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Drug resistance markers within an evolving efficacy of anti-malarial drugs in Cameroon: a systematic review and meta-analysis (1998-2020).
Niba, Peter Thelma Ngwa; Nji, Akindeh M; Evehe, Marie-Solange; Ali, Innocent M; Netongo, Palmer Masumbe; Ngwafor, Randolph; Moyeh, Marcel N; Ngum, Lesley Ngum; Ndum, Oliva Ebie; Acho, Fon Abongwa; Mbu'u, Cyrille Mbanwi; Fosah, Dorothy A; Atogho-Tiedeu, Barbara; Achonduh-Atijegbe, Olivia; Djokam-Dadjeu, Rosine; Chedjou, Jean Paul Kengne; Bigoga, Jude D; Moukoko, Carole Else Eboumbou; Ajua, Anthony; Achidi, Eric; Tallah, Esther; Leke, Rose G F; Tourgordi, Alexis; Ringwald, Pascal; Alifrangis, Michael; Mbacham, Wilfred F.
Afiliación
  • Niba PTN; MARCAD-DELTAS Programme, Laboratory for Public Health Research Biotechnologies, University of Yaoundé I, Yaoundé, Cameroon.
  • Nji AM; The Biotechnology Centre, University of Yaoundé I, Yaoundé, Cameroon.
  • Evehe MS; Department of Biochemistry, Faculty of Science, University of Yaoundé I, Yaoundé, Cameroon.
  • Ali IM; MARCAD-DELTAS Programme, Laboratory for Public Health Research Biotechnologies, University of Yaoundé I, Yaoundé, Cameroon.
  • Netongo PM; The Biotechnology Centre, University of Yaoundé I, Yaoundé, Cameroon.
  • Ngwafor R; Department of Biochemistry, Faculty of Science, University of Yaoundé I, Yaoundé, Cameroon.
  • Moyeh MN; The Biotechnology Centre, University of Yaoundé I, Yaoundé, Cameroon.
  • Ngum LN; Department of Biochemistry, Faculty of Science, University of Yaoundé I, Yaoundé, Cameroon.
  • Ndum OE; MARCAD-DELTAS Programme, Laboratory for Public Health Research Biotechnologies, University of Yaoundé I, Yaoundé, Cameroon.
  • Acho FA; The Biotechnology Centre, University of Yaoundé I, Yaoundé, Cameroon.
  • Mbu'u CM; Department of Biochemistry, Faculty of Science, University of Dschang, Dschang, Cameroon.
  • Fosah DA; The Biotechnology Centre, University of Yaoundé I, Yaoundé, Cameroon.
  • Atogho-Tiedeu B; Department of Biochemistry, Faculty of Science, University of Yaoundé I, Yaoundé, Cameroon.
  • Achonduh-Atijegbe O; The Biotechnology Centre, University of Yaoundé I, Yaoundé, Cameroon.
  • Djokam-Dadjeu R; National Malaria Control Programme, Ministry of Public Health, Yaoundé, Cameroon.
  • Chedjou JPK; MARCAD-DELTAS Programme, Laboratory for Public Health Research Biotechnologies, University of Yaoundé I, Yaoundé, Cameroon.
  • Bigoga JD; The Biotechnology Centre, University of Yaoundé I, Yaoundé, Cameroon.
  • Moukoko CEE; Department of Biochemistry and Molecular Biology, Faculty of Science, University of Buea, Buea, Cameroon.
  • Ajua A; MARCAD-DELTAS Programme, Laboratory for Public Health Research Biotechnologies, University of Yaoundé I, Yaoundé, Cameroon.
  • Achidi E; The Biotechnology Centre, University of Yaoundé I, Yaoundé, Cameroon.
  • Tallah E; Department of Biochemistry, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon.
  • Leke RGF; Institute of Medical Research and Medicinal Plant Studies, Ministry of Scientific Research and Innovation, Yaoundé, Cameroon.
  • Tourgordi A; The Biotechnology Centre, University of Yaoundé I, Yaoundé, Cameroon.
  • Ringwald P; Université Des Montagnes, Banganté, West Region, Cameroon.
  • Alifrangis M; The Biotechnology Centre, University of Yaoundé I, Yaoundé, Cameroon.
  • Mbacham WF; The Biotechnology Centre, University of Yaoundé I, Yaoundé, Cameroon.
Malar J ; 20(1): 32, 2021 Jan 09.
Artículo en Inglés | MEDLINE | ID: mdl-33422080
ABSTRACT

