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Sawadogo H, Soulama I, Zida A, Zongo C, Sawadogo PM, Guiguemde KT, Nikiema S, Badoum SE, Sawadogo S, Tou A, Sombié S, Tchekounou C, Sermé SS, Ouedraogo-Traoré R, Guiguemdé TR, Savadogo A. Plasmodium falciparum Genetic Diversity and Resistance Genotype Profile in Infected Placental Samples Collected After Delivery in Ouagadougou. Infect Drug Resist 2023; 16:6673-6680. [PMID: 37849789 PMCID: PMC10578158 DOI: 10.2147/idr.s420004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 10/04/2023] [Indexed: 10/19/2023] Open
Abstract
Purpose Intermittent preventive treatment with sulfadoxine-pyrimethamine is widely used for the prevention of malaria in pregnant women in Africa. Known resistance cases of sulfadoxine-pyrimethamine during pregnancy need to be follow up to support IPTp implementation in Burkina Faso. However, data on the development and spread of resistance to this molecule are lacking. This study aimed to investigating the genetic diversity of P. falciparum and the mutation prevalence in the dhfr and dhps genes infected from postpartum infected placentas. Patients and Methods This was a prospective and cross-sectional study conducted between April 2019 and March 2020 in four health districts of Ouagadougou capital city. From the placentas collected after delivery, P. falciparum detection and mps1 and msp2 polymorphism analysis were performed by nested PCR. The resistance profile was checked after analyzing the mutation point on dhfr and dhps genes. Results PCR-positive samples were estimated at 96% for msp1 and 98% for msp2. The polymorphism analysis showed that the RO33 and 3D7 allelic families were the most widespread with 62.5% and 91.83%, respectively. Multiple infections by msp1 and msp2 were frequent with 12.50% and 92.92%, respectively. The prevalence of individual dhfr mutation point, 51I, 108A, and 59R, was 1.96, 15.68, and 7.84, respectively, and the dhps mutation point, 437G, was 3.92. There is no detected mutation at the point 164L and 540E. The triple (51I+108A+59R) in dhfr and quadruple (51I+108A+59R+ 437G) mutation were not found. Conclusion The results showed that Plasmodium falciparum has a high genetic diversity of msp1 and msp2. This suggests that dhfr and dhps mutant genotypes are potential early warning factors in the increase in the sulfadoxine-pyrimethamine resistance.
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Affiliation(s)
- Haffsatou Sawadogo
- Laboratory of Applied Biochemistry and Immunology (LABIA), Joseph KI - ZERBO University, Ouagadougou, Burkina Faso
- Parasitology-Mycology Department, Centre Hospitalier Universitaire Yalgado Ouédraogo (CHU-YO), Ouagadougou, Burkina Faso
| | - Issiaka Soulama
- Health Science Research Institute (IRSS), Ouagadougou, Burkina Faso
- National Malaria Research and Training Center (CNRFP), Ouagadougou, Burkina Faso
| | - Adama Zida
- Parasitology-Mycology Department, Centre Hospitalier Universitaire Yalgado Ouédraogo (CHU-YO), Ouagadougou, Burkina Faso
- Health Sciences Training and Research Unit (UFR/SDS), Joseph KI - ZERBO University, Ouagadougou, Burkina Faso
| | - Cheikna Zongo
- Laboratory of Applied Biochemistry and Immunology (LABIA), Joseph KI - ZERBO University, Ouagadougou, Burkina Faso
| | - Patindoilba Marcel Sawadogo
- Parasitology-Mycology Department, Centre Hospitalier Universitaire Yalgado Ouédraogo (CHU-YO), Ouagadougou, Burkina Faso
- Health Sciences Training and Research Unit (UFR/SDS), Joseph KI - ZERBO University, Ouagadougou, Burkina Faso
| | - Kiswendsida Thierry Guiguemde
- Health Sciences Training and Research Unit (UFR/SDS), Joseph KI - ZERBO University, Ouagadougou, Burkina Faso
- Centre Hospitalier Universitaire Pédiatrique – Charles de Gaulle (CHU-CDG), Ouagadougou, Burkina Faso
| | - Seni Nikiema
- Molecular Biology and Genetics Laboratory (LABIOGENE), Joseph KI - ZERBO University, Ouagadougou, Burkina Faso
| | - Salimata Emilie Badoum
- Laboratory of Applied Biochemistry and Immunology (LABIA), Joseph KI - ZERBO University, Ouagadougou, Burkina Faso
- Health Action Research Group (GRAS), Ouagadougou, Burkina Faso
| | - Salam Sawadogo
- Molecular Biology and Genetics Laboratory (LABIOGENE), Joseph KI - ZERBO University, Ouagadougou, Burkina Faso
| | - Aïcha Tou
- National Malaria Research and Training Center (CNRFP), Ouagadougou, Burkina Faso
