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Prevalence of Plasmodium falciparum Pfcrt and Pfmdr1 alleles in settings with different levels of Plasmodium vivax co-endemicity in Ethiopia

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 f...

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Autores principales: Hailemeskel, Elifaged, Menberu, Temesgen, Shumie, Girma, Behaksra, Sinknesh, Chali, Wakweya, Keffale, Migbaru, Belachew, Mulualem, Shitaye, Getasew, Mohammed, Hussien, Abebe, Daniel, Ashine, Temesgen, Drakeley, Chris, Mamo, Hassen, Petros, Beyene, Bousema, Teun, Tadesse, Fitsum G., Gadisa, Endalamaw
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6796752/
https://www.ncbi.nlm.nih.gov/pubmed/31539706
http://dx.doi.org/10.1016/j.ijpddr.2019.09.002
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author Hailemeskel, Elifaged
Menberu, Temesgen
Shumie, Girma
Behaksra, Sinknesh
Chali, Wakweya
Keffale, Migbaru
Belachew, Mulualem
Shitaye, Getasew
Mohammed, Hussien
Abebe, Daniel
Ashine, Temesgen
Drakeley, Chris
Mamo, Hassen
Petros, Beyene
Bousema, Teun
Tadesse, Fitsum G.
Gadisa, Endalamaw
author_facet Hailemeskel, Elifaged
Menberu, Temesgen
Shumie, Girma
Behaksra, Sinknesh
Chali, Wakweya
Keffale, Migbaru
Belachew, Mulualem
Shitaye, Getasew
Mohammed, Hussien
Abebe, Daniel
Ashine, Temesgen
Drakeley, Chris
Mamo, Hassen
Petros, Beyene
Bousema, Teun
Tadesse, Fitsum G.
Gadisa, Endalamaw
author_sort Hailemeskel, Elifaged
collection PubMed
description 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.
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spelling pubmed-67967522019-10-22 Prevalence of Plasmodium falciparum Pfcrt and Pfmdr1 alleles in settings with different levels of Plasmodium vivax co-endemicity in Ethiopia Hailemeskel, Elifaged Menberu, Temesgen Shumie, Girma Behaksra, Sinknesh Chali, Wakweya Keffale, Migbaru Belachew, Mulualem Shitaye, Getasew Mohammed, Hussien Abebe, Daniel Ashine, Temesgen Drakeley, Chris Mamo, Hassen Petros, Beyene Bousema, Teun Tadesse, Fitsum G. Gadisa, Endalamaw Int J Parasitol Drugs Drug Resist Regular Article 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. Elsevier 2019-09-09 /pmc/articles/PMC6796752/ /pubmed/31539706 http://dx.doi.org/10.1016/j.ijpddr.2019.09.002 Text en © 2019 The Authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Regular Article
Hailemeskel, Elifaged
Menberu, Temesgen
Shumie, Girma
Behaksra, Sinknesh
Chali, Wakweya
Keffale, Migbaru
Belachew, Mulualem
Shitaye, Getasew
Mohammed, Hussien
Abebe, Daniel
Ashine, Temesgen
Drakeley, Chris
Mamo, Hassen
Petros, Beyene
Bousema, Teun
Tadesse, Fitsum G.
Gadisa, Endalamaw
Prevalence of Plasmodium falciparum Pfcrt and Pfmdr1 alleles in settings with different levels of Plasmodium vivax co-endemicity in Ethiopia
title Prevalence of Plasmodium falciparum Pfcrt and Pfmdr1 alleles in settings with different levels of Plasmodium vivax co-endemicity in Ethiopia
title_full Prevalence of Plasmodium falciparum Pfcrt and Pfmdr1 alleles in settings with different levels of Plasmodium vivax co-endemicity in Ethiopia
title_fullStr Prevalence of Plasmodium falciparum Pfcrt and Pfmdr1 alleles in settings with different levels of Plasmodium vivax co-endemicity in Ethiopia
title_full_unstemmed Prevalence of Plasmodium falciparum Pfcrt and Pfmdr1 alleles in settings with different levels of Plasmodium vivax co-endemicity in Ethiopia
title_short Prevalence of Plasmodium falciparum Pfcrt and Pfmdr1 alleles in settings with different levels of Plasmodium vivax co-endemicity in Ethiopia
title_sort prevalence of plasmodium falciparum pfcrt and pfmdr1 alleles in settings with different levels of plasmodium vivax co-endemicity in ethiopia
topic Regular Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6796752/
https://www.ncbi.nlm.nih.gov/pubmed/31539706
http://dx.doi.org/10.1016/j.ijpddr.2019.09.002
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