Dynamic changes in genetic diversity, drug resistance mutations, and treatment outcomes of falciparum malaria from the low-transmission to the pre-elimination phase on the islands of São Tomé and Príncipe
Abstract Background With effective vector control and case management, substantial progress has been made towards eliminating malaria on the islands of São Tomé and Príncipe (STP). This study assessed the dynamic changes in the genetic diversity of Plasmodium falciparum, the anti-malarial drug resis...
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ftdoajarticles:oai:doaj.org/article:a10cf52fd3bd401a8099a6013bc6f181 2023-05-15T15:17:13+02:00 Dynamic changes in genetic diversity, drug resistance mutations, and treatment outcomes of falciparum malaria from the low-transmission to the pre-elimination phase on the islands of São Tomé and Príncipe Ying-An Chen Tsen-Ju Shiu Lien-Fen Tseng Chien-Fu Cheng Wei-Liang Shih Arlindo Vicente de Assunção Carvalho Kun-Hsien Tsai 2021-12-01T00:00:00Z https://doi.org/10.1186/s12936-021-04007-3 https://doaj.org/article/a10cf52fd3bd401a8099a6013bc6f181 EN eng BMC https://doi.org/10.1186/s12936-021-04007-3 https://doaj.org/toc/1475-2875 doi:10.1186/s12936-021-04007-3 1475-2875 https://doaj.org/article/a10cf52fd3bd401a8099a6013bc6f181 Malaria Journal, Vol 20, Iss 1, Pp 1-15 (2021) São Tomé and Príncipe Malaria Plasmodium falciparum Merozoite surface proteins Antimalarial drug resistance mutations Recurrence Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 article 2021 ftdoajarticles https://doi.org/10.1186/s12936-021-04007-3 2022-12-31T09:46:37Z Abstract Background With effective vector control and case management, substantial progress has been made towards eliminating malaria on the islands of São Tomé and Príncipe (STP). This study assessed the dynamic changes in the genetic diversity of Plasmodium falciparum, the anti-malarial drug resistance mutations, and malaria treatment outcomes between 2010 and 2016 to provide insights for the prevention of malaria rebounding. Methods Polymorphic regions of merozoite surface proteins 1 and 2 (msp1 and msp2) were sequenced in 118 dried blood spots (DBSs) collected from malaria patients who had visited the Central Hospital in 2010–2016. Mutations in the multi-drug resistance I (pfmdr1), chloroquine resistance transporter (pfcrt), and kelch 13 (pfk13) genes were analysed by polymerase chain reaction-restriction fragment length polymorphism (PCR–RFLP) and sequencing in 111 DBSs. A total of 7482 cases that completed a 28-day follow-up were evaluated for treatment outcomes based on the microscopic results. Regression models were used to characterize factors associated with levels of parasite density and treatment failures. Results Parasite strains in STP showed significant changes during and after the peak incidence in 2012. The prevalent allelic type in msp1 changed from K1 to MAD20, and that in msp2 changed from 3D7/IC to FC27. The dominant alleles of drug-resistance markers were pfmdr1 86Y, 184F, D1246, and pfcrt 76 T (Y-F-D-T, 51.4%). The average parasite density in malaria cases declined threefold from low-transmission (2010–2013) to pre-elimination period (2014–2016). Logistic regression models showed that patients with younger age (OR for age = 0.97–0.98, p < 0.001), higher initial parasite density (log10-transformed, OR = 1.44, p < 0.001), and receiving quinine treatment (compared to artemisinin-based combination therapy, OR = 1.91–1.96, p < 0.001) were more likely to experience treatment failures during follow-up. Conclusions Plasmodium falciparum in STP had experienced changes in prevalent strains, ... Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Malaria Journal 20 1 |
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Directory of Open Access Journals: DOAJ Articles |
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ftdoajarticles |
language |
English |
topic |
São Tomé and Príncipe Malaria Plasmodium falciparum Merozoite surface proteins Antimalarial drug resistance mutations Recurrence Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
spellingShingle |
São Tomé and Príncipe Malaria Plasmodium falciparum Merozoite surface proteins Antimalarial drug resistance mutations Recurrence Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 Ying-An Chen Tsen-Ju Shiu Lien-Fen Tseng Chien-Fu Cheng Wei-Liang Shih Arlindo Vicente de Assunção Carvalho Kun-Hsien Tsai Dynamic changes in genetic diversity, drug resistance mutations, and treatment outcomes of falciparum malaria from the low-transmission to the pre-elimination phase on the islands of São Tomé and Príncipe |
topic_facet |
São Tomé and Príncipe Malaria Plasmodium falciparum Merozoite surface proteins Antimalarial drug resistance mutations Recurrence Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
description |
Abstract Background With effective vector control and case management, substantial progress has been made towards eliminating malaria on the islands of São Tomé and Príncipe (STP). This study assessed the dynamic changes in the genetic diversity of Plasmodium falciparum, the anti-malarial drug resistance mutations, and malaria treatment outcomes between 2010 and 2016 to provide insights for the prevention of malaria rebounding. Methods Polymorphic regions of merozoite surface proteins 1 and 2 (msp1 and msp2) were sequenced in 118 dried blood spots (DBSs) collected from malaria patients who had visited the Central Hospital in 2010–2016. Mutations in the multi-drug resistance I (pfmdr1), chloroquine resistance transporter (pfcrt), and kelch 13 (pfk13) genes were analysed by polymerase chain reaction-restriction fragment length polymorphism (PCR–RFLP) and sequencing in 111 DBSs. A total of 7482 cases that completed a 28-day follow-up were evaluated for treatment outcomes based on the microscopic results. Regression models were used to characterize factors associated with levels of parasite density and treatment failures. Results Parasite strains in STP showed significant changes during and after the peak incidence in 2012. The prevalent allelic type in msp1 changed from K1 to MAD20, and that in msp2 changed from 3D7/IC to FC27. The dominant alleles of drug-resistance markers were pfmdr1 86Y, 184F, D1246, and pfcrt 76 T (Y-F-D-T, 51.4%). The average parasite density in malaria cases declined threefold from low-transmission (2010–2013) to pre-elimination period (2014–2016). Logistic regression models showed that patients with younger age (OR for age = 0.97–0.98, p < 0.001), higher initial parasite density (log10-transformed, OR = 1.44, p < 0.001), and receiving quinine treatment (compared to artemisinin-based combination therapy, OR = 1.91–1.96, p < 0.001) were more likely to experience treatment failures during follow-up. Conclusions Plasmodium falciparum in STP had experienced changes in prevalent strains, ... |
format |
Article in Journal/Newspaper |
author |
Ying-An Chen Tsen-Ju Shiu Lien-Fen Tseng Chien-Fu Cheng Wei-Liang Shih Arlindo Vicente de Assunção Carvalho Kun-Hsien Tsai |
author_facet |
Ying-An Chen Tsen-Ju Shiu Lien-Fen Tseng Chien-Fu Cheng Wei-Liang Shih Arlindo Vicente de Assunção Carvalho Kun-Hsien Tsai |
author_sort |
Ying-An Chen |
title |
Dynamic changes in genetic diversity, drug resistance mutations, and treatment outcomes of falciparum malaria from the low-transmission to the pre-elimination phase on the islands of São Tomé and Príncipe |
title_short |
Dynamic changes in genetic diversity, drug resistance mutations, and treatment outcomes of falciparum malaria from the low-transmission to the pre-elimination phase on the islands of São Tomé and Príncipe |
title_full |
Dynamic changes in genetic diversity, drug resistance mutations, and treatment outcomes of falciparum malaria from the low-transmission to the pre-elimination phase on the islands of São Tomé and Príncipe |
title_fullStr |
Dynamic changes in genetic diversity, drug resistance mutations, and treatment outcomes of falciparum malaria from the low-transmission to the pre-elimination phase on the islands of São Tomé and Príncipe |
title_full_unstemmed |
Dynamic changes in genetic diversity, drug resistance mutations, and treatment outcomes of falciparum malaria from the low-transmission to the pre-elimination phase on the islands of São Tomé and Príncipe |
title_sort |
dynamic changes in genetic diversity, drug resistance mutations, and treatment outcomes of falciparum malaria from the low-transmission to the pre-elimination phase on the islands of são tomé and príncipe |
publisher |
BMC |
publishDate |
2021 |
url |
https://doi.org/10.1186/s12936-021-04007-3 https://doaj.org/article/a10cf52fd3bd401a8099a6013bc6f181 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Malaria Journal, Vol 20, Iss 1, Pp 1-15 (2021) |
op_relation |
https://doi.org/10.1186/s12936-021-04007-3 https://doaj.org/toc/1475-2875 doi:10.1186/s12936-021-04007-3 1475-2875 https://doaj.org/article/a10cf52fd3bd401a8099a6013bc6f181 |
op_doi |
https://doi.org/10.1186/s12936-021-04007-3 |
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Malaria Journal |
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20 |
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1766347477899804672 |