Evolution of Plasmodium falciparum drug resistance genes following artemisinin combination therapy in Sudan.
Autor: | Bakhiet AMA; Department of Biochemistry, Faculty of Medicine and Health Sciences, Sultan Qaboos University, Al Khoudh, Oman.; Sudan Academy of Sciences, Department of Epidemiology and Molecular Biology, Khartoum, Sudan., Abdelraheem MH; Department of Microbiology and Immunology, Faculty of Medicine and Health Sciences, Sultan Qaboos University, Al Khoudh, Oman., Kheir A; Ahfad University for Women, Omdurman, Sudan., Omer S; Tropical Medicine Research Institute, Khartoum, Sudan., Gismelseed L; Institute of Endemic Diseases, University of Khartoum, Khartoum, Sudan., Abdel-Muhsin AA; Sudan Academy of Sciences, Department of Epidemiology and Molecular Biology, Khartoum, Sudan.; Department of Biology, Faculty of Science, University of Hail, Kingdom of Saudi Arabia., Naiem A; Department of Biochemistry, Faculty of Medicine and Health Sciences, Sultan Qaboos University, Al Khoudh, Oman., Al Hosni A; Department of Biochemistry, Faculty of Medicine and Health Sciences, Sultan Qaboos University, Al Khoudh, Oman., Al Dhuhli A; Department of Biochemistry, Faculty of Medicine and Health Sciences, Sultan Qaboos University, Al Khoudh, Oman., Al Rubkhi M; Department of Biochemistry, Faculty of Medicine and Health Sciences, Sultan Qaboos University, Al Khoudh, Oman., Al-Hamidhi S; Department of Biochemistry, Faculty of Medicine and Health Sciences, Sultan Qaboos University, Al Khoudh, Oman., Gadalla A; Division of Population Medicine, School of Medicine, College of Biomedical Sciences, Cardiff University, Cardiff, UK., Mukhtar M; Institute of Endemic Diseases, University of Khartoum, Khartoum, Sudan.; Bioscience Research, Institute, Ibn Sina University, Khartoum, Sudan., Sultan AA; Department of Microbiology and Immunology, Weill Cornell Medicine - Qatar, Qatar Foundation - Education City, Doha, Qatar., Babiker HA; Department of Biochemistry, Faculty of Medicine and Health Sciences, Sultan Qaboos University, Al Khoudh, Oman. |
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Jazyk: | angličtina |
Zdroj: | Transactions of the Royal Society of Tropical Medicine and Hygiene [Trans R Soc Trop Med Hyg] 2019 Nov 01; Vol. 113 (11), pp. 693-700. |
DOI: | 10.1093/trstmh/trz059 |
Abstrakt: | Background: Malaria control efforts in Sudan rely heavily on case management. In 2004, health authorities adopted artemisinin-based combination therapies (ACTs) for the treatment of uncomplicated malaria. However, some recent surveys have reported ACT failure and a prevalent irrational malaria treatment practice. Here we examine whether the widespread use of ACT and failure to adhere to national guidelines have led to the evolution of drug resistance genes. Methods: We genotyped known drug resistance markers (Pfcrt, Pfmdr-1, Pfdhfr, Pfdhps, Pfk13 propeller) and their flanking microsatellites among Plasmodium falciparum isolates obtained between 2009 and 2016 in different geographical regions in Sudan. Data were then compared with published findings pre-ACT (1992-2003). Results: A high prevalence of Pfcrt76T, Pfmdr-1-86Y, Pfdhfr51I, Pfdhfr108N, Pfdhps37G was observed in all regions, while no Pfk13 mutations were detected. Compared with pre-ACT data, Pfcrt-76T and Pfmdr-1-86Y have decayed, while Pfdhfr-51I, Pfdhfr-108N and Pfdhps-437G strengthened. Haplotypes Pfcrt-CVIET, Pfmdr-1-NFSND/YFSND, Pfdhfr-ICNI and Pfdhps-SGKAA predominated in all sites. Microsatellites flanking drug resistance genes showed lower diversity than neutral ones, signifying high ACT pressure/selection. Conclusions: Evaluation of P. falciparum drug resistance genes in Sudan matches the drug deployment pattern. Regular monitoring of these genes, coupled with clinical response, should be considered to combat the spread of ACT resistance. (© The Author(s) 2019. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.) |
Databáze: | MEDLINE |
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