Global threat from drug resistant HIV in sub-Saharan Africa

BMJ ◽  
2012 ◽  
Vol 344 (jun18 1) ◽  
pp. e4159-e4159 ◽  
Author(s):  
R. L. Hamers ◽  
C. Kityo ◽  
J. M. A. Lange ◽  
T. F. R. d. Wit ◽  
P. Mugyenyi
Keyword(s):  
Sub Saharan Africa ◽  
Drug Resistant ◽  
Sub Saharan ◽  
Global Threat

scholarly journals Interactions Between Antenatal Sulfadoxine-Pyrimethamine, Drug-Resistant Plasmodium falciparum Parasites, and Delivery Outcomes in Malawi

2020 ◽  
Vol 222 (4) ◽  
pp. 661-669 ◽  
Author(s):  
Steve M Taylor ◽  
Brandt Levitt ◽  
Betsy Freedman ◽  
Mwayiwawo Madanitsa ◽  
Kyaw-Lay Thwai ◽  
...  
Keyword(s):  
Birth Weight ◽  
Preventive Therapy ◽  
Sub Saharan Africa ◽  
Drug Resistant ◽  
Wild Type ◽  
Resistance Marker ◽  
Chain Reaction ◽  
Delivery Outcomes ◽  
Polymerase Chain ◽  
Sub Saharan

Abstract Background Sulfadoxine-pyrimethamine (SP) is used as intermittent preventive therapy in pregnancy (IPTp) for malaria in sub-Saharan Africa. The resistance marker dhps A581G has been associated with reduced IPTp-SP efficacy and enhanced morbidity in SP recipients. Methods We measured SP-resistance allele frequencies in Malawian women participating in a trial comparing IPTp with SP against intermittent screening by rapid diagnostic tests (ISTp). We genotyped polymerase chain reaction-detected parasites using deep sequencing of SP-resistance alleles. Results Among 125 placental infections, A581G-bearing parasites were associated with reduced birth weight (mean difference [MD], 252 g; 95% confidence interval [CI], 46–457; P = .017). Relative to ISTp, IPTp-SP was associated with higher birth weights in women with wild-type parasites (MD, 116 g; 95% CI, −40 to 272; P = .142) and lower birth weights in women with A581G-bearing parasites (MD, 192 g; 95% CI, −264 to 648; P = .385) (Pinteraction = .033). Similar associations were noted on gestational age (Pinteraction = .075). Amongst only IPTp-SP recipients, relative to women who last received SP > 4 weeks before delivery, recent SP receipt was associated with lower birth weight in women with wild-type parasites (MD, 118 g; 95% CI, −376 to 139; P = .361) and higher birth weight in women with A581G-bearing parasites (MD, 783 g; 95% CI, −20 to 1586; P = .054) (Pinteraction = .005). Conclusions The effectiveness in birth weight of IPTp-SP is compromised by A581G-bearing parasites, but there was no evidence that the adverse effects of these parasites are exacerbated by antenatal SP. ISRCTN Registry www.isrctn.com/ISRCTN69800930.

scholarly journals Review of multidrug-resistant and extensively drug-resistant TB: global perspectives with a focus on sub-Saharan Africa

2010 ◽  
Vol 15 (9) ◽  
pp. 1052-1066 ◽  
Author(s):  
Giovanni Battista Migliori ◽  
Keertan Dheda ◽  
Rosella Centis ◽  
Peter Mwaba ◽  
Matthew Bates ◽  
...  
Keyword(s):  
Multidrug Resistant ◽  
Sub Saharan Africa ◽  
Drug Resistant ◽  
Global Perspectives ◽  
Extensively Drug Resistant ◽  
Sub Saharan

scholarly journals Epidemic multiple drug resistant Salmonella Typhimurium causing invasive disease in sub-Saharan Africa have a distinct genotype

