Trends in chloroquine resistance marker, Pfcrt-K76T mutation ten years after chloroquine withdrawal in Tanzania
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- 作者：Asia Mohammed (18)
Arnold Ndaro (18)
Akili Kalinga (19)
Alphaxard Manjurano (20)
Jackline F Mosha (20)
Dominick F Mosha (18)
Marco van Zwetselaar (18)
Jan B Koenderink (21)
Frank W Mosha (18)
Michael Alifrangis (22)
Hugh Reyburn (18) (23)
Cally Roper (23)
Reginald A Kavishe (18) - 关键词：Plasmodium falciparum ; Chloroquine ; Pfcrt ; Tanzania ; Drug resistance ; Malaria ; Mutations ; Parasites ; Polymorphisms
- 刊名：Malaria Journal
- 出版年：2013
- 出版时间：December 2013
- 年：2013
- 卷：12
- 期：1
- 全文大小：205 KB
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Arnold Ndaro (18)
Akili Kalinga (19)
Alphaxard Manjurano (20)
Jackline F Mosha (20)
Dominick F Mosha (18)
Marco van Zwetselaar (18)
Jan B Koenderink (21)
Frank W Mosha (18)
Michael Alifrangis (22)
Hugh Reyburn (18) (23)
Cally Roper (23)
Reginald A Kavishe (18)
18. Kilimanjaro Christian Medical University College and Kilimanjaro Clinical Research Institute, Moshi, Tanzania
19. National Institute for Medical Research, Tukuyu Centre, Tukuyu, Tanzania
20. National Institute for Medical Research, Mwanza Centre, Mwanza, Tanzania
21. Department of Pharmacology and Toxicology, Nijmegen Centre for Molecular Life Sciences, Radboud University Medical Centre, Nijmegen, The Netherlands
22. Centre for Medical Parasitology, Department of International Health, Immunology & Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
23. London School of Hygiene and Tropical Medicine, London, UK - ISSN：1475-2875
文摘
Background Plasmodium falciparum resistance to anti-malarial drugs remains a major obstacle to the control of malaria. In 2001 Tanzania replaced chloroquine (CQ) with sulphadoxine-pyrimethamine (SP) as first-line drug, which in turn was replaced by artemisinin combination therapy in 2006. SP has however, continued to be used in intermittent preventive treatment of malaria in pregnancy (IPTp) despite reports of high levels of resistance to SP due to the lack of alternatives to SP for IPTp. Recent reports have indicated recovery of CQ-susceptibility in Malawi, Kenya, Mozambique, and Tanzania based on the prevalence of wild types at codon 76 of the Pfcrt gene in indigenous P. falciparum populations. The current prevalence of this Pfcrt-76 CQ resistance marker from six regions of Tanzania mainland is hereby reported. Methods DNA extracted from filter-paper dried blood spots and rapid diagnostics kit strips collected from finger-prick blood were used to genotype the Pfcrt-76 resistance marker using PCR-RFLP. Data from previously published studies were used to generate CQ susceptibility recovery trends using logistic regression model. Results Seven hundred and forty one (741) samples were genotyped. The current frequency of the CQ-susceptible Pfcrt-K76 was above 92% and did not differ between regions in Tanzania (χ2--.37; p--.795). The K76 allelic prevalence was between 85.7 and 93% in regions (χ2--.88, p--.163). The CQ resistance recovery trends showed regional variability that may be caused by differences in malaria transmission intensity, but overall the trends converge as the susceptibility levels in all regions approach >90%. Conclusions CQ withdrawal in Tanzania has resulted into >90% recovery of susceptibility in ten years of withdrawal. These findings are in support of the search for CQ-based combination drugs as a possible future alternative to SP for IPTp in places where full recovery of CQ-susceptibility will be evident.