe the molecular epidemiology of dengue in Malaysia in recent years are limited. In the present study, we describe the genetic composition and dispersal patterns of Dengue virus (DENV) by using 4,004 complete envelope gene sequences of all four serotypes (DENV-1 = 1,567, DENV-2 = 1,417, DENV-3 = 762 and DENV-4 = 258) collected across Malaysia from 2015 to 2021. The findings revealed that DENV populations in Malaysia were highly diverse, and the overall heterogeneity was maintained through repetitive turnover of genotypes. Phylogeography analyses suggested that DENV dispersal occurred through an extensive network, mainly among countries in South and East Asia and Malaysian states, as well as among different states, especially within Peninsular Malaysia. The results further suggested Selangor and Johor as major hubs of DENV emergence and spread in Malaysia.
- Open Access
Assessing the Risk of Dengue Virus Local Transmission: Study on Vector Competence of Italian Aedes albopictus
The frequency of locally transmitted dengue virus (DENV) infections has increased in Europe in recent years, facilitated by the invasive mosquito species Aedes albopictus, which is well established in a large area of Europe. In Italy, the first indigenous dengue outbreak was reported in August 2020 with 11 locally acquired cases in the Veneto region (northeast Italy), caused by a DENV-1 viral strain closely related to a previously described strain circulating in Singapore and China. In this study, we evaluated the vector competence of two Italian populations of Ae. albopictus compared to an Ae. aegypti lab colony. We performed experimental infections using a DENV-1 strain that is phylogenetically close to the strain responsible for the 2020 Italian autochthonous outbreak. Our results showed that local Ae. albopictus is susceptible to infection and is able to transmit the virus, confirming the relevant risk of possible outbreaks starting from an imported case.
Open AccessAssessing the Risk of Dengue Virus Local Transmission: Study on Vector Competence of Italian Aedes albopictus
The frequency of locally transmitted dengue virus (DENV) infections has increased in Europe in recent years, facilitated by the invasive mosquito species Aedes albopictus, which is well established in a large area of Europe. In Italy, the first indigenous dengue outbreak was reported in August 2020 with 11 locally acquired cases in the Veneto region (northeast Italy), caused by a DENV-1 viral strain closely related to a previously described strain circulating in Singapore and China. In this study, we evaluated the vector competence of two Italian populations of Ae. albopictus compared to an Ae. aegypti lab colony. We performed experimental infections using a DENV-1 strain that is phylogenetically close to the strain responsible for the 2020 Italian autochthonous outbreak. Our results showed that local Ae. albopictus is susceptible to infection and is able to transmit the virus, confirming the relevant risk of possible outbreaks starting from an imported case.
- Open Access
Genetic Diversity and Dispersal of DENGUE Virus among Three Main Island Groups of the Philippines during 2015–2017
Dengue has been one of the major public health concerns in the Philippines for more than a century. The annual dengue case burden has been increasing in recent years, exceeding 200,000 in 2015 and 2019. However, there is limited information on the molecular epidemiology of dengue in the Philippines. We, therefore, conducted a study to understand the genetic composition and dispersal of DENV in the Philippines from 2015 to 2017 under UNITEDengue. Our analyses included 377 envelope (E) gene sequences of all 4 serotypes obtained from infections in 3 main island groups (Luzon, Visayas, and Mindanao) of the Philippines. The findings showed that the overall diversity of DENV was generally low. DENV-1 was relatively more diverse than the other serotypes. Virus dispersal was evident among the three main island groups, but each island group demonstrated a distinct genotype composition. These observations suggested that the intensity of virus dispersal was not substantive enough to maintain a uniform heterogeneity among island groups so that each island group behaved as an independent epidemiological unit. The analyses suggested Luzon as one of the major sources of DENV emergence and CAR, Calabarzon, and CARAGA as important hubs of virus dispersal in the Philippines. Our findings highlight the importance of virus surveillance and molecular epidemiological analyses to gain deep insights into virus diversity, lineage dominance, and dispersal patterns that could assist in understanding the epidemiology and transmission risk of dengue in endemic regions.
