scholarly journals Incomplete reversal of genotypic resistance of Plasmodium falciparum to chloroquine after a decade of change in malaria treatment policy in Uganda

2016 ◽  
pp. 15
Author(s):  
Moses Ocan ◽  
Fred A. Katabazi ◽  
Edgar Kigozi ◽  
Freddie Bwanga ◽  
Samuel Kyobe ◽  
...  
Keyword(s):  
Plasmodium Falciparum ◽  
Malaria Treatment ◽  
Genotypic Resistance ◽  
Treatment Policy

scholarly journals Mass Intake of Hydroxychloroquine or Chloroquine in the Present Context of the COVID-19 Outbreak: Possible Consequences in Endemic Malaria Settings

2020 ◽  
Author(s):  
Dieudonné Mvumbi
Keyword(s):  
Drug Resistance ◽  
Plasmodium Falciparum ◽  
Malaria Control ◽  
Malaria Prevalence ◽  
Malaria Treatment ◽  
Curative Treatment ◽  
Molecular Changes ◽  
Treatment Policy ◽  
Endemic Malaria ◽  
Present Context

World is currently experiencing a new pandemic for which no curative treatment is available. At this time, coronavirus disease 2019 (Covid-19) has reached 183 countries and has caused several deaths. Many reports presented chloroquine (CQ) and hydrochloroquine (HCQ), former drugs used against malaria, as the best current choice to fight this terrible disease. As these molecules had been withdrawn in malaria treatment policy due to chemoresistance, their reintroduction could have some consequences. Though local malaria prevalence could decrease for a while, molecular changes are likely to happen on some plasmodium falciparum genes involved in conferring drug resistance. This could threaten efforts in malaria control, if these molecules are widely administered.

scholarly journals Increased prevalence of pfdhfr and pfdhps mutations associated with sulfadoxine–pyrimethamine resistance in Plasmodium falciparum isolates from Jazan Region, Southwestern Saudi Arabia: important implications for malaria treatment policy

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Aymen M. Madkhali ◽  
Hesham M. Al-Mekhlafi ◽  
Wahib M. Atroosh ◽  
Ahmad Hassn Ghzwani ◽  
Khalid Ammash Zain ◽  
...  
Keyword(s):  
Plasmodium Falciparum ◽  
Saudi Arabia ◽  
Point Mutations ◽  
Dried Blood Spots ◽  
Malaria Treatment ◽  
Single Mutation ◽  
Treatment Policy ◽  
High Prevalence ◽  
Quadruple Mutant

Abstract Background Despite significant progress in eliminating malaria from the Kingdom of Saudi Arabia, the disease is still endemic in the southwestern region of the country. Artesunate plus sulfadoxine–pyrimethamine (AS + SP) has been used in Saudi Arabia since 2007 as a first-line treatment for uncomplicated Plasmodium falciparum malaria. This study aimed to investigate the prevalence of mutations associated with resistance to artemisinin and sulfadoxine–pyrimethamine (SP) resistance in P. falciparum parasites circulating in Jazan region, southwestern Saudi Arabia. Methods A total of 151 P. falciparum isolates were collected between April 2018 and March 2019 from 12 of the governorates in Jazan region. Genomic DNA was extracted from dried blood spots and amplified using nested PCR. Polymorphisms in the propeller domain of the P. falciparum k13 (pfkelch13) gene and point mutations in the P. falciparum dihydrofolate reductase (pfdhfr) and dihydropteroate synthase (pfdhps) genes were identified by sequencing. Results No mutations in the pfkelch13 propeller domain were found in any of the 151 isolates. However, point mutations in the pfdhfr and pfdhps genes were detected in 90.7% (137/151) of the isolates. The pfdhfr double mutations N51I + S108N (i.e. ACICNI haplotype) and triple mutations N51I + C59R + S108N (i.e. ACIRNI haplotype) were detected in 47% and 37.8% of the isolates, respectively. Moreover, the pfdhps single mutation at codon A437G and double mutations A437G + K540E (i.e. SGEAAI haplotype) were observed in 4.6% and 51.7% of the isolates, respectively. Interestingly, 23.8%, 25.1 and 12.6% of the isolates had quintuple, quadruple and triple mutated combined pfdhfr–pfdhps genotypes, respectively. Furthermore, significant associations were found between the prevalence of mutant haplotypes and the age, gender and nationality of the patients (P < 0.05). Conclusion This study revealed a high prevalence of point mutations in the pfdhfr and pfdhps genes of P. falciparum isolates from Jazan region, with quintuple and quadruple mutant pfdhfr–pfdhps genotypes reported for the first time in Saudi Arabia and the Arabian Peninsula. Despite the absence of the pfkelch13 mutation in the isolates examined, the pfdhfr and pfdhps mutations undermine the efficacy of SP partner drug, thereby threatening the main falciparum malaria treatment policy in Saudi Arabia, i.e. the use of AS + SP. Therefore, the continuous molecular and in-vivo monitoring of ACT efficacy in Jazan region is highly recommended.

