Towards a re-emergence of chloroquine sensitivity in Cote d'Ivoire?
Towards a re-emergence of chloroquine sensitivity in Cote d'Ivoire?
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DOI：
10.1186/s12936-018-2551-7
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发表时间：
2018-11-07
期刊：
影响因子：
3
通讯作者：
Djaman, Joseph Allico
中科院分区：
文献类型：
--
作者：
Dagnogo, Olefongo;Ako, Aristide Berenger;Djaman, Joseph Allico
背景恶性疟原虫对抗疟疾药物的抗药性阻碍了根除疟疾的努力。最近有报道称，在马拉维和赞比亚等几个国家，抗氯喹恶性疟原虫的流行率有所下降，这增加了在不久的将来重新引入氯喹的希望，理想的情况是与另一种治疗简单疟疾的抗疟疾药物联合使用。在科特迪瓦，氯喹的临床疗效下降，加上携带pfcrt基因的Thr-76突变等位基因的临床分离株比例很高，导致2004年停止使用氯喹。以前的研究表明，尽管氯喹已不再作为一线抗疟疾药物，但Thr-76突变等位基因的高流行率仍持续存在。本研究旨在了解我国禁止销售和使用氯喹十年后Pfcrt基因突变等位基因Thr-76T的流行情况。结果对三个研究地点的序列进行分析，发现Thr-76突变等位基因的患病率为15%(10/)，而Lys-76野生型等位基因的患病率为62%(40/)。Anonkoua Koute未发现Thr-76等位基因突变，而在Port-Bouet和Ayame的分离株序列中，Thr-76突变的比例分别为31%(5/16)和25%(5/20)。结论科特迪瓦停用氯喹10多年后，Anonkoua-Koute、Port-Bouet和Ayame对这种抗疟疾药物敏感的寄生虫比例似乎有所增加。
BackgroundResistance of Plasmodium falciparum to anti-malarial drugs has hampered efforts to eradicate malaria. Recent reports of a decline in the prevalence of chloroquine-resistant P. falciparum in several countries, including Malawi and Zambia, is raising the hope of reintroducing chloroquine in the near future, ideally in combination with another anti-malarial drug for the treatment of uncomplicated malaria. In Cote d'Ivoire, the decrease in the clinical efficacy of chloroquine, in addition to a high proportion of clinical isolates carrying the Thr-76 mutant allele of the pfcrt gene, had led to the discontinuation of the use of chloroquine in 2004. Previous studies have indicated the persistence of a high prevalence of the Thr-76 mutant allele despite the withdrawal of chloroquine as first-line anti-malarial drug. This present study is conducted to determine the prevalence of the Thr-76T mutant allele of the Pfcrt gene after a decade of the ban on the sale and use of chloroquine in Cote d'Ivoire.ResultsAnalysis of the 64 sequences from all three study sites indicated a prevalence of 15% (10/64) of the Thr-76 mutant allele against 62% (40/64) of the Lys-76 wild-type allele. No mutation of the allele Thr-76 was observed at Anonkoua Koute while this mutant allele was in 31% (5/16) and 25% (5/20) of isolate sequences from Port-Bouet and Ayame respectively.ConclusionMore than a decade after the discontinuation of the use of chloroquine in Cote d'Ivoire, the proportion of parasites sensitive to this anti-malarial seems to increase in Anonkoua-koute, Port-bouet and Ayame.