Open AccessGenetic Diversity and Dispersal of DENGUE Virus among Three Main Island Groups of the Philippines during 2015–2017
Dengue has been one of the major public health concerns in the Philippines for more than a century. The annual dengue case burden has been increasing in recent years, exceeding 200,000 in 2015 and 2019. However, there is limited information on the molecular epidemiology of dengue in the Philippines. We, therefore, conducted a study to understand the genetic composition and dispersal of DENV in the Philippines from 2015 to 2017 under UNITEDengue. Our analyses included 377 envelope (E) gene sequences of all 4 serotypes obtained from infections in 3 main island groups (Luzon, Visayas, and Mindanao) of the Philippines. The findings showed that the overall diversity of DENV was generally low. DENV-1 was relatively more diverse than the other serotypes. Virus dispersal was evident among the three main island groups, but each island group demonstrated a distinct genotype composition. These observations suggested that the intensity of virus dispersal was not substantive enough to maintain a uniform heterogeneity among island groups so that each island group behaved as an independent epidemiological unit. The analyses suggested Luzon as one of the major sources of DENV emergence and CAR, Calabarzon, and CARAGA as important hubs of virus dispersal in the Philippines. Our findings highlight the importance of virus surveillance and molecular epidemiological analyses to gain deep insights into virus diversity, lineage dominance, and dispersal patterns that could assist in understanding the epidemiology and transmission risk of dengue in endemic regions.
- Open Access
Isolation and Genetic Characterization of Japanese Encephalitis Virus Two Decades after Its Elimination in Singapore
Japanese encephalitis virus (JEV) is an important arbovirus in Asia that can cause serious neurological disease. JEV is transmitted by mosquitoes in an enzootic cycle involving porcine and avian reservoirs, in which humans are accidental, dead-end hosts. JEV is currently not endemic in Singapore, after pig farming was abolished in 1992; the last known human case was reported in 2005. However, due to its location along the East-Asian Australasian Flyway (EAAF), Singapore is vulnerable to JEV re-introduction from the endemic regions. Serological and genetic evidence in the last decade suggests JEV’s presence in the local fauna. In the present study, we report the genetic characterization and the first isolation of JEV from 3214 mosquito pools consisting of 41,843 Culex mosquitoes, which were trapped from April 2014 to May 2021. The findings demonstrated the presence of genotype I of JEV (n = 10), in contrast to the previous reports of the presence of genotype II of JEV in Singapore. The genetic analyses also suggested that JEV has entered Singapore on several occasions and has potentially established an enzootic cycle in the local fauna. These observations have important implications in the risk assessment and the control of Japanese encephalitis in non-endemic countries, such as Singapore, that are at risk for JEV transmission.
Open AccessIsolation and Genetic Characterization of Japanese Encephalitis Virus Two Decades after Its Elimination in Singapore
Japanese encephalitis virus (JEV) is an important arbovirus in Asia that can cause serious neurological disease. JEV is transmitted by mosquitoes in an enzootic cycle involving porcine and avian reservoirs, in which humans are accidental, dead-end hosts. JEV is currently not endemic in Singapore, after pig farming was abolished in 1992; the last known human case was reported in 2005. However, due to its location along the East-Asian Australasian Flyway (EAAF), Singapore is vulnerable to JEV re-introduction from the endemic regions. Serological and genetic evidence in the last decade suggests JEV’s presence in the local fauna. In the present study, we report the genetic characterization and the first isolation of JEV from 3214 mosquito pools consisting of 41,843 Culex mosquitoes, which were trapped from April 2014 to May 2021. The findings demonstrated the presence of genotype I of JEV (n = 10), in contrast to the previous reports of the presence of genotype II of JEV in Singapore. The genetic analyses also suggested that JEV has entered Singapore on several occasions and has potentially established an enzootic cycle in the local fauna. These observations have important implications in the risk assessment and the control of Japanese encephalitis in non-endemic countries, such as Singapore, that are at risk for JEV transmission.
