Kelch13 and MDR1 Polymorphisms, and Drug Effectiveness at Day 3 after Dihydroartemisinin-Piperaquine Treatment for Plasmodium falciparum Malaria on Bioko Island, Equatorial Guinea: 2014-2017
作者： Yu-Zhong Zheng , Jiang-Tao Chen , Xue-Yan Liang , Carlos Salas Ehapo , Urbano Monsuy Eyi
DOI: 10.1101/594366
关键词:
摘要: Artemisinin (ART) combination therapies were introduced on malaria endemic Bioko Island in 2004 through Malaria Control Project. Recently, ART-resistant Plasmodium falciparum strain with Kelch13 (K13) propeller M579I mutation originating from Equatorial Guinea was observed as an increased parasite clearance time day 3 after dihydroartemisinin-Piperaquine (DHA-PIP) treatment (D3 positivity). Here, we surveyed DHA-PIP effectiveness and molecular markers of drug resistance at D3 2014 to 2017. Among the 371 uncomplicated P. patients, 86.3% (320/471) successfully followed up D3. 5.9% (19/320) patients showed positivity. K13 MDR1 gene sequenced 46 collected D0 (baseline population) 19 D3-positivity patients. Five non-synonymous mutations (H136N; K189N; K248N; K326E; K332N) found. There no statistical difference frequency these between baseline population samples (p>0.05). Additionally, none polymorphisms known be involved ART-resistance Asia or Africa detected. For gene, 38.5% (25/65) carried N86Y mutation; 73.8% (48/65) Y184F mutation. Parasites surviving post-treatment significantly more likely than carry (p <0.05). These results suggest that is not best predictive marker for ART Africa. More isolates cases delayed indicated vitro vivo monitoring derivatives ACT partner drugs should regularly performed Island, Guinea.
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