| | - Salif Sombié
- National Malaria Research and Training Center (CNRFP), Ouagadougou, Burkina Faso
| | - Chanolle Tchekounou
- Laboratory of Applied Biochemistry and Immunology (LABIA), Joseph KI - ZERBO University, Ouagadougou, Burkina Faso
- International Institute of Science and Technology (Iistech), Ouagadougou, Burkina Faso
| | - Sindié Samuel Sermé
- Laboratory of Applied Biochemistry and Immunology (LABIA), Joseph KI - ZERBO University, Ouagadougou, Burkina Faso
- Health Action Research Group (GRAS), Ouagadougou, Burkina Faso
| | | | - Tinga Robert Guiguemdé
- Parasitology-Mycology Laboratory, National Institute of Health Sciences (INSP), Nazi Boni University, Bobo-Dioulasso, Burkina Faso
| | - Aly Savadogo
- Laboratory of Applied Biochemistry and Immunology (LABIA), Joseph KI - ZERBO University, Ouagadougou, Burkina Faso
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Baina MT, Djontu JC, Lissom A, Doulamo NVA, Umuhoza DM, Ntabi JDM, Vouvoungui CJ, Boumpoutou RK, Mayela J, Diafouka-Kietela S, Nguimbi E, Ntoumi F. Plasmodium falciparum msp-1 and msp-2 genetic diversity and multiplicity of infection in isolates from Congolese patients in the Republic of Congo. Parasitol Res 2023; 122:2433-2443. [PMID: 37624380 DOI: 10.1007/s00436-023-07951-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 08/18/2023] [Indexed: 08/26/2023]
Abstract
With limited up to date data from the Republic of Congo, the aim of this study was to investigate allelic polymorphism of merozoite surface protein-1 (msp-1) and merozoite surface protein-2 (msp-2). This will help assess the genetic diversity and multiplicity of Plasmodium falciparum infection (MOI), from uncomplicated malaria individuals living in Brazzaville. Between March and October 2021, a cross-sectional study was carried out at a health center in Madibou District located in the south of Brazzaville. Plasmodium infection was diagnosed in human blood by microscopy and the block 2 of P. falciparum msp-1 and block 3 of msp-2 genes were genotyped by nested PCR. Overall, 57 genotypes with fragment sizes ranging from 110 to 410 bp were recorded for msp-1, among which 25, 21, and 11 genotypes identified for K1, MAD20, and RO33 allelic families respectively. RO33 (34.3%) and MAD20 (34.3%) allelic families were more frequent compared to K1 (31.4%) although the difference was not statistically significant. Also, 47 msp-2 genotypes were identified, including 26 FC27 genotypes type, and 21 genotypes belonging to the 3D7 allelic family. FC27 was more frequent (52.3%) compared to 3D7 (47.7%). The prevalence of the polyclonal infection was 90.0% while the MOI was 2.90 ± 1.0. The MOI and polyclonal infection were not significantly associated with the parasitaemia and anaemia. This study reveals a high genetic diversity and the trend of increasing MOI of P. falciparum isolates from the south of Brazzaville, compared to the reports from the same setting before the COVID-19 pandemic.
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Affiliation(s)
- Marcel Tapsou Baina
- Fondation Congolaise pour la Recherche Médicale, Brazzaville, Republic of Congo
- Faculté des Sciences et Techniques, Université Marien Ngouabi, Brazzaville, Republic of Congo
| | - Jean Claude Djontu
- Fondation Congolaise pour la Recherche Médicale, Brazzaville, Republic of Congo.
| | - Abel Lissom
- Fondation Congolaise pour la Recherche Médicale, Brazzaville, Republic of Congo
- Department of Zoology, Faculty of Science, University of Bamenda, Bamenda, Cameroon
| | - Naura Veil Assioro Doulamo
- Fondation Congolaise pour la Recherche Médicale, Brazzaville, Republic of Congo
- Faculté des Sciences et Techniques, Université Marien Ngouabi, Brazzaville, Republic of Congo
| | - Dieu Merci Umuhoza
- Fondation Congolaise pour la Recherche Médicale, Brazzaville, Republic of Congo
- Faculté des Sciences et Techniques, Université Marien Ngouabi, Brazzaville, Republic of Congo
| | - Jacque Dollon Mbama Ntabi
- Fondation Congolaise pour la Recherche Médicale, Brazzaville, Republic of Congo
- Faculté des Sciences et Techniques, Université Marien Ngouabi, Brazzaville, Republic of Congo
| | - Christevy Jeanney Vouvoungui
- Fondation Congolaise pour la Recherche Médicale, Brazzaville, Republic of Congo
- Faculté des Sciences et Techniques, Université Marien Ