Historical trends and new surveillance of Plasmodium falciparum drug resistance markers in Angola
Abstract Background Plasmodium falciparum resistance to chloroquine (CQ) and sulfadoxine-pyrimethamine (SP) has historically posed a major threat to malaria control throughout the world. The country of Angola officially replaced CQ with artemisinin-based combination therapy (ACT) as a first-line tre...
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ftdoajarticles:oai:doaj.org/article:a8703c75c02c4ddf860c50ea4b2c804f 2023-05-15T15:18:19+02:00 Historical trends and new surveillance of Plasmodium falciparum drug resistance markers in Angola Emily R. Ebel Fátima Reis Dmitri A. Petrov Sandra Beleza 2021-04-01T00:00:00Z https://doi.org/10.1186/s12936-021-03713-2 https://doaj.org/article/a8703c75c02c4ddf860c50ea4b2c804f EN eng BMC https://doi.org/10.1186/s12936-021-03713-2 https://doaj.org/toc/1475-2875 doi:10.1186/s12936-021-03713-2 1475-2875 https://doaj.org/article/a8703c75c02c4ddf860c50ea4b2c804f Malaria Journal, Vol 20, Iss 1, Pp 1-9 (2021) Plasmodium falciparum Angola Chloroquine Lumefantrine Drug resistance Selection Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 article 2021 ftdoajarticles https://doi.org/10.1186/s12936-021-03713-2 2022-12-31T09:26:44Z Abstract Background Plasmodium falciparum resistance to chloroquine (CQ) and sulfadoxine-pyrimethamine (SP) has historically posed a major threat to malaria control throughout the world. The country of Angola officially replaced CQ with artemisinin-based combination therapy (ACT) as a first-line treatment in 2006, but malaria cases and deaths have recently been rising. Many classic resistance mutations are relevant for the efficacy of currently available drugs, making it important to continue monitoring their frequency in Angola. Methods Plasmodium falciparum DNA was sampled from the blood of 50 hospital patients in Cabinda, Angola from October-December of 2018. Each infection was genotyped for 13 alleles in the genes crt, mdr1, dhps, dhfr, and kelch13, which are collectively involved in resistance to six common anti-malarials. To compare frequency patterns over time, P. falciparum genotype data were also collated from studies published from across Angola in the last two decades. Results The two most important alleles for CQ resistance, crt 76T and mdr1 86Y, were found at respective frequencies of 71.4% and 6.5%. Historical data suggest that mdr1 N86 has been steadily replacing 86Y throughout Angola in the last decade, while the frequency of crt 76T has been more variable across studies. Over a third of new samples from Cabinda were ‘quintuple mutants’ for SP resistance in dhfr/dhps, with a sixth mutation at dhps A581G present at 9.6% frequency. The markers dhfr 51I, dhfr 108N, and dhps 437G have been nearly fixed in Angola since the early 2000s, whereas dhfr 59R may have risen to high frequency more recently. Finally, no non-synonymous polymorphisms were detected in kelch13, which is involved in artemisinin resistance in Southeast Asia. Conclusions Genetic markers of P. falciparum resistance to CQ are likely declining in frequency in Angola, consistent with the official discontinuation of CQ in 2006. The high frequency of multiple genetic markers of SP resistance is consistent with the continued public and ... Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Malaria Journal 20 1 |
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topic |
Plasmodium falciparum Angola Chloroquine Lumefantrine Drug resistance Selection Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
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Plasmodium falciparum Angola Chloroquine Lumefantrine Drug resistance Selection Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 Emily R. Ebel Fátima Reis Dmitri A. Petrov Sandra Beleza Historical trends and new surveillance of Plasmodium falciparum drug resistance markers in Angola |
topic_facet |
Plasmodium falciparum Angola Chloroquine Lumefantrine Drug resistance Selection Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
description |
Abstract Background Plasmodium falciparum resistance to chloroquine (CQ) and sulfadoxine-pyrimethamine (SP) has historically posed a major threat to malaria control throughout the world. The country of Angola officially replaced CQ with artemisinin-based combination therapy (ACT) as a first-line treatment in 2006, but malaria cases and deaths have recently been rising. Many classic resistance mutations are relevant for the efficacy of currently available drugs, making it important to continue monitoring their frequency in Angola. Methods Plasmodium falciparum DNA was sampled from the blood of 50 hospital patients in Cabinda, Angola from October-December of 2018. Each infection was genotyped for 13 alleles in the genes crt, mdr1, dhps, dhfr, and kelch13, which are collectively involved in resistance to six common anti-malarials. To compare frequency patterns over time, P. falciparum genotype data were also collated from studies published from across Angola in the last two decades. Results The two most important alleles for CQ resistance, crt 76T and mdr1 86Y, were found at respective frequencies of 71.4% and 6.5%. Historical data suggest that mdr1 N86 has been steadily replacing 86Y throughout Angola in the last decade, while the frequency of crt 76T has been more variable across studies. Over a third of new samples from Cabinda were ‘quintuple mutants’ for SP resistance in dhfr/dhps, with a sixth mutation at dhps A581G present at 9.6% frequency. The markers dhfr 51I, dhfr 108N, and dhps 437G have been nearly fixed in Angola since the early 2000s, whereas dhfr 59R may have risen to high frequency more recently. Finally, no non-synonymous polymorphisms were detected in kelch13, which is involved in artemisinin resistance in Southeast Asia. Conclusions Genetic markers of P. falciparum resistance to CQ are likely declining in frequency in Angola, consistent with the official discontinuation of CQ in 2006. The high frequency of multiple genetic markers of SP resistance is consistent with the continued public and ... |
format |
Article in Journal/Newspaper |
author |
Emily R. Ebel Fátima Reis Dmitri A. Petrov Sandra Beleza |
author_facet |
Emily R. Ebel Fátima Reis Dmitri A. Petrov Sandra Beleza |
author_sort |
Emily R. Ebel |
title |
Historical trends and new surveillance of Plasmodium falciparum drug resistance markers in Angola |
title_short |
Historical trends and new surveillance of Plasmodium falciparum drug resistance markers in Angola |
title_full |
Historical trends and new surveillance of Plasmodium falciparum drug resistance markers in Angola |
title_fullStr |
Historical trends and new surveillance of Plasmodium falciparum drug resistance markers in Angola |
title_full_unstemmed |
Historical trends and new surveillance of Plasmodium falciparum drug resistance markers in Angola |
title_sort |
historical trends and new surveillance of plasmodium falciparum drug resistance markers in angola |
publisher |
BMC |
publishDate |
2021 |
url |
https://doi.org/10.1186/s12936-021-03713-2 https://doaj.org/article/a8703c75c02c4ddf860c50ea4b2c804f |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Malaria Journal, Vol 20, Iss 1, Pp 1-9 (2021) |
op_relation |
https://doi.org/10.1186/s12936-021-03713-2 https://doaj.org/toc/1475-2875 doi:10.1186/s12936-021-03713-2 1475-2875 https://doaj.org/article/a8703c75c02c4ddf860c50ea4b2c804f |
op_doi |
https://doi.org/10.1186/s12936-021-03713-2 |
container_title |
Malaria Journal |
container_volume |
20 |
container_issue |
1 |
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1766348512479412224 |