Drug resistance markers within an evolving efficacy of anti-malarial drugs in Cameroon: a systematic review and meta-analysis (1998-2020).

Autor: Niba PTN; MARCAD-DELTAS Programme, Laboratory for Public Health Research Biotechnologies, University of Yaoundé I, Yaoundé, Cameroon.; The Biotechnology Centre, University of Yaoundé I, Yaoundé, Cameroon.; Department of Biochemistry, Faculty of Science, University of Yaoundé I, Yaoundé, Cameroon., Nji AM; MARCAD-DELTAS Programme, Laboratory for Public Health Research Biotechnologies, University of Yaoundé I, Yaoundé, Cameroon.; The Biotechnology Centre, University of Yaoundé I, Yaoundé, Cameroon.; Department of Biochemistry, Faculty of Science, University of Yaoundé I, Yaoundé, Cameroon., Evehe MS; The Biotechnology Centre, University of Yaoundé I, Yaoundé, Cameroon.; Department of Biochemistry, Faculty of Science, University of Yaoundé I, Yaoundé, Cameroon., Ali IM; MARCAD-DELTAS Programme, Laboratory for Public Health Research Biotechnologies, University of Yaoundé I, Yaoundé, Cameroon.; The Biotechnology Centre, University of Yaoundé I, Yaoundé, Cameroon.; Department of Biochemistry, Faculty of Science, University of Dschang, Dschang, Cameroon., Netongo PM; The Biotechnology Centre, University of Yaoundé I, Yaoundé, Cameroon.; Department of Biochemistry, Faculty of Science, University of Yaoundé I, Yaoundé, Cameroon., Ngwafor R; The Biotechnology Centre, University of Yaoundé I, Yaoundé, Cameroon.; National Malaria Control Programme, Ministry of Public Health, Yaoundé, Cameroon., Moyeh MN; MARCAD-DELTAS Programme, Laboratory for Public Health Research Biotechnologies, University of Yaoundé I, Yaoundé, Cameroon.; The Biotechnology Centre, University of Yaoundé I, Yaoundé, Cameroon.; Department of Biochemistry and Molecular Biology, Faculty of Science, University of Buea, Buea, Cameroon., Ngum LN; MARCAD-DELTAS Programme, Laboratory for Public Health Research Biotechnologies, University of Yaoundé I, Yaoundé, Cameroon.; The Biotechnology Centre, University of Yaoundé I, Yaoundé, Cameroon.; Department of Biochemistry, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon.; Institute of Medical Research and Medicinal Plant Studies, Ministry of Scientific Research and Innovation, Yaoundé, Cameroon., Ndum OE; The Biotechnology Centre, University of Yaoundé I, Yaoundé, Cameroon.; Université Des Montagnes, Banganté, West Region, Cameroon., Acho FA; The Biotechnology Centre, University of Yaoundé I, Yaoundé, Cameroon., Mbu'u CM; The Biotechnology Centre, University of Yaoundé I, Yaoundé, Cameroon.; Department of Microbiology, Faculty of Science, University of Yaoundé I, Yaoundé, Cameroon., Fosah DA; National Malaria Control Programme, Ministry of Public Health, Yaoundé, Cameroon., Atogho-Tiedeu B; The Biotechnology Centre, University of Yaoundé I, Yaoundé, Cameroon.; Department of Biochemistry, Faculty of Science, University of Yaoundé I, Yaoundé, Cameroon., Achonduh-Atijegbe O; The Biotechnology Centre, University of Yaoundé I, Yaoundé, Cameroon., Djokam-Dadjeu R; The Biotechnology Centre, University of Yaoundé I, Yaoundé, Cameroon.; Department of Biochemistry, Faculty of Science, University of Yaoundé I, Yaoundé, Cameroon., Chedjou JPK; MARCAD-DELTAS Programme, Laboratory for Public Health Research Biotechnologies, University of Yaoundé I, Yaoundé, Cameroon.; The Biotechnology Centre, University of Yaoundé I, Yaoundé, Cameroon.; Department of Biochemistry, Faculty of Science, University of Yaoundé I, Yaoundé, Cameroon., Bigoga JD; MARCAD-DELTAS Programme, Laboratory for Public Health Research Biotechnologies, University of Yaoundé I, Yaoundé, Cameroon.; The Biotechnology Centre, University of Yaoundé I, Yaoundé, Cameroon.; Department of Biochemistry, Faculty of Science, University of Yaoundé I, Yaoundé, Cameroon., Moukoko CEE; Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon.; Malaria Research Service, Centre Pasteur Cameroon, Yaoundé, Cameroon., Ajua A; Department