Drug resistance markers within an evolving efficacy of anti-malarial drugs in Cameroon: a systematic review and meta-analysis (1998-2020).
Drug resistance markers within an evolving efficacy of anti-malarial drugs in Cameroon: a systematic review and meta-analysis (1998-2020).
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DOI：
10.1186/s12936-020-03543-8
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发表时间：
2021-01-09
期刊：
影响因子：
3
通讯作者：
Mbacham WF
中科院分区：
文献类型：
--
作者：
Niba PTN;Nji AM;Evehe MS;Ali IM;Netongo PM;Ngwafor R;Moyeh MN;Ngum LN;Ndum OE;Acho FA;Mbu'u CM;Fosah DA;Atogho-Tiedeu B;Achonduh-Atijegbe O;Djokam-Dadjeu R;Chedjou JPK;Bigoga JD;Moukoko CEE;Ajua A;Achidi E;Tallah E;Leke RGF;Tourgordi A;Ringwald P;Alifrangis M;Mbacham WF
疟疾在喀麦隆仍然高度流行。耐药性的迅速出现和蔓延是导致从单一疗法向以青蒿素为基础的联合疗法转变的原因。本系统综述和荟萃分析旨在确定1998年1月至2020年8月喀麦隆抗疟疾药物疗效变化过程中恶性疟原虫耐药标记物的流行和分布。纳入恶性疟原虫抗疟疾耐药基因Pfcrt、Pfmdr1、Pfdhfr、Pfdhps、Pfatp6、Pfcytb和Pfk13的单核苷酸多态性（snp）研究采用PRISMA- p和PRISMA声明。采用Cochran 's Q和I2统计来评估纳入研究的异质性。采用随机效应模型作为判定研究间异质性的标准。在筛选的902份记录中，48项研究纳入了分子数据的汇总荟萃分析。从47,382份样本中共分型了18,706个抗疟耐药基因snp，总流行率为35.4% （95% CI 29.1 ~ 42.3%）。1998 ~ 2020年间，Pfcrt 76 T（79.9% ~ 43.0%）、Pfmdr1 86Y（82.7% ~ 30.5%）、Pfdhfr 51I（72.2% ~ 66.9%）、Pfdhfr 59R（76.5% ~ 67.8%）、Pfdhfr 108 N（80.8% ~ 67.6%）等关键突变体的数量均显著下降（P < 0.0001）。唯一的例外是Pfdhps 437G随着时间的推移而增加（30.4% ~ 46.9%,P < 0.0001）， Pfdhps 540E基本保持不变（0.0% ~ 0.4%,P = 0.201）。在研究突变单倍型时，研究发现Pfcrt CVIET混合五倍型的患病率从1998年的57.1%显著增加到2020年的57.9% （P < 0.0001）。此外，在同一研究期间，Pfdhfr IRN三突变单倍型无显著变化（66.2% ~ 67.3%,P = 0.427）。未检测到与青蒿素耐药性相关的Pfk13氨基酸多态性。这篇综述报道了在过去的20年里，恶性疟原虫对4-氨基喹啉和氨基醇产生耐药性的基因突变的流行率总体下降。通过Pfk13基因中SNPs的存在来衡量的对青蒿素的耐药性在喀麦隆似乎不是一个问题。系统评价注册号PROSPERO CRD42020162620
Malaria remains highly endemic in Cameroon. The rapid emergence and spread of drug resistance was responsible for the change from monotherapies to artemisinin-based combinations. This systematic review and meta-analysis aimed to determine the prevalence and distribution of Plasmodium falciparum drug resistance markers within an evolving efficacy of anti-malarial drugs in Cameroon from January 1998 to August 2020. The PRISMA-P and PRISMA statements were adopted in the inclusion of studies on single nucleotide polymorphisms (SNPs) of P. falciparum anti-malarial drug resistance genes (Pfcrt, Pfmdr1, Pfdhfr, Pfdhps, Pfatp6, Pfcytb and Pfk13). The heterogeneity of the included studies was evaluated using the Cochran’s Q and I2 statistics. The random effects model was used as standard in the determination of heterogeneity between studies. Out of the 902 records screened, 48 studies were included in this aggregated meta-analysis of molecular data. A total of 18,706 SNPs of the anti-malarial drug resistance genes were genotyped from 47,382 samples which yielded a pooled prevalence of 35.4% (95% CI 29.1–42.3%). Between 1998 and 2020, there was significant decline (P < 0.0001 for all) in key mutants including Pfcrt 76 T (79.9%-43.0%), Pfmdr1 86Y (82.7%-30.5%), Pfdhfr 51I (72.2%-66.9%), Pfdhfr 59R (76.5%-67.8%), Pfdhfr 108 N (80.8%-67.6%). The only exception was Pfdhps 437G which increased over time (30.4%-46.9%, P < 0.0001) and Pfdhps 540E that remained largely unchanged (0.0%-0.4%, P = 0.201). Exploring mutant haplotypes, the study observed a significant increase in the prevalence of Pfcrt CVIET mixed quintuple haplotype from 57.1% in 1998 to 57.9% in 2020 (P < 0.0001). In addition, within the same study period, there was no significant change in the triple Pfdhfr IRN mutant haplotype (66.2% to 67.3%, P = 0.427). The Pfk13 amino acid polymorphisms associated with artemisinin resistance were not detected. This review reported an overall decline in the prevalence of P. falciparum gene mutations conferring resistance to 4-aminoquinolines and amino alcohols for a period over two decades. Resistance to artemisinins measured by the presence of SNPs in the Pfk13 gene does not seem to be a problem in Cameroon. Systematic review registration PROSPERO CRD42020162620
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影响因子：
8.1
作者：
Apinjoh TO;Mugri RN;Miotto O;Chi HF;Tata RB;Anchang-Kimbi JK;Fon EM;Tangoh DA;Nyingchu RV;Jacob C;Amato R;Djimde A;Kwiatkowski D;Achidi EA;Amambua-Ngwa A
通讯作者：
Amambua-Ngwa A
影响因子：
6.4
作者：
Basco, LK;Ringwald, P
通讯作者：
Ringwald, P
DOI：
10.1590/s0074-02762012000100018
发表时间：
2012-02-01
期刊：
Memórias do Instituto Oswaldo Cruz
影响因子：
--
作者：
Awasthi, Gauri;Satya, Godavarthi Bhogendra Krishna;Das, Aparup
通讯作者：
Das, Aparup
影响因子：
3
作者：
Berzosa P;Esteban-Cantos A;García L;González V;Navarro M;Fernández T;Romay-Barja M;Herrador Z;Rubio JM;Ncogo P;Santana-Morales M;Valladares B;Riloha M;Benito A
通讯作者：
Benito A
DOI：
10.4269/ajtmh.2002.67.378
发表时间：
2002-10-01
影响因子：
3.3
作者：
Basco, LK;Ndounga, M;Soula, G
通讯作者：
Soula, G