Molecular surveillance for polymorphisms associated with artemisinin-based combination therapy resistance in Plasmodium falciparum isolates collected in Mozambique, 2018

Malaria Journal

Arsénio Nhacolo¹  Arlindo Chidimatembue¹  Lídia Nhamussua¹  Alfredo Mayor²  Quique Bassat³  Abel Nhama⁴  Pedro Aíde⁴  Eusébio Macete⁵  Crizólgo Salvador⁶  Sónia Enosse⁶  Ira Goldman⁷  Samaly S. Svigel⁷  Venkatachalam Udhayakumar⁷  Naomi W. Lucchi⁷  Eric S. Halsey⁸  Rose Zulliger⁹  Baltazar Candrinho^1,10  Abuchahama Saifodine^1,11  Eva De Carvalho^1,12 

[1] Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique;Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique;ISGlobal, Hospital Clínic – Universitat de Barcelona, Barcelona, Spain;Consorcio de Investigación Biomédica en Red de Epidemiología Y Salud Pública (CIBERESP), Madrid, Spain;Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique;ISGlobal, Hospital Clínic – Universitat de Barcelona, Barcelona, Spain;ICREA, Pg. Lluís Companys 23, 08010, Barcelona, Spain;Pediatric Infectious Diseases Unit, Pediatrics Department, Hospital Sant Joan de Déu (University of Barcelona), Barcelona, Spain;Consorcio de Investigación Biomédica en Red de Epidemiología Y Salud Pública (CIBERESP), Madrid, Spain;Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique;Instituto Nacional de Saúde (INS), Ministério da Saúde, Maputo, Mozambique;Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique;National Directorate of Public Health, Ministry of Health, Maputo, Mozambique;Instituto Nacional de Saúde (INS), Ministério da Saúde, Maputo, Mozambique;Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, USA;Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, USA;United States President’s Malaria Initiative, Atlanta, GA, USA;Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, USA;United States President’s Malaria Initiative, Centers for Disease Control and Prevention, Maputo, Mozambique;National Malaria Control Programme, Ministry of Health, Maputo, Mozambique;United States President’s Malaria Initiative, US Agency for International Development, Maputo, Mozambique;World Health Organization (WHO), Maputo, Mozambique;

关键词: Antimalarial drug resistance;    Plasmodium falciparum;    pfk13;    Pfcrt;    pfmdr1;    Artemisinin-based combination therapy (ACT);    Polymorphisms;    Mozambique;   

DOI  :  10.1186/s12936-021-03930-9

来源: Springer

【 摘 要 】

BackgroundDue to the threat of emerging anti-malarial resistance, the World Health Organization recommends incorporating surveillance for molecular markers of anti-malarial resistance into routine therapeutic efficacy studies (TESs). In 2018, a TES of artemether-lumefantrine (AL) and artesunate-amodiaquine (ASAQ) was conducted in Mozambique, and the prevalence of polymorphisms in the pfk13, pfcrt, and pfmdr1 genes associated with drug resistance was investigated.MethodsChildren aged 6–59 months were enrolled in four study sites. Blood was collected and dried on filter paper from participants who developed fever within 28 days of initial malaria treatment. All samples were first screened for Plasmodium falciparum using a multiplex real-time PCR assay, and polymorphisms in the pfk13, pfcrt, and pfmdr1 genes were investigated by Sanger sequencing.ResultsNo pfk13 mutations, associated with artemisinin partial resistance, were observed. The only pfcrt haplotype observed was the wild type CVMNK (codons 72–76), associated with chloroquine sensitivity. Polymorphisms in pfmdr1 were only observed at codon 184, with the mutant 184F in 43/109 (39.4%) of the samples, wild type Y184 in 42/109 (38.5%), and mixed 184F/Y in 24/109 (22.0%). All samples possessed N86 and D1246 at these two codons.ConclusionIn 2018, no markers of artemisinin resistance were documented. Molecular surveillance should continue to monitor the prevalence of these markers to inform decisions on malaria treatment in Mozambique.

【 授权许可】

CC BY