RESUMO
Newly arrived refugees offer insights into malaria epidemiology in their countries of origin. We evaluated asymptomatic refugee children within 7 days of arrival in Uganda from South Sudan and the Democratic Republic of Congo (DRC) in 2022 for parasitemia, parasite species, and Plasmodium falciparum drug resistance markers. Asymptomatic P. falciparum infections were common in both populations. Coinfection with P. malariae was more common in DRC refugees. Prevalences of markers of aminoquinoline resistance (PfCRT K76T, PfMDR1 N86Y) were much higher in South Sudan refugees, of antifolate resistance (PfDHFR C59R and I164L, PfDHPS A437G, K540E, and A581G) much higher in DRC refugees, and of artemisinin partial resistance (ART-R; PfK13 C469Y and A675V) moderate in both populations. Prevalences of most mutations differed from those seen in Ugandans attending health centers near the refugee centers. Refugee evaluations yielded insights into varied malaria epidemiology and identified markers of ART-R in 2 previously little-studied countries.
Assuntos
Antimaláricos , Resistência a Medicamentos , Malária Falciparum , Plasmodium falciparum , Proteínas de Protozoários , Refugiados , Humanos , Uganda/epidemiologia , Antimaláricos/uso terapêutico , Antimaláricos/farmacologia , Resistência a Medicamentos/genética , Prevalência , Pré-Escolar , Plasmodium falciparum/efeitos dos fármacos , Plasmodium falciparum/genética , Malária Falciparum/epidemiologia , Malária Falciparum/parasitologia , Malária Falciparum/tratamento farmacológico , Feminino , Masculino , Criança , Proteínas de Protozoários/genética , Lactente , Proteínas de Membrana Transportadoras/genética , Proteínas Associadas à Resistência a Múltiplos Medicamentos/genética , Sudão/epidemiologia , Biomarcadores/sangue , Artemisininas/uso terapêutico , Artemisininas/farmacologia , Parasitemia/epidemiologia , Parasitemia/tratamento farmacológico , Plasmodium malariae/genética , Plasmodium malariae/efeitos dos fármacosRESUMO
The global prevalence of resistance to antiviral drugs combined with antiretroviral therapy (cART) emphasizes the need for continuous monitoring to better understand the dynamics of drug-resistant mutations to guide treatment optimization and patient management as well as check the spread of resistant viral strains. We have recently integrated next-generation sequencing (NGS) into routine HIV drug resistance (HIVDR) monitoring, with key challenges in the bioinformatic analysis and interpretation of the complex data generated, while ensuring data security and privacy for patient information. To address these challenges, here we present HIV-DRIVES (HIV Drug Resistance Identification, Variant Evaluation, and Surveillance), an NGS-HIVDR bioinformatics pipeline that has been developed and validated using Illumina short reads, FASTA, and Sanger ab1.seq files.