- Open Access
- 26 May 2022
- Published by MDPI AG in Microorganisms
- Vol. 10 (6) , 1100
Lineage Replacement Associated with Fitness Gain in Mammalian Cells and Aedes aegypti: A Catalyst for Dengue Virus Type 2 Transmission
Shifting of virus serotypes and clade replacement events are known to drive dengue epidemics. However, only a few studies have attempted to elucidate the virus attributes that contribute to such epidemics. In 2007, Singapore experienced a dengue outbreak affecting more than 8000 individuals. The outbreak ensued with the shuffling of dominant clades (from clade I to clade II) of Dengue virus 2 (DENV-2) cosmopolitan genotype, at a time when the Aedes premise index was significantly low. Therefore, we hypothesized that clade II had higher epidemic potential and fitness than clade I. To test this hypothesis, we tested the replication and apoptotic qualities of clade I and II isolates in mammalian cells and their ability to infect and disseminate in a field strain of Ae. Aegypti. Our findings indicated that clade II replicated more efficiently in mammalian cells than clade I and possessed higher transmission potential in local vectors. This could collectively improve the epidemic potential of clade II, which dominated during the outbreak in 2007. The findings exemplify complex interactions between the emergence, adaptation and transmission potential of DENV, and testify the epidemiological importance of a deeper understanding of virus and vector dynamics in endemic regions.
- 26 May 2022
- Published by MDPI AG in Microorganisms
- Vol. 10 (6) , 1100
Open AccessLineage Replacement Associated with Fitness Gain in Mammalian Cells and Aedes aegypti: A Catalyst for Dengue Virus Type 2 Transmission
Shifting of virus serotypes and clade replacement events are known to drive dengue epidemics. However, only a few studies have attempted to elucidate the virus attributes that contribute to such epidemics. In 2007, Singapore experienced a dengue outbreak affecting more than 8000 individuals. The outbreak ensued with the shuffling of dominant clades (from clade I to clade II) of Dengue virus 2 (DENV-2) cosmopolitan genotype, at a time when the Aedes premise index was significantly low. Therefore, we hypothesized that clade II had higher epidemic potential and fitness than clade I. To test this hypothesis, we tested the replication and apoptotic qualities of clade I and II isolates in mammalian cells and their ability to infect and disseminate in a field strain of Ae. Aegypti. Our findings indicated that clade II replicated more efficiently in mammalian cells than clade I and possessed higher transmission potential in local vectors. This could collectively improve the epidemic potential of clade II, which dominated during the outbreak in 2007. The findings exemplify complex interactions between the emergence, adaptation and transmission potential of DENV, and testify the epidemiological importance of a deeper understanding of virus and vector dynamics in endemic regions.
- Open Access
- 1 September 2021
- Published by Elsevier in International Journal of Infectious Diseases
- Vol. 110, 417-425
Transient transmission of Chikungunya virus in Singapore exemplifies successful mitigation of severe epidemics in a vulnerable population
- 1 September 2021
- Published by Elsevier in International Journal of Infectious Diseases
- Vol. 110, 417-425
Open AccessTransient transmission of Chikungunya virus in Singapore exemplifies successful mitigation of severe epidemics in a vulnerable population
- Open Access
- 29 June 2021
- Published by Springer Nature in Scientific Reports
- Vol. 11 (1) , 1-15
Evolution, heterogeneity and global dispersal of cosmopolitan genotype of Dengue virus type 2
Dengue virus type 2 (DENV-2) contributes substantially to the dengue burden and dengue-related mortality in the tropics and sub-tropics. DENV-2 includes six genotypes, among which cosmopolitan genotype is the most widespread. The present study investigated the evolution, intra-genotype heterogeneity and dispersal of cosmopolitan genotype to understand unique genetic characteristics that have shaped the molecular epidemiology and distribution of cosmopolitan lineages. The spatial analysis demonstrated a wide geo-distribution of cosmopolitan genotype through an extensive inter-continental network, anchored in Southeast Asia and Indian sub-continent. Intra-genotype analyses using 3367 envelope gene sequences revealed six distinct lineages within the cosmopolitan genotype, namely the Indian sub-continent lineage and five other lineages. Indian sub-continent lineage was the most diverged among six lineages and has almost reached the nucleotide divergence threshold of 6% within E gene to qualify as a separate genotype. Genome wide amino acid signatures and selection pressure analyses further suggested differences in evolutionary characteristics between the Indian sub-continent lineage and other lineages. The present study narrates a comprehensive genomic analysis of cosmopolitan genotype and presents notable genetic characteristics that occurred during its evolution and global expansion. Whether those characteristics conferred a fitness advantage to cosmopolitan genotype in different geographies warrant further investigations.
