Plasmodium vivax Infections in Duffy-Negative Individuals in the Democratic Republic of the Congo
Plasmodium vivax Infections in Duffy-Negative Individuals in the Democratic Republic of the Congo
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DOI：
10.4269/ajtmh.18-0277
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发表时间：
2018-01-01
影响因子：
3.3
通讯作者：
Meshnick, Steven R.
中科院分区：
文献类型：
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作者：
Brazeau, Nicholas F.;Whitesell, Amy N.;Meshnick, Steven R.
虽然间日疟原虫被认为是缺乏撒哈拉以南非洲地区，因为保护性突变赋予达菲阴性表型，最近的证据表明，间日疟原虫病例在这些地区普遍存在。我们从参加2013-2014年刚果民主共和国（DRC）人口与健康调查的儿童中选择了292个干血点，以评估间日疟原虫感染。通过聚合酶链反应确定了4例间日疟原虫感染，每例感染发生在地理位置不同的调查组群中。使用这些作为索引案例，我们测试了来自四个集群的其余73个样本。通过这种方法，确定了10例间日疟原虫确诊病例、3例可能病例和1例可能病例。在14例间日疟原虫感染者中，有9例合并恶性疟原虫感染。通过对抑制Duffy抗原表达的加塔基序中的单点突变进行测序，确认所有14个个体均为Duffy阴性。这一发现与越来越多的文献一致，这些文献表明间日疟原虫可以感染非洲的达菲阴性个体。未来的分子和测序工作需要了解这些分离株与来自亚洲和南美洲的其他间日疟原虫样本的关系，并发现与间日疟原虫毒力和红细胞侵袭相关的变异。
Although Plasmodium vivax has been assumed to be absent from sub-Saharan Africa because of the protective mutation conferring the Duffy-negative phenotype, recent evidence has suggested that P. vivax cases are prevalent in these regions. We selected 292 dried blood spots from children who participated in the 2013-2014 Demographic and Health Survey of the Democratic Republic of the Congo (DRC), to assess for P. vivax infection. Four P. vivax infections were identified by polymerase chain reaction, each in a geographically different survey cluster. Using these as index cases, we tested the remaining 73 samples from the four clusters. With this approach, 10 confirmed cases, three probable cases, and one possible case of P. vivax were identified. Among the 14 P. vivax cases, nine were coinfected with Plasmodium falciparum. All 14 individuals were confirmed to be Duffy-negative by sequencing for the single point mutation in the GATA motif that represses the expression of the Duffy antigen. This finding is consistent with a growing body of literature that suggests that P. vivax can infect Duffy-negative individuals in Africa. Future molecular and sequencing work is needed to understand the relationship of these isolates with other P. vivax samples from Asia and South America and discover variants linked to P. vivax virulence and erythrocyte invasion.