Plasmodium falciparum drug resistance in Madagascar: facing the spread of unusual pfdhfr and pfmdr-1 haplotypes and the decrease of dihydroartemisinin susceptibility.
Antimicrob Agents Chemother
; 53(11): 4588-97, 2009 Nov.
Article
em En
| MEDLINE
| ID: mdl-19704124
ABSTRACT
The aim of this study was to provide the first comprehensive spatiotemporal picture of Plasmodium falciparum resistance in various geographic areas in Madagascar. Additional data about the antimalarial resistance in the neighboring islands of the Comoros archipelago were also collected. We assessed the prevalence of pfcrt, pfmdr-1, pfdhfr, and pfdhps mutations and the pfmdr-1 gene copy number in 1,596 P. falciparum isolates collected in 26 health centers (20 in Madagascar and 6 in the Comoros Islands) from 2006 to 2008. The in vitro responses to a panel of drugs by 373 of the parasite isolates were determined. The results showed (i) unusual profiles of chloroquine susceptibility in Madagascar, (ii) a rapid rise in the frequency of parasites with both the pfdhfr and the pfdhps mutations, (iii) the alarming emergence of the single pfdhfr 164L genotype, and (iv) the progressive loss of the most susceptible isolates to artemisinin derivatives. In the context of the implementation of the new national policy for the fight against malaria, continued surveillance for the detection of P. falciparum resistance in the future is required.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Plasmodium falciparum
/
Tetra-Hidrofolato Desidrogenase
/
Haplótipos
/
Proteínas Associadas à Resistência a Múltiplos Medicamentos
/
Artemisininas
/
Antimaláricos
Tipo de estudo:
Risk_factors_studies
Limite:
Animals
País/Região como assunto:
Africa
Idioma:
En
Revista:
Antimicrob Agents Chemother
Ano de publicação:
2009
Tipo de documento:
Article
País de afiliação:
Madagascar