RESUMO
BACKGROUND: Since 2014, seasonal malaria chemoprevention (SMC) with amodiaquine-sulfadoxine-pyrimethamine (AQ-SP) has been implemented on a large scale during the high malaria transmission season in Burkina Faso. This paper reports the prevalence of microscopic and submicroscopic malaria infection at the outset and after the first round of SMC in children under 5 years old in Bama, Burkina Faso, as well as host and parasite factors involved in mediating the efficacy and tolerability of SMC. METHODS: Two sequential cross-sectional surveys were conducted in late July and August 2017 during the first month of SMC in a rural area in southwest Burkina Faso. Blood smears and dried blood spots were collected from 106 to 93 children under five, respectively, at the start of SMC and again 3 weeks later. Malaria infection was detected by microscopy and by PCR from dried blood spots. For all children, day 7 plasma concentrations of desethylamodiaquine (DEAQ) were measured and CYP2C8 genetic variants influencing AQ metabolism were genotyped. Samples were additionally genotyped for pfcrt K76T and pfmdr1 N86Y, molecular markers associated with reduced amodiaquine susceptibility. RESULTS: 2.8% (3/106) of children were positive for Plasmodium falciparum infection by microscopy and 13.2% (14/106) by nested PCR within 2 days of SMC administration. Three weeks after SMC administration, in the same households, 4.3% (4/93) of samples were positive by microscopy and 14.0% (13/93) by PCR (p = 0.0007). CYP2C8*2, associated with impaired amodiaquine metabolism, was common with an allelic frequency of 17.1% (95% CI 10.0-24.2). Day 7 concentration of DEAQ ranged from 0.48 to 362.80 ng/mL with a median concentration of 56.34 ng/mL. Pfmdr1 N86 predominated at both time points, whilst a non-significant trend towards a higher prevalence of pfcrt 76T was seen at week 3. CONCLUSION: This study showed a moderate prevalence of low-level malaria parasitaemia in children 3 weeks following SMC during the first month of administration. Day 7 concentrations of the active DEAQ metabolite varied widely, likely reflecting variability in adherence and possibly metabolism. These findings highlight factors that may contribute to the effectiveness of SMC in children in a high transmission setting.
Assuntos
Amodiaquina/análogos & derivados , Antimaláricos/sangue , Citocromo P-450 CYP2C8/genética , Resistência a Medicamentos/genética , Genes de Protozoários/efeitos dos fármacos , Malária Falciparum/prevenção & controle , Polimorfismo Genético/efeitos dos fármacos , Amodiaquina/sangue , Amodiaquina/uso terapêutico , Antimaláricos/uso terapêutico , Burkina Faso/epidemiologia , Quimioprevenção , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Lactente , Malária Falciparum/epidemiologia , Malária Falciparum/parasitologia , Masculino , Plasma/químicaRESUMO
Constructed wetlands (CWs) are systems designed to maximize pollutants removal by various mechanisms, most of which are associated with the presence of plants. However, the substances secreted by plants to defend themselves against external aggressions during their growth are very little studied in these systems. This study aimed to characterize the chemical constituents of Pennisetum purpureum extracts used in an experimental mesocosm filled with shale and laterite treating domestic wastewater. Above-ground biomass, strain diameter and secondary metabolites of P. purpureum plants grown on the different substrates (shale and laterite) were monitored, as were those grown on the experimental site (control). In addition, the removal performance of chemical oxygen demand (COD), biochemical oxygen demand (BOD5), total Kjedahl nitrogen (TKN) and Total Phosphorus (TP) was determined at the outlet of CWs. Plant biomass measured on the shale bed (13.7 ± 0.5 kg m-2) was higher than on the laterite bed (12.5 ± 0.1 kg m-2), both lower than the biomass obtained in the natural environment (14.9 ± 0.6 kg m-2). Performances ranged from 83 ± 5.4 to 76.9 ± 7 % (COD), 84.7 ± 6.8 to 78 ± 8.1 % (BOD5), 72.2 ± 10.7 to 55.5 ± 16.4 % (NTK) and 72.4 ± 4.9 to 58.4 ± 3.4 % (TP), with higher efficiencies in the shale-filled bed. Plant extracts from the experimental site were richer in secondary metabolites (total polyphenol [73.5 mgEAG/gMS], total flavonoids [18.1 mgEQ/gMS] and condensed tannin [13.3 mgEC/gMS]) than those from plants grown in CWs. However, plants in the shale-filled bed secreted more total polyphenol (57.7 mgEAG/gMS), total flavonoids (12.1 mgEQ/gMS) and condensed tannin (12 mgEC/gMS) than those in the laterite-filled bed. In short, wastewater and filtration materials have an influence on the secretion of secondary plant metabolites. However, of the two materials, shale seems to be better suited to CWs, as it promotes an environment close to the natural environment.