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Prevalence of Plasmodium falciparum Pfcrt and Pfmdr1 alleles in settings with different levels of Plasmodium vivax co-endemicity in Ethiopia.
International Journal for Parasitology: Drugs and Drug Resistance ( IF 4.1 ) Pub Date : 2019-09-09 , DOI: 10.1016/j.ijpddr.2019.09.002
Elifaged Hailemeskel 1 , Temesgen Menberu 2 , Girma Shumie 2 , Sinknesh Behaksra 2 , Wakweya Chali 2 , Migbaru Keffale 3 , Mulualem Belachew 2 , Getasew Shitaye 2 , Hussien Mohammed 4 , Daniel Abebe 3 , Temesgen Ashine 2 , Chris Drakeley 5 , Hassen Mamo 6 , Beyene Petros 6 , Teun Bousema 7 , Fitsum G Tadesse 8 , Endalamaw Gadisa 2
Affiliation  

Plasmodium falciparum and P. vivax co-exist at different endemicity levels across Ethiopia. For over two decades Artemether-Lumefantrine (AL) is the first line treatment for uncomplicated P. falciparum, while chloroquine (CQ) is still used to treat P. vivax. It is currently unclear whether a shift from CQ to AL for P. falciparum treatment has implications for AL efficacy and results in a reversal of mutations in genes associated to CQ resistance, given the high co-endemicity of the two species and the continued availability of CQ for the treatment of P. vivax. This study thus assessed the prevalence of Pfcrt-K76T and Pfmdr1-N86Y point mutations in P. falciparum. 18S RNA gene based nested PCR confirmed P. falciparum samples (N = 183) collected through community and health facility targeted cross-sectional surveys from settings with varying P. vivax and P. falciparum endemicity were used. The proportion of Plasmodium infections that were P. vivax was 62.2% in Adama, 41.4% in Babile, 30.0% in Benishangul-Gumuz to 6.9% in Gambella. The Pfcrt-76T mutant haplotype was observed more from samples with higher endemicity of P. vivax as being 98.4% (61/62), 100% (31/31), 65.2% (15/23) and 41.5% (22/53) in samples from Adama, Babile, Benishangul-Gumuz and Gambella, respectively. However, a relatively higher proportion of Pfmdr1-N86 allele (77.3-100%) were maintained in all sites. The observed high level of the mutant Pfcrt-76T allele in P. vivax co-endemic sites might require that utilization of CQ needs to be re-evaluated in settings co-endemic for the two species. A country-wide assessment is recommended to clarify the implication of the observed level of variation in drug resistance markers on the efficacy of AL-based treatment against uncomplicated P. falciparum malaria.

中文翻译:

在埃塞俄比亚具有不同水平间日疟原虫共流行的环境中,恶性疟原虫Pfcrt和Pfmdr1等位基因的患病率。

恶性疟原虫和间日疟原虫在埃塞俄比亚以不同的流行水平共存。在过去的二十多年中,蒿甲醚-卢美他汀(AL)是简单的恶性疟原虫的一线治疗,而氯喹(CQ)仍用于治疗间日疟原虫。目前尚不清楚,鉴于恶性疟原虫的治疗从CQ转变为AL是否对AL疗效有影响,并导致与CQ抗性相关的基因突变逆转,因为这两个物种具有很高的共存性和CQ用于治疗间日疟原虫。因此,这项研究评估了恶性疟原虫中Pfcrt-K76T和Pfmdr1-N86Y点突变的患病率。基于18S RNA基因的嵌套式PCR证实了恶性疟原虫样品(N = 183)是通过社区和卫生机构针对性的横断面调查从不同的P设置中收集的。间质和恶性疟原虫流行。间日疟原虫感染的比例在阿达玛占62.2%,在巴比勒占41.4%,在贝尼桑古尔-古穆兹占30.0%,在甘贝拉占6.9%。从具有较高间日疟原虫流行性的样品中观察到Pfcrt-76T突变单倍型分别为98.4%(61/62),100%(31/31),65.2%(15/23)和41.5%(22/53) )分别来自Adama,Babile,Benishangul-Gumuz和Gambella。但是,在所有位点中都保留了相对较高比例的Pfmdr1-N86等位基因(77.3-100%)。在间日疟原虫共流行位点中观察到的高水平突变体Pfcrt-76T等位基因可能需要在这两个物种共流行的环境中重新评估CQ的利用。
更新日期:2019-11-01
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