- 29 June 2021
- Published by Springer Nature in Scientific Reports
- Vol. 11 (1) , 1-15
Open AccessEvolution, heterogeneity and global dispersal of cosmopolitan genotype of Dengue virus type 2
Dengue virus type 2 (DENV-2) contributes substantially to the dengue burden and dengue-related mortality in the tropics and sub-tropics. DENV-2 includes six genotypes, among which cosmopolitan genotype is the most widespread. The present study investigated the evolution, intra-genotype heterogeneity and dispersal of cosmopolitan genotype to understand unique genetic characteristics that have shaped the molecular epidemiology and distribution of cosmopolitan lineages. The spatial analysis demonstrated a wide geo-distribution of cosmopolitan genotype through an extensive inter-continental network, anchored in Southeast Asia and Indian sub-continent. Intra-genotype analyses using 3367 envelope gene sequences revealed six distinct lineages within the cosmopolitan genotype, namely the Indian sub-continent lineage and five other lineages. Indian sub-continent lineage was the most diverged among six lineages and has almost reached the nucleotide divergence threshold of 6% within E gene to qualify as a separate genotype. Genome wide amino acid signatures and selection pressure analyses further suggested differences in evolutionary characteristics between the Indian sub-continent lineage and other lineages. The present study narrates a comprehensive genomic analysis of cosmopolitan genotype and presents notable genetic characteristics that occurred during its evolution and global expansion. Whether those characteristics conferred a fitness advantage to cosmopolitan genotype in different geographies warrant further investigations.
- Open Access
- 7 April 2021
- Published by Springer Nature in Research Square
Evolution, heterogeneity and global dispersal of cosmopolitan genotype: The most widespread genotype of Dengue Virus type 2
Dengue virus type 2 (DENV-2) contributes substantially to the dengue burden and dengue-related mortality in the tropics and sub-tropics. DENV-2 includes six genotypes, among which cosmopolitan genotype is the most widespread. The present study investigated the evolution, intra-genotype heterogeneity and dispersal of cosmopolitan genotype to understand unique genetic characteristics that have shaped the molecular epidemiology and distribution of cosmopolitan lineages. The spatial analysis demonstrated a wide geo-distribution of cosmopolitan genotype through an extensive inter-continental network, anchored in Southeast Asia and Indian sub-continent. Intra-genotype analyses using 2,392 envelope gene sequences revealed six distinct lineages within the cosmopolitan genotype, namely the Indian sub-continent lineage and five other lineages. Indian sub-continent lineage was the most diverged among six lineages and has almost reached the nucleotide divergence threshold of 6% within E gene to qualify as a separate genotype. Genome wide amino acid signatures and selection pressure analyses further suggested differences in evolutionary characteristics between the Indian sub-continent lineage and other lineages. The present study narrates a comprehensive genomic analysis of cosmopolitan genotype and presents notable genetic characteristics that occurred during its evolution and global expansion. Whether those characteristics conferred a fitness advantage to cosmopolitan genotype in different geographies warrant further investigations.
- 7 April 2021
- Published by Springer Nature in Research Square
Open AccessEvolution, heterogeneity and global dispersal of cosmopolitan genotype: The most widespread genotype of Dengue Virus type 2
Dengue virus type 2 (DENV-2) contributes substantially to the dengue burden and dengue-related mortality in the tropics and sub-tropics. DENV-2 includes six genotypes, among which cosmopolitan genotype is the most widespread. The present study investigated the evolution, intra-genotype heterogeneity and dispersal of cosmopolitan genotype to understand unique genetic characteristics that have shaped the molecular epidemiology and distribution of cosmopolitan lineages. The spatial analysis demonstrated a wide geo-distribution of cosmopolitan genotype through an extensive inter-continental network, anchored in Southeast Asia and Indian sub-continent. Intra-genotype analyses using 2,392 envelope gene sequences revealed six distinct lineages within the cosmopolitan genotype, namely the Indian sub-continent lineage and five other lineages. Indian sub-continent lineage was the most diverged among six lineages and has almost reached the nucleotide divergence threshold of 6% within E gene to qualify as a separate genotype. Genome wide amino acid signatures and selection pressure analyses further suggested differences in evolutionary characteristics between the Indian sub-continent lineage and other lineages. The present study narrates a comprehensive genomic analysis of cosmopolitan genotype and presents notable genetic characteristics that occurred during its evolution and global expansion. Whether those characteristics conferred a fitness advantage to cosmopolitan genotype in different geographies warrant further investigations.