Molecular surveillance of antimalarial drug resistance in Democratic Republic of Congo: high variability of chloroquinoresistance and lack of amodiaquinoresistance
| Autor: | Raphaël Boreux, Marie-Pierre Hayette, Niko Speybroeck, Doudou Malekita Yobi, Pius Zakayi Kabututu, Patrick De Mol, Joris L. Likwela, Nadine Kalenda Kayiba, Emile W. Okitolonda, Hippolyte Situakibanza, Georges Lelo Mvumbi, Dieudonné Makaba Mvumbi |
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| Přispěvatelé: | UCL - SSS/IRSS - Institut de recherche santé et société |
| Rok vydání: | 2020 |
| Předmět: |
Resistance
Drug Resistance Protozoan Proteins Drug resistance Chloroquine Medicine Mass Screening Prospective Studies Malaria Falciparum Child Rapid diagnostic test Surveillance Middle Aged Infectious Diseases Child Preschool Democratic Republic of the Congo medicine.drug Adult medicine.medical_specialty lcsh:Arctic medicine. Tropical medicine Adolescent lcsh:RC955-962 Plasmodium falciparum Amodiaquine lcsh:Infectious and parasitic diseases Antimalarials Young Adult parasitic diseases Humans lcsh:RC109-216 Aged Polymorphism Genetic business.industry Research Haplotype Infant Newborn Molecular DRC Infant Membrane Transport Proteins medicine.disease Virology Parasitology Tropical medicine Mutation Dried Blood Spot Testing business Malaria |
| Zdroj: | Malaria Journal, Vol. 19, no.1, p. 8p. (2020) Malaria Journal Malaria Journal, Vol 19, Iss 1, Pp 1-8 (2020) |
| Popis: | Background The loss of chloroquine (CQ) effectiveness has led to its withdrawal from national policies as a first-line treatment for uncomplicated malaria in several endemic countries, such as the Democratic Republic of Congo (DRC). The K76T mutation on the pfcrt gene has been identified as a marker of CQ resistance and the SVMNT haplotype in codons 72–76 on the same gene has been associated with resistance to amodiaquine (AQ). In the DRC, the prevalence of K76T has decreased from 100% in 2000 to 63.9% in 2014. The purpose of this study was to determine the prevalence of K76T mutations in circulating strains of Plasmodium falciparum, 16 years after CQ withdrawal in the DRC and to investigate the presence of the SVMNT haplotype. Methods In 2017, ten geographical sites across the DRC were selected. Dried blood samples were collected from patients attending health centres. Malaria was first detected by a rapid diagnostic test (RDT) available on site (SD Bioline Malaria Ag Pf or CareStart Malaria Pf) or thick blood smear and then confirmed by a P. falciparum species-specific real-time PCR assay. A pfcrt gene segment containing a fragment that encodes amino acids at positions 72–76 was amplified by conventional PCR before sequencing. Results A total of 1070 patients were enrolled. Of the 806 PCR-confirmed P. falciparum positive samples, 764 were successfully sequenced. The K76T mutation was detected in 218 samples (28.5%; 95% CI 25.4%–31.9%), mainly (96%) with the CVIET haplotype. Prevalence of CQ resistance marker was unequally distributed across the country, ranging from 1.5% in Fungurume to 89.5% in Katana. The SVMNT haplotype, related to AQ resistance, was not detected. Conclusion Overall, the frequency of the P. falciparum CQ resistance marker has decreased significantly and no resistance marker to AQ was detected in the DRC in 2017. However, the between regions variability of CQ resistance remains high in the country. Further studies are needed for continuous monitoring of the CQ resistance level for its prospective re-use in malaria management. The absence of the AQ resistance marker is in line with the use of this drug in the current DRC malaria treatment policy. |
| Databáze: | OpenAIRE |
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