Response of children with Plasmodium falciparum to chloroquine and development of a national malaria treatment policy in Zaire

1988 ◽  
Vol 82 (3) ◽  
pp. 353-357 ◽  
Author(s):  
K.M. Paluku ◽  
Joel G. Breman ◽  
Melinda Moore ◽  
N.P. Ngimbi ◽  
John D. Sexton ◽  
...  
Keyword(s):  
Plasmodium Falciparum ◽  
Malaria Treatment ◽  
Treatment Policy

scholarly journals Prevalence of the molecular marker of Plasmodium falciparum resistance to chloroquine and sulphadoxine/pyrimethamine in Benin seven years after the change of malaria treatment policy

2013 ◽  
Vol 12 (1) ◽  
Author(s):  
Aurore Ogouyèmi-Hounto ◽  
Nicaise Tuikue Ndam ◽  
Dorothée Kinde Gazard ◽  
Sitou d’Almeida ◽  
Lucette Koussihoude ◽  
...  
Keyword(s):  
Plasmodium Falciparum ◽  
Molecular Marker ◽  
Malaria Treatment ◽  
Treatment Policy ◽  
Sulphadoxine Pyrimethamine

scholarly journals Malaria treatment policy change in Uganda: what role did evidence play?

2014 ◽  
Vol 13 (1) ◽  
Author(s):  
Juliet Nabyonga-Orem ◽  
Freddie Ssengooba ◽  
Jean Macq ◽  
Bart Criel
Keyword(s):  
Policy Change ◽  
Malaria Treatment ◽  
Treatment Policy

scholarly journals Increased Prevalence of Mutant Allele Pfdhps 437G and Pfdhfr Triple Mutation in Plasmodium falciparum Isolates from a Rural Area of Gabon, Three Years after the Change of Malaria Treatment Policy

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Jacques-Mari Ndong Ngomo ◽  
Denise Patricia Mawili-Mboumba ◽  
Noé Patrick M’Bondoukwe ◽  
Rosalie Nikiéma Ndong Ella ◽  
Marielle Karine Bouyou Akotet
Keyword(s):  
Plasmodium Falciparum ◽  
Dihydrofolate Reductase ◽  
Mutant Allele ◽  
Continuous Monitoring ◽  
Intermittent Preventive Treatment ◽  
Point Mutations ◽  
Preventive Treatment ◽  
Malaria Treatment ◽  
Pcr Rflp ◽  
Elevated Frequency

In Gabon, sulfadoxine-pyrimethamine (SP) is recommended for intermittent preventive treatment during pregnancy (IPTp-SP) and for uncomplicated malaria treatment through ACTs drug. P. falciparum strains resistant to SP are frequent in areas where this drug is highly used and is associated with the occurrence of mutations on Plasmodium falciparum dihydrofolate reductase (Pfdhfr) and dihydropteroate synthetase (Pfdhps) genes. The aim of the study was to compare the proportion of mutations on Pfdhfr and Pfdhps genes in isolates collected at Oyem in northern Gabon, in 2005 at the time of IPTp-SP introduction and three years later. Point mutations were analyzed by nested PCR-RFLP method. Among 91 isolates, more than 90% carried Pfdhfr 108N and Pfdhfr 59R alleles. Frequencies of Pfdhfr 51I (98%) and Pfdhps 437G (67.7%) mutant alleles were higher in 2008. Mutations at codons 164, 540, and 581 were not detected. The proportion of the triple Pfdhfr mutation and quadruple mutation including A437G was high: 91.9% in 2008 and 64.8% in 2008, respectively. The present study highlights an elevated frequency of Pfdhfr and Pfdhps mutant alleles, although quintuple mutations were not found in north Gabon. These data suggest the need of a continuous monitoring of SP resistance in Gabon.

scholarly journals A systematic approach to the development of a rational malaria treatment policy in Zambia

1998 ◽  
Vol 3 (10) ◽  
pp. 854-854
Author(s):  
Lawrence M. Barat ◽  
Benson Himonga ◽  
Simon Nkunika ◽  
Mary Ettling ◽  
Trenton K. Ruebush ◽  
...  
Keyword(s):  
Systematic Approach ◽  
Malaria Treatment ◽  
Treatment Policy
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