RESUMEN
Imported malaria has been a great challenge for public health in Qatar due to influx of large number of migrant workers. Antimalarial drug resistance has emerged as one of the greatest challenges facing malaria control today. Monitoring parasite haplotypes that predict susceptibility to major antimalarial can guide treatment policies. This study aimed to determine molecular drug resistance pattern in imported malaria cases in Qatar. Blood samples from the uncomplicated P. falciparum malaria patients were collected at Hamad General Hospital, HMC, Doha, Qatar. The samples were further confirmed by nested-polymerase chain reaction (PCR) for P. falciparum. Molecular markers of chloroquine (Pfcrt and Pfmdr1) were analyzed by using nested PCR- RFLP method to determine the key point mutations associated with chloroquine (CQ) drug resistance. A total 118 blood samples were positive for P. falciparum. Overall, by RFLP, 72% harboured wild type allele (N86) of Pfmdr1 gene. The prevalence of Pfcrt mutant (T76), WT (K76) and mixed alleles (K76T) was 63.6% (n = 75), 22.9% (n = 27) and 13.5% (n = 16), respectively. Mean parasitaemia level was higher among the wild type alleles of Pfcrt gene as compared to the mixed/mutant alleles whereas mixed alleles of Pfmdr1 gene having high parasitaemia. Molecular surveillance strategy based on imported malaria cases can be used to detect and track CQ drug-resistant malaria. The data presented here might be helpful for enrichment of molecular surveillance of antimalarial resistance and will be useful for developing and updating antimalarial guidance for non-immune imported cases in Qatar.
Asunto(s)
Antimaláricos/farmacología , Cloroquina/farmacología , Enfermedades Transmisibles Importadas/parasitología , Resistencia a Medicamentos , Malaria Falciparum/parasitología , Proteínas de Transporte de Membrana/genética , Proteínas Asociadas a Resistencia a Múltiples Medicamentos/genética , Plasmodium falciparum/genética , Proteínas Protozoarias/genética , Adolescente , Adulto , Sangre/parasitología , ADN Protozoario/genética , Monitoreo Epidemiológico , Femenino , Humanos , Masculino , Persona de Mediana Edad , Plasmodium falciparum/efectos de los fármacos , Plasmodium falciparum/aislamiento & purificación , Mutación Puntual , Reacción en Cadena de la Polimerasa , Polimorfismo de Longitud del Fragmento de Restricción , Prevalencia , Qatar/epidemiología , Encuestas y Cuestionarios , Adulto JovenRESUMEN
Salmonella meningitis is an unusual complication of Salmonella sepsis that occurs almost exclusively in infants and young children. Cases that do occur in adults are associated with a high morbidity and mortality. The present study concerns a rare case of Salmonella meningitis, the first to be reported in Qatar, in a previously healthy young adult man who was admitted with fever, headache and nuchal rigidity. Cerebrospinal fluid (CSF) culture produced Salmonella paratyphi A, although cultures of blood were negative. The patient was admitted to the medical intensive care unit (MICU) and assisted with mechanical ventilation for 1 week, then transferred to the medical ward where he exhibited progressive improvement on treatment with meropenam for 3 weeks. The patient was found to have an incidental schwannoma causing right-sided hydronephrosis, and hydroureter, treated with double J stent insertion. He was discharged in good condition without any neurological sequelae.