Longitudinal Survey of Plasmodium falciparum Infection in Vietnam: Characteristics of Antimalarial Resistance and Their Associated Factors
Longitudinal Survey of Plasmodium falciparum Infection in Vietnam: Characteristics of Antimalarial Resistance and Their Associated Factors
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DOI：
10.1128/jcm.01449-09
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发表时间：
2010-01-01
影响因子：
9.4
通讯作者：
Nakazawa, Shusuke
中科院分区：
文献类型：
--
作者：
Isozumi, Rie;Uemura, Haruki;Nakazawa, Shusuke
恶性疟原虫（Plasmodium falciparum）是人类疟疾的主要病因，是造成高发病率和高死亡率的重要病原体之一。越南的疟疾患者总数在过去十年中逐渐减少。然而，具有耐药性的病原体的传播仍然是一个重大问题。确定与耐药性有关的基因型趋势对越南控制疟疾至关重要。我们在2001年、2002年和2005年至2007年对恶性疟原虫疟疾进行了纵向调查。测序分析pfcrt、pfmdr1、pfdhfr、pfdhps基因；并对研究年份、年龄、性别和基因型的相关性进行统计学分析。结果发现，2002年以后，耐氯喹基因型pfcrt 76T的比例迅速下降。仅在2001年和2002年观察到pfdhfr和pfdhps基因的大量突变，而在2002年观察到恶性疟原虫二氢蝶酸合成酶（pfdhps）中出现了新的K540Y突变。对于男性和较年轻年龄组的人来说，对恶性疟原虫感染的易感性与pfcrt 76K菌株或pfdhfr和pfdhps突变数量减少的菌株之间存在相关性。携带pfcrt 76T的疟原虫在pfdhfr和pfdhps中表现出更多的突变。
Plasmodium falciparum is the main cause of human malaria and is one of the important pathogens causing high rates of morbidity and mortality. The total number of malaria patients in Vietnam has gradually decreased over the last decade. However, the spread of pathogens with drug resistance remains a significant problem. Defining the trend in genotypes related to drug resistance is essential for the control of malaria in Vietnam. We undertook a longitudinal survey of Plasmodium falciparum malaria in 2001, 2002, and 2005 to 2007. The pfcrt, pfmdr1, pfdhfr, and pfdhps genes were analyzed by sequencing; and correlations by study year, age, gender, and genotype were identified statistically. The ratio of the chloroquine resistance genotype pfcrt 76T was found to have decreased rapidly after 2002. High numbers of mutations in the pfdhfr and pfdhps genes were observed only in 2001 and 2002, while the emergence of parasites with a new K540Y mutation in the P. falciparum dihydropteroate synthetase (PfDHPS) was observed in 2002. For males and those in younger age brackets, a correlation between vulnerability to P. falciparum infection and strains with pfcrt 76K or strains with decreased numbers of mutations in pfdhfr and pfdhps was demonstrated. The parasites with pfcrt 76T exhibited a greater number of mutations in pfdhfr and pfdhps.