BACKGROUND:

Malaria remains highly endemic in Cameroon. The rapid emergence and spread of drug resistance was responsible for the change from monotherapies to artemisinin-based combinations. This systematic review and meta-analysis aimed to determine the prevalence and distribution of Plasmodium falciparum drug resistance markers within an evolving efficacy of anti-malarial drugs in Cameroon from January 1998 to August 2020.

METHODS:

The PRISMA-P and PRISMA statements were adopted in the inclusion of studies on single nucleotide polymorphisms (SNPs) of P. falciparum anti-malarial drug resistance genes (Pfcrt, Pfmdr1, Pfdhfr, Pfdhps, Pfatp6, Pfcytb and Pfk13). The heterogeneity of the included studies was evaluated using the Cochran's Q and I2 statistics. The random effects model was used as standard in the determination of heterogeneity between studies.

RESULTS:

Out of the 902 records screened, 48 studies were included in this aggregated meta-analysis of molecular data. A total of 18,706 SNPs of the anti-malarial drug resistance genes were genotyped from 47,382 samples which yielded a pooled prevalence of 35.4% (95% CI 29.1-42.3%). Between 1998 and 2020, there was significant decline (P < 0.0001 for all) in key mutants including Pfcrt 76 T (79.9%-43.0%), Pfmdr1 86Y (82.7%-30.5%), Pfdhfr 51I (72.2%-66.9%), Pfdhfr 59R (76.5%-67.8%), Pfdhfr 108 N (80.8%-67.6%). The only exception was Pfdhps 437G which increased over time (30.4%-46.9%, P < 0.0001) and Pfdhps 540E that remained largely unchanged (0.0%-0.4%, P = 0.201). Exploring mutant haplotypes, the study observed a significant increase in the prevalence of Pfcrt CVIET mixed quintuple haplotype from 57.1% in 1998 to 57.9% in 2020 (P < 0.0001). In addition, within the same study period, there was no significant change in the triple Pfdhfr IRN mutant haplotype (66.2% to 67.3%, P = 0.427). The Pfk13 amino acid polymorphisms associated with artemisinin resistance were not detected.

CONCLUSIONS:

This review reported an overall decline in the prevalence of P. falciparum gene mutations conferring resistance to 4-aminoquinolines and amino alcohols for a period over two decades. Resistance to artemisinins measured by the presence of SNPs in the Pfk13 gene does not seem to be a problem in Cameroon. Systematic review registration PROSPERO CRD42020162620.
Texto completo: Disponible Colección: Bases de datos internacionales Contexto en salud: Agenda de Salud Sostenible para las Américas / Enfermedades Desatendidas Tema en salud: Objetivo 5: Medicamentos, vacunas y tecnologías sanitarias / Malária Base de datos: MEDLINE Tipo de estudio: Factores de riesgo / Revisión sistemática Idioma: Inglés Revista: Malar J Asunto de la revista: Medicina Tropical Año: 2021 Tipo del documento: Artículo País de afiliación: Camerún

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Texto completo: Disponible Colección: Bases de datos internacionales Contexto en salud: Agenda de Salud Sostenible para las Américas / Enfermedades Desatendidas Tema en salud: Objetivo 5: Medicamentos, vacunas y tecnologías sanitarias / Malária Base de datos: MEDLINE Tipo de estudio: Factores de riesgo / Revisión sistemática Idioma: Inglés Revista: Malar J Asunto de la revista: Medicina Tropical Año: 2021 Tipo del documento: Artículo País de afiliación: Camerún