2009 ◽  
Vol 19 (12) ◽  
pp. 2279-2287 ◽  
Author(s):  
R. A. Kingsley ◽  
C. L. Msefula ◽  
N. R. Thomson ◽  
S. Kariuki ◽  
K. E. Holt ◽  
...  
Keyword(s):  
Salmonella Typhimurium ◽  
Invasive Disease ◽  
Sub Saharan Africa ◽  
Multiple Drug ◽  
Drug Resistant ◽  
Distinct Genotype ◽  
Multiple Drug Resistant ◽  
Sub Saharan

scholarly journals Genomic investigation of a suspected multi-drug resistant Klebsiella pneumoniae outbreak in a neonatal care unit in sub-Saharan Africa

2020 ◽  
Author(s):  
Jennifer Cornick ◽  
Patrick Musicha ◽  
Chikondi Peno ◽  
Ezgi Saeger ◽  
Pui-ying Iroh Toh ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Whole Genome Sequencing ◽  
Genome Sequencing ◽  
Resistance Genes ◽  
Sub Saharan Africa ◽  
Whole Genome ◽  
Drug Resistant ◽  
Sub Saharan ◽  
Neonatal Care Unit ◽  
Suspected Outbreak

ABSTRACTA suspected outbreak of multi-drug resistant (MDR) Klebsiella pneumoniae in a Malawian neonatal unit was investigated using whole-genome sequencing. Strain-types, virulence and resistance genes of K. pneumoniae isolated from patients from the hospital over a four-year period were identified. A MDR ST340 clone was implicated as the likely outbreak cause.

scholarly journals The phylogeography and incidence of multi-drug resistant typhoid fever in sub-Saharan Africa

2018 ◽  
Vol 9 (1) ◽  
Author(s):  
Se Eun Park ◽  
Duy Thanh Pham ◽  
Christine Boinett ◽  
Vanessa K. Wong ◽  
Gi Deok Pak ◽  
...  
Keyword(s):  
Typhoid Fever ◽  
Sub Saharan Africa ◽  
Drug Resistant ◽  
Sub Saharan

scholarly journals Combination Therapy Counteracts the Enhanced Transmission of Drug-Resistant Malaria Parasites to Mosquitoes

2004 ◽  
Vol 48 (10) ◽  
pp. 3940-3943 ◽  
Author(s):  
Rachel L. Hallett ◽  
Colin J. Sutherland ◽  
Neal Alexander ◽  
Rosalynn Ord ◽  
Musa Jawara ◽  
...  
Keyword(s):  
Combination Therapy ◽  
Selective Advantage ◽  
Treated Group ◽  
Sub Saharan Africa ◽  
Drug Resistant ◽  
Mosquito Vectors ◽  
Malaria Parasites ◽  
Enhanced Transmission ◽  
Sub Saharan ◽  
The Impact

ABSTRACT Malaria parasites carrying genes conferring resistance to antimalarials are thought to have a selective advantage which leads to higher rates of transmissibility from the drug-treated host. This is a likely mechanism for the increasing prevalence of parasites with resistance to chloroquine (CQ) and sulfadoxine-pyrimethamine in sub-Saharan Africa. Combination therapy is the key strategy being implemented to reduce the impact of resistance, but its effect on the transmission of genetically resistant parasites from treated patients to mosquito vectors has not been measured directly. In a trial comparing CQ monotherapy to the combination CQ plus artesunate (AS) in Gambian children with uncomplicated falciparum malaria, we measured transmissibility by feeding Anopheles gambiae mosquitoes with blood from 43 gametocyte-positive patients through a membrane. In the CQ-treated group, gametocytes from patients carrying parasites with the CQ resistance-associated allele pfcrt-76T prior to treatment produced infected mosquitoes with 38 times higher Plasmodium falciparum oocyst burdens than mosquitoes fed on gametocytes from patients infected with sensitive parasites (P < 0.001). Gametocytes from parasites carrying the resistance-associated allele pfmdr1-86Y produced 14-fold higher oocyst burdens than gametocytes from patients infected with sensitive parasites (P = 0.011). However, parasites carrying either of these resistance-associated alleles pretreatment were not associated with higher mosquito oocyst burdens in the CQ-AS-treated group. Thus, combination therapy overcomes the transmission advantage enjoyed by drug-resistant parasites.

Sign in / Sign up

Export Citation Format

Share Document