of Biochemistry and Molecular Biology, Faculty of Science, University of Buea, Buea, Cameroon., Achidi E; Department of Biochemistry and Molecular Biology, Faculty of Science, University of Buea, Buea, Cameroon., Tallah E; Malaria Consortium-Cameroon Coalition Against Malaria, Yaoundé, Cameroon., Leke RGF; MARCAD-DELTAS Programme, Laboratory for Public Health Research Biotechnologies, University of Yaoundé I, Yaoundé, Cameroon.; The Biotechnology Centre, University of Yaoundé I, Yaoundé, Cameroon.; Malaria Consortium-Cameroon Coalition Against Malaria, Yaoundé, Cameroon., Tourgordi A; The Cameroon Office of the World Health Organization, Yaoundé, Cameroon., Ringwald P; Global Malaria Programme, World Health Organization, Geneva, Switzerland., Alifrangis M; Centre for Medical Parasitology, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.; Department of Infectious Diseases, Copenhagen University Hospital, Copenhagen, Denmark., Mbacham WF; MARCAD-DELTAS Programme, Laboratory for Public Health Research Biotechnologies, University of Yaoundé I, Yaoundé, Cameroon. wfmbacham@yahoo.com.; The Biotechnology Centre, University of Yaoundé I, Yaoundé, Cameroon. wfmbacham@yahoo.com.; Department of Biochemistry, Faculty of Science, University of Yaoundé I, Yaoundé, Cameroon. wfmbacham@yahoo.com.; Malaria Consortium-Cameroon Coalition Against Malaria, Yaoundé, Cameroon. wfmbacham@yahoo.com.
Jazyk: angličtina
Zdroj: Malaria journal [Malar J] 2021 Jan 09; Vol. 20 (1), pp. 32. Date of Electronic Publication: 2021 Jan 09.
DOI: 10.1186/s12936-020-03543-8
Abstrakt: Background: Malaria remains highly endemic in Cameroon. The rapid emergence and spread of drug resistance was responsible for the change from monotherapies to artemisinin-based combinations. This systematic review and meta-analysis aimed to determine the prevalence and distribution of Plasmodium falciparum drug resistance markers within an evolving efficacy of anti-malarial drugs in Cameroon from January 1998 to August 2020.
Methods: The PRISMA-P and PRISMA statements were adopted in the inclusion of studies on single nucleotide polymorphisms (SNPs) of P. falciparum anti-malarial drug resistance genes (Pfcrt, Pfmdr1, Pfdhfr, Pfdhps, Pfatp6, Pfcytb and Pfk13). The heterogeneity of the included studies was evaluated using the Cochran's Q and I 2 statistics. The random effects model was used as standard in the determination of heterogeneity between studies.
Results: Out of the 902 records screened, 48 studies were included in this aggregated meta-analysis of molecular data. A total of 18,706 SNPs of the anti-malarial drug resistance genes were genotyped from 47,382 samples which yielded a pooled prevalence of 35.4% (95% CI 29.1-42.3%). Between 1998 and 2020, there was significant decline (P < 0.0001 for all) in key mutants including Pfcrt 76 T (79.9%-43.0%), Pfmdr1 86Y (82.7%-30.5%), Pfdhfr 51I (72.2%-66.9%), Pfdhfr 59R (76.5%-67.8%), Pfdhfr 108 N (80.8%-67.6%). The only exception was Pfdhps 437G which increased over time (30.4%-46.9%, P < 0.0001) and Pfdhps 540E that remained largely unchanged (0.0%-0.4%, P = 0.201). Exploring mutant haplotypes, the study observed a significant increase in the prevalence of Pfcrt CVIET mixed quintuple haplotype from 57.1% in 1998 to 57.9% in 2020 (P < 0.0001). In addition, within the same study period, there was no significant change in the triple Pfdhfr IRN mutant haplotype (66.2% to 67.3%, P = 0.427). The Pfk13 amino acid polymorphisms associated with artemisinin resistance were not detected.
Conclusions: This review reported an overall decline in the prevalence of P. falciparum gene mutations conferring resistance to 4-aminoquinolines and amino alcohols for a period over two decades. Resistance to artemisinins measured by the presence of SNPs in the Pfk13 gene does not seem to be a problem in Cameroon. Systematic review registration PROSPERO CRD42020162620.
Databáze: MEDLINE
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