Lack of significant recovery of chloroquine sensitivity in Plasmodium falciparum parasites following discontinuance of chloroquine use in Papua New Guinea

Autor: Naoyuki Fukuda, Steven Tiwara, Shoki Yatsushiro, Masato Yamauchi, Toshihiro Mita, Francis Hombhanje, Shin-Ichiro Tachibana, Makoto Sekihara, Mie Ikeda, Toshiyuki Mori, Makoto Hirai
Jazyk: angličtina
Rok vydání: 2018
Předmět:
0301 basic medicine
Male
Genotyping Techniques
Resistance
Drug Resistance
Protozoan Proteins
chemistry.chemical_compound
0302 clinical medicine
Parasitic Sensitivity Tests
Chloroquine
Recovery
Fitness
Medicine
Malaria
Falciparum
Child
biology
Middle Aged
Infectious Diseases
Child
Preschool
Female
Multidrug Resistance-Associated Proteins
medicine.drug
Adult
medicine.medical_specialty
lcsh:Arctic medicine. Tropical medicine
Adolescent
Genotype
lcsh:RC955-962
030231 tropical medicine
Plasmodium falciparum
Lumefantrine
pfcrt
lcsh:Infectious and parasitic diseases
03 medical and health sciences
Papua New Guinea
Antimalarials
Inhibitory Concentration 50
Young Adult
parasitic diseases
Humans
lcsh:RC109-216
Genotyping
business.industry
Research
Infant
Newborn
Infant
Membrane Transport Proteins
biology.organism_classification
medicine.disease
Virology
Drug Utilization
Discontinuation
030104 developmental biology
Cross-Sectional Studies
Parasitology
chemistry
Tropical medicine
business
Malaria
Zdroj: Malaria Journal, Vol 17, Iss 1, Pp 1-10 (2018)
Malaria Journal
ISSN: 1475-2875
Popis: Background Chloroquine treatment for Plasmodium falciparum has been discontinued in almost all endemic regions due to the spread of resistant isolates. Reversal of chloroquine susceptibility after chloroquine discontinuation has been reported in dozens of endemic regions. However, this phenomenon has been mostly observed in Africa and is not well documented in other malaria endemic regions. To investigate this, an ex vivo study on susceptibility to chloroquine and lumefantrine was conducted during 2016–2018 in Wewak, Papua New Guinea where chloroquine had been removed from the official malaria treatment regimen in 2010. Genotyping of pfcrt and pfmdr1 was also performed. Results In total, 368 patients were enrolled in this study. Average IC50 values for chloroquine were 106.6, 80.5, and 87.6 nM in 2016, 2017, and 2018, respectively. These values were not significantly changed from those obtained in 2002/2003 (108 nM). The majority of parasites harboured a pfcrt K76T the mutation responsible for chloroquine resistance. However, a significant upward trend was observed in the frequency of the K76 (wild) allele from 2.3% in 2016 to 11.7% in 2018 (P = 0.008; Cochran–Armitage trend test). Conclusions Eight years of chloroquine withdrawal has not induced a significant recovery of susceptibility in Papua New Guinea. However, an increasing tendency of parasites harbouring chloroquine-susceptible K76 suggests a possibility of resurgence of chloroquine susceptibility in the future. Electronic supplementary material The online version of this article (10.1186/s12936-018-2585-x) contains supplementary material, which is available to authorized users.
Databáze: OpenAIRE
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