Low prevalence of highly sulfadoxine‐resistant dihydropteroate synthase alleles in Plasmodium falciparum isolates in Benin

Autor: Alexis Tchevoede, Ramani Saliou, Samaly S. Svigel, Adicath Adeothy, Monica E. Patton, Eric S. Halsey, Augustin Kpemasse, Fortuné Dagnon, Naomi W. Lucchi, Antoine Sianou, Ernest Houngbo, Venkatachalam Udhayakumar
Rok vydání: 2021
Předmět:
Male
0301 basic medicine
Pfdhps
medicine.medical_treatment
Intermittent Preventive Treatment in Pregnant
Drug resistance
Sulfadoxine Pyrimethamine
0302 clinical medicine
Seasonal Malaria Chemoprevention
Prevalence
Benin
Malaria
Falciparum
education.field_of_study
Drug Combinations
Pyrimethamine
Infectious Diseases
Child
Preschool
Female
medicine.drug
lcsh:Arctic medicine. Tropical medicine
lcsh:RC955-962
Sulfadoxine
Plasmodium falciparum
030106 microbiology
030231 tropical medicine
Population
Pfdhfr
Biology
lcsh:Infectious and parasitic diseases
Antimalarials
03 medical and health sciences
parasitic diseases
medicine
Humans
lcsh:RC109-216
education
Alleles
Dihydropteroate Synthase
Research
Pregnant women
Infant
medicine.disease
biology.organism_classification
Virology
Sulfadoxine/pyrimethamine
Malaria
Parasitology
Dihydropteroate synthase
Zdroj: Malaria Journal, Vol 20, Iss 1, Pp 1-8 (2021)
Malaria Journal
ISSN: 1475-2875
DOI: 10.1186/s12936-021-03605-5
Popis: Background In 2004, in response to high levels of treatment failure associated with sulfadoxine-pyrimethamine (SP) resistance, Benin changed its first-line malaria treatment from SP to artemisinin-based combination therapy for treatment of uncomplicated Plasmodium falciparum malaria. Resistance to SP is conferred by accumulation of single nucleotide polymorphisms (SNPs) in P. falciparum genes involved in folate metabolism, dihydrofolate reductase (Pfdhfr) and dihydropteroate synthase (Pfdhps), targeted by pyrimethamine and sulfadoxine, respectively. Because SP is still used for intermittent preventive treatment in pregnant women (IPTp) and seasonal malaria chemoprevention (SMCP) in Benin, the prevalence of Pfdhfr and Pfdhps SNPs in P. falciparum isolates collected in 2017 were investigated. Methods This study was carried out in two sites where the transmission of P. falciparum malaria is hyper-endemic: Klouékanmey and Djougou. Blood samples were collected from 178 febrile children 6–59 months old with confirmed uncomplicated P. falciparum malaria and were genotyped for SNPs associated with SP resistance. Results The Pfdhfr triple mutant IRN (N51I, C59R, and S108N) was the most prevalent (84.6%) haplotype and was commonly found with the Pfdhps single mutant A437G (50.5%) or with the Pfdhps double mutant S436A and A437G (33.7%). The quintuple mutant, PfdhfrIRN/PfdhpsGE (A437G and K540E), was rarely observed (0.8%). The A581G and A613S mutant alleles were found in 2.6 and 3.9% of isolates, respectively. Six isolates (3.9%) were shown to harbour a mutation at codon I431V, recently identified in West African parasites. Conclusions This study showed that Pfdhfr triple IRN mutants are near fixation in this population and that the highly sulfadoxine-resistant Pfdhps alleles are not widespread in Benin. These data support the continued use of SP for chemoprevention in these study sites, which should be complemented by periodic nationwide molecular surveillance to detect emergence of resistant genotypes.
Databáze: OpenAIRE
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