Prevalence of molecular markers of drug resistance in an area of seasonal malaria chemoprevention in children in Senegal

Malaria Journal

Research

Cheikh Sokhna¹  El-Hadj Ba¹  Paul Milligan²  Matthew Cairns²  Rachel Hallett²  Colin Sutherland²  Aminata C Lo³  Roger Tine³  Jean LA Ndiaye³  Annie Abiola³  Jules F Gomis³  Magatte Ndiaye³  Yemou Dieng³  Omar Ndir³  Babacar Faye³  Daouda Ndiaye³  Oumar Gaye³  Omar Faye³  Badara Cisse⁴ 

[1] Institut de Recherche pour le Développement, Dakar, Senegal;London School of Hygiene and Tropical Medicine, London, UK;Service of Parasitology, Faculty of Medicine, University Cheikh Anta Diop, Dakar, Senegal;Service of Parasitology, Faculty of Medicine, University Cheikh Anta Diop, Dakar, Senegal;London School of Hygiene and Tropical Medicine, London, UK;

关键词: Plasmodium falciparum;    SMC;    Sulphadoxine-pyrimethamine;    Amodiaquine;    Prevalence;    Pfdhfr;    Pfdhps;    Pfcrt;    Pfmdr1;   

DOI  :  10.1186/1475-2875-12-137

 received in 2013-01-08, accepted in 2013-04-07,  发布年份 2013

来源: Springer

【 摘 要 】

BackgroundIn sub-Saharan Africa, malaria is the leading cause of morbidity and mortality especially in children. In Senegal, seasonal malaria chemoprevention (SMC) previously referred to as intermittent preventive treatment in children (IPTc) is a new strategy for malaria control in areas of high seasonal transmission. An effectiveness study of SMC, using sulphadoxine-pyrimethamine (SP) plus amodiaquine (AQ), was conducted in central Senegal from 2008 to 2010 to obtain information about safety, feasibility of delivery, and cost effectiveness of SMC. Here are report the effect of SMC delivery on the prevalence of markers of resistance to SP and AQ.MethodsThis study was conducted in three health districts in Senegal with 54 health posts with a gradual introduction of SMC. Three administrations of the combination AQ + SP were made during the months of September, October and November of each year in children aged less than 10 years living in the area. Children were surveyed in December of each year and samples (filter paper and thick films) were made in 2008, 2009 and 2010. The prevalence of mutations in the pfdhfr, pfdhps, pfmdr1 and pfcrt genes was investigated by sequencing and RTPCR in samples positive by microscopy for Plasmodium falciparum.ResultsMutations at codon 540 of pfdhps and codon 164 of pfdhfr were not detected in the study. Among children with parasitaemia at the end of the transmission seasons, the CVIET haplotypes of pfcrt and the 86Y polymorphism of pfmdr1 were more common among those that had received SMC, but the number of infections detected was very low and confidence intervals were wide. The overall prevalence of these mutations was lower in SMC areas than in control areas, reflecting the lower prevalence of parasitaemia in areas where SMC was delivered.ConclusionThe sensitivity of P. falciparum to SMC drugs should be regularly monitored in areas deploying this intervention. Overall the prevalence of genotypes associated with resistance to either SP or AQ was lower in SMC areas due to the reduced number of parasitaemia individuals.

【 授权许可】

CC BY   
© Lo et al.; licensee BioMed Central Ltd. 2013