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Clinical and molecular surveillance of drug resistant vivax malaria in Myanmar (2009-2016).
Nyunt, Myat Htut; Han, Jin-Hee; Wang, Bo; Aye, Khin Myo; Aye, Kyin Hla; Lee, Seong-Kyun; Htut, Ye; Kyaw, Myat Phone; Han, Kay Thwe; Han, Eun-Taek.
Afiliação
  • Nyunt MH; Department of Medical Environmental Biology and Tropical Medicine, School of Medicine, Kangwon National University, Chuncheon, Republic of Korea.
  • Han JH; Department of Medical Research, Yangon, Myanmar.
  • Wang B; Department of Medical Environmental Biology and Tropical Medicine, School of Medicine, Kangwon National University, Chuncheon, Republic of Korea.
  • Aye KM; Department of Clinical Laboratory, The First Affiliated Hospital of Anhui Medical University, Anhui, China.
  • Aye KH; Department of Medical Research, Yangon, Myanmar.
  • Lee SK; Department of Medical Research, Yangon, Myanmar.
  • Htut Y; Department of Medical Environmental Biology and Tropical Medicine, School of Medicine, Kangwon National University, Chuncheon, Republic of Korea.
  • Kyaw MP; Department of Medical Research, Yangon, Myanmar.
  • Han KT; Department of Medical Research, Yangon, Myanmar.
  • Han ET; Department of Medical Research, Yangon, Myanmar.
Malar J ; 16(1): 117, 2017 03 16.
Article em En | MEDLINE | ID: mdl-28298235
ABSTRACT

BACKGROUND:

One of the major challenges for control and elimination of malaria is ongoing spread and emergence of drug resistance. While epidemiology and surveillance of the drug resistance in falciparum malaria is being explored globally, there are few studies on drug resistance vivax malaria.

METHODS:

To assess the spread of drug-resistant vivax malaria in Myanmar, a multisite, prospective, longitudinal study with retrospective analysis of previous therapeutic efficacy studies, was conducted. A total of 906 from nine study sites were included in retrospective analysis and 208 from three study sites in prospective study. Uncomplicated vivax mono-infected patients were recruited and monitored with longitudinal follow-up until day 28 after treatment with chloroquine. Amplification and sequence analysis of molecular markers, such as mutations in pvcrt-O, pvmdr1, pvdhps and pvdhfr, were done in day-0 samples in prospective study.

RESULTS:

Clinical failure cases were found only in Kawthaung, southern Myanmar and western Myanmar sites within 2009-2016. Chloroquine resistance markers, pvcrt-O 'AAG' insertion and pvmdr1 mutation (Y976F) showed higher mutant rate in southern and central Myanmar than western site 66.7, 72.7 vs 48.3% and 26.7, 17.0 vs 1.7%, respectively. A similar pattern of significantly higher mutant rate of antifolate resistance markers, pvdhps (S382A, K512M, A553G) and pvdhfr (F57L/I, S58R, T61M, S117T/N) were noted.

CONCLUSIONS:

Although clinical failure rate was low, widespread distribution of chloroquine and antifolate resistance molecular makers alert to the emergence and spread of drug resistance vivax malaria in Myanmar. Proper strategy and action plan to eliminate and contain the resistant strain strengthened together with clinical and molecular surveillance on drug resistance vivax is recommended.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Plasmodium vivax / Resistência a Medicamentos / Cloroquina / Antagonistas do Ácido Fólico / Antimaláricos Tipo de estudo: Observational_studies / Screening_studies Limite: Adolescent / Adult / Humans País/Região como assunto: Asia Idioma: En Ano de publicação: 2017 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Plasmodium vivax / Resistência a Medicamentos / Cloroquina / Antagonistas do Ácido Fólico / Antimaláricos Tipo de estudo: Observational_studies / Screening_studies Limite: Adolescent / Adult / Humans País/Região como assunto: Asia Idioma: En Ano de publicação: 2017 Tipo de documento: Article