Artemisinin-Resistant Plasmodium falciparum with High Survival Rates, Uganda, 2014-2016.

Artemisinin-Resistant Plasmodium falciparum with High Survival Rates, Uganda, 2014-2016.
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DOI:
10.3201/eid2404.170141
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发表时间:
2018-04
影响因子:
11.8
通讯作者:
Mita T
Mita T
中科院分区:
医学2区
文献类型:
--
作者:
Ikeda M;Kaneko M;Tachibana SI;Balikagala B;Sakurai-Yatsushiro M;Yatsushiro S;Takahashi N;Yamauchi M;Sekihara M;Hashimoto M;Katuro OT;Olia A;Obwoya PS;Auma MA;Anywar DA;Odongo-Aginya EI;Okello-Onen J;Hirai M;Ohashi J;Palacpac NMQ;Kataoka M;Tsuboi T;Kimura E;Horii T;Mita T

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由于90%的疟疾病例发生在非洲,非洲出现的青蒿素耐药性恶性疟原虫对公共卫生构成严重威胁。为了评估2014-2016年期间乌干达青蒿素耐药寄生虫的出现,我们使用了最近开发的体外环期存活测定法,该测定法估计了环期特异性恶性疟原虫对青蒿素的敏感性。我们在乌干达古卢进行了4次横断面调查,以评估青蒿素的敏感性。在194株分离株中,4株分离株的存活率(暴露于药物的活寄生虫与未暴露于药物的对照的比率)较高(>10%)。类似的发病率与药物治疗后寄生虫清除延迟密切相关,被认为是青蒿素耐药表型的代表。其中,仅在1个分离株A675 V中观察到PfKelch 13突变。群体遗传学分析表明,这些可能的青蒿素耐药菌株起源于非洲。对非洲可能对青蒿素有抗药性的寄生虫进行大规模监测,将提供关于治疗结果的有用信息,并有助于区域疟疾控制。
Because ≈90% of malaria cases occur in Africa, emergence of artemisinin-resistant Plasmodium falciparum in Africa poses a serious public health threat. To assess emergence of artemisinin-resistant parasites in Uganda during 2014–2016, we used the recently developed ex vivo ring-stage survival assay, which estimates ring-stage–specific P. falciparum susceptibility to artemisinin. We conducted 4 cross-sectional surveys to assess artemisinin sensitivity in Gulu, Uganda. Among 194 isolates, survival rates (ratio of viable drug-exposed parasites to drug-nonexposed controls) were high (>10%) for 4 isolates. Similar rates have been closely associated with delayed parasite clearance after drug treatment and are considered to be a proxy for the artemisinin-resistant phenotype. Of these, the PfKelch13 mutation was observed in only 1 isolate, A675V. Population genetics analysis suggested that these possibly artemisinin-resistant isolates originated in Africa. Large-scale surveillance of possibly artemisinin-resistant parasites in Africa would provide useful information about treatment outcomes and help regional malaria control.
柬埔寨恶性疟原虫疟疾中的双氢青蒿素-哌喹抗药性:一项多地点前瞻性队列研究。
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DOI: 10.1093/jac/dkn482
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