Status of the Multidrug Resistance-1 Gene of Plasmodium falciparum in Four Malaria Epidemiological Strata, Two Decades after the Abolition of Chloroquine as First-Line Treatment for Uncomplicated Malaria in Cameroon.

IF 2.1 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Journal of Tropical Medicine Pub Date : 2023-01-01 DOI:10.1155/2023/6688380
David Denis Sofeu-Feugaing, Fabrice Nkengeh Ajonglefac, Marcel Nyuylam Moyeh, Tobias Obejum Apinjoh, Marianne Elodie Essende, Gilchrist Destin Talla Kouam, Stephen Mbigha Ghogomu
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Abstract

Drug-resistant malaria parasites pose a threat to global malaria control efforts, and it is important to know the extent of these drug-resistant mutations in each region to determine appropriate control measures. Chloroquine (CQ) was widely used in Cameroon for decades, but its declining clinical efficacy due to resistance prompted health authorities in 2004 to resort to artemisinin-based combination therapy (ACT) as the first-line treatment for uncomplicated malaria. Despite numerous efforts to control malaria, it persists, and the emergence and spread of resistance to ACTs make the development of new drugs or the possible reintroduction of discontinued drugs increasingly urgent. Malaria-positive blood samples were collected from 798 patients on Whatman filter paper to determine the status of resistance to CQ. DNA was extracted by boiling in Chelex and analysis of Plasmodium species. Four hundred P. falciparum monoinfected samples, 100 per study area, were amplified by nested PCR, and allele-specific restriction analysis of Pfmdr1 gene molecular markers was performed. Fragments were analyzed using a 3% ethidium bromide-stained agarose gel. P. falciparum was the most abundant Plasmodium species, accounting for 87.21% of P. falciparum monoinfections only. No infection with P. vivax was detected. The majority of samples contained the wild type for all 3 SNPs evaluated on the Pfmdr1 gene with N86, Y184, and D1246 accounting for 45.50%, 40.00%, and 70.00%, respectively. The most abundant haplotype observed was the Y184D1246 double wild type at 43.70%. The results suggest that P. falciparum is the major infecting species and that P. falciparum species with the susceptible genotype are gradually recapturing the parasite population.

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喀麦隆取消氯喹作为无并发症疟疾一线治疗药物20年后,恶性疟原虫耐多药-1基因在4个疟疾流行病学层中的地位
耐药疟疾寄生虫对全球疟疾控制工作构成威胁,重要的是要了解这些耐药突变在每个区域的程度,以确定适当的控制措施。氯喹(CQ)在喀麦隆广泛使用了几十年,但由于耐药性,其临床疗效不断下降,促使卫生当局在2004年采用以青蒿素为基础的联合疗法(ACT)作为治疗无并发症疟疾的一线疗法。尽管为控制疟疾作出了许多努力,但疟疾仍然存在,对以青蒿素为基础的联合疗法的耐药性的出现和蔓延使得开发新药或可能重新使用已停用药物的问题日益紧迫。采用Whatman滤纸采集798例疟疾阳性患者血样,以确定其对CQ的耐药性状况。采用蒸煮法提取DNA,并对疟原虫种类进行分析。采用巢式PCR扩增400份恶性疟原虫单感染样本,每个研究区100份,并对Pfmdr1基因分子标记进行等位基因特异性限制性分析。使用3%溴化乙锭染色琼脂糖凝胶分析碎片。恶性疟原虫是最丰富的疟原虫种类,仅占单一恶性疟原虫感染病例的87.21%。未发现间日疟原虫感染。Pfmdr1基因3个单核苷酸多态性均为野生型,其中N86、Y184和D1246分别占45.50%、40.00%和70.00%。单倍型中Y184D1246双野生型最多,占43.70%。结果表明,恶性疟原虫是主要的感染种,具有易感基因型的恶性疟原虫正在逐渐夺回寄生虫种群。
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来源期刊
Journal of Tropical Medicine
Journal of Tropical Medicine Immunology and Microbiology-Parasitology
CiteScore
3.90
自引率
4.50%
发文量
0
审稿时长
14 weeks
期刊介绍: Journal of Tropical Medicine is a peer-reviewed, Open Access journal that publishes original research articles, review articles, and clinical studies on all aspects of tropical diseases. Articles on the pathology, diagnosis, and treatment of tropical diseases, parasites and their hosts, epidemiology, and public health issues will be considered. Journal of Tropical Medicine aims to facilitate the communication of advances addressing global health and mortality relating to tropical diseases.
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