En-route to the 'elimination' of genotypic chloroquine resistance in Western and Southern Zambia, 14 years after chloroquine withdrawal.
ATP-Binding Cassette Transporters
/ genetics
Antimalarials
/ pharmacology
Chloroquine
/ pharmacology
Cross-Sectional Studies
Dried Blood Spot Testing
Drug Resistance
/ genetics
Genotype
Humans
Malaria, Falciparum
/ epidemiology
Membrane Transport Proteins
/ genetics
Plasmodium falciparum
/ drug effects
Polymerase Chain Reaction
Prevalence
Protozoan Proteins
/ genetics
Time Factors
Zambia
/ epidemiology
Chloroquine resistance
Chloroquine sensitivity
Genotypes
Plasmodium falciparum
Zambia
Journal
Malaria journal
ISSN: 1475-2875
Titre abrégé: Malar J
Pays: England
ID NLM: 101139802
Informations de publication
Date de publication:
03 Dec 2019
03 Dec 2019
Historique:
received:
14
05
2019
accepted:
24
11
2019
entrez:
5
12
2019
pubmed:
5
12
2019
medline:
9
4
2020
Statut:
epublish
Résumé
Anti-malarial resistance is, and continues to be a significant challenge in the fight against malaria and a threat to achieving malaria elimination. In Zambia, chloroquine (CQ), a safe, affordable and well-tolerated drug, was removed from use in 2003 due to high levels of resistance evidenced with treatment failure. This study sought to investigate the prevalence of chloroquine resistance markers in Southern and Western Provinces of Zambia 14 years after the withdrawal of CQ. Data from a cross-sectional, all-age household survey, conducted during the peak malaria transmission season (April-May 2017) was analysed. During the all-age survey, socio-demographic information and coverage of malaria interventions were collected. Consenting individuals were tested for malaria with a rapid diagnostic test and a spot of blood collected on filter paper to create a dried blood spot (DBS). Photo-induced electronic transfer-polymerase chain reaction (PET-PCR) was used to analyse the DBS for the presence of all four malaria species. Plasmodium falciparum positive samples were analysed by high resolution melt (HRM) PCR to detect the presence of genotypic markers of drug resistance in the P. falciparum chloroquine resistance transporter (Pfcrt) and P. falciparum multi-drug resistance (Pfmdr) genes. A total of 181 P. falciparum positive samples were examined for pfcrt K76T and MDR N86. Of the 181 samples 155 successfully amplified for Pfcrt and 145 for Pfmdr N86. The overall prevalence of CQ drug-resistant parasites was 1.9% (3/155), with no significant difference between the two provinces. No N86Y/F mutations in the Pfmdr gene were observed in any of the sample. This study reveals the return of CQ sensitive parasites in Southern and Western Provinces of Zambia 14 years after its withdrawal. Surveillance of molecular resistant markers for anti-malarials should be included in the Malaria Elimination Programme so that resistance is monitored country wide.
Sections du résumé
BACKGROUND
BACKGROUND
Anti-malarial resistance is, and continues to be a significant challenge in the fight against malaria and a threat to achieving malaria elimination. In Zambia, chloroquine (CQ), a safe, affordable and well-tolerated drug, was removed from use in 2003 due to high levels of resistance evidenced with treatment failure. This study sought to investigate the prevalence of chloroquine resistance markers in Southern and Western Provinces of Zambia 14 years after the withdrawal of CQ.
METHODS
METHODS
Data from a cross-sectional, all-age household survey, conducted during the peak malaria transmission season (April-May 2017) was analysed. During the all-age survey, socio-demographic information and coverage of malaria interventions were collected. Consenting individuals were tested for malaria with a rapid diagnostic test and a spot of blood collected on filter paper to create a dried blood spot (DBS). Photo-induced electronic transfer-polymerase chain reaction (PET-PCR) was used to analyse the DBS for the presence of all four malaria species. Plasmodium falciparum positive samples were analysed by high resolution melt (HRM) PCR to detect the presence of genotypic markers of drug resistance in the P. falciparum chloroquine resistance transporter (Pfcrt) and P. falciparum multi-drug resistance (Pfmdr) genes.
RESULTS
RESULTS
A total of 181 P. falciparum positive samples were examined for pfcrt K76T and MDR N86. Of the 181 samples 155 successfully amplified for Pfcrt and 145 for Pfmdr N86. The overall prevalence of CQ drug-resistant parasites was 1.9% (3/155), with no significant difference between the two provinces. No N86Y/F mutations in the Pfmdr gene were observed in any of the sample.
CONCLUSION
CONCLUSIONS
This study reveals the return of CQ sensitive parasites in Southern and Western Provinces of Zambia 14 years after its withdrawal. Surveillance of molecular resistant markers for anti-malarials should be included in the Malaria Elimination Programme so that resistance is monitored country wide.
Identifiants
pubmed: 31796087
doi: 10.1186/s12936-019-3031-4
pii: 10.1186/s12936-019-3031-4
pmc: PMC6889585
doi:
Substances chimiques
ATP-Binding Cassette Transporters
0
Antimalarials
0
Membrane Transport Proteins
0
PfCRT protein, Plasmodium falciparum
0
Protozoan Proteins
0
mdr gene protein, Plasmodium
0
Chloroquine
886U3H6UFF
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
391Références
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