Spatial and molecular mapping of Pfkelch13 gene polymorphism in Africa in the era of emerging Plasmodium falciparum resistance to artemisinin: a systematic review.

Autor:	Kayiba NK; Institute of Health and Society, Université catholique de Louvain, Brussels, Belgium; Department of Public Health, University of Mbujimayi, Mbujimayi, DR Congo; Department of Epidemiology and Biostatistics, University of Kinshasa, Kinshasa, DR Congo., Yobi DM; Department of Basic Sciences, University of Kinshasa, Kinshasa, DR Congo., Tshibangu-Kabamba E; Department of Basic Sciences, University of Mbujimayi, Mbujimayi, DR Congo; Department of Environmental and Preventive Medicine, Oita University, Yufu, Japan., Tuan VP; Department of Endoscopy, Cho Ray Hospital, Ho Chi Minh, Vietnam; Department of Environmental and Preventive Medicine, Oita University, Yufu, Japan., Yamaoka Y; Department of Environmental and Preventive Medicine, Oita University, Yufu, Japan., Devleesschauwer B; Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium; Department of Veterinary Public Health and Food Safety, Ghent University, Merelbeke, Belgium., Mvumbi DM; Department of Basic Sciences, University of Kinshasa, Kinshasa, DR Congo., Okitolonda Wemakoy E; Department of Epidemiology and Biostatistics, University of Kinshasa, Kinshasa, DR Congo., De Mol P; Department of Parasitology and Mycology, University Hospital of Liège, Liège, Belgium., Mvumbi GL; Department of Basic Sciences, University of Kinshasa, Kinshasa, DR Congo., Hayette MP; Department of Parasitology and Mycology, University Hospital of Liège, Liège, Belgium., Rosas-Aguirre A; Institute of Health and Society, Université catholique de Louvain, Brussels, Belgium., Speybroeck N; Institute of Health and Society, Université catholique de Louvain, Brussels, Belgium. Electronic address: niko.speybroeck@uclouvain.be.
Jazyk:	angličtina
Zdroj:	The Lancet. Infectious diseases [Lancet Infect Dis] 2021 Apr; Vol. 21 (4), pp. e82-e92. Date of Electronic Publication: 2020 Oct 27.
DOI:	10.1016/S1473-3099(20)30493-X
Abstrakt:	The spread of Plasmodium falciparum isolates carrying mutations in the kelch13 (Pfkelch13) gene associated with artemisinin resistance (PfART-R) in southeast Asia threatens malaria control and elimination efforts. Emergence of PfART-R in Africa would result in a major public health problem. In this systematic review, we investigate the frequency and spatial distribution of Pfkelch13 mutants in Africa, including mutants linked to PfART-R in southeast Asia. Seven databases were searched (PubMed, Embase, Scopus, African Journal Online, African Index Medicus, Bioline, and Web of Science) for relevant articles about polymorphisms of the Pfkelch13 gene in Africa before January, 2019. Following PRISMA guidelines, 53 studies that sequenced the Pfkelch13 gene of 23 100 sample isolates in 41 sub-Saharan African countries were included. The Pfkelch13 sequence was highly polymorphic (292 alleles, including 255 in the Pfkelch13-propeller domain) but with mutations occurring at very low relative frequencies. Non-synonymous mutations were found in only 626 isolates (2·7%) from west, central, and east Africa. According to WHO, nine different mutations linked to PfART-R in southeast Asia (Phe446Ile, Cys469Tyr, Met476Ile, Arg515Lys, Ser522Cys, Pro553Leu, Val568Gly, Pro574Leu, and Ala675Val) were detected, mainly in east Africa. Several other Pfkelch13 mutations, such as those structurally similar to southeast Asia PfART-R mutations, were also identified, but their relevance for drug resistance is still unknown. This systematic review shows that Africa, thought to not have established PfART-R, reported resistance-related mutants in the past 5 years. Surveillance using PfART-R molecular markers can provide valuable decision-making information to sustain the effectiveness of artemisinin in Africa. (Copyright © 2021 Elsevier Ltd. All rights reserved.)
Databáze:	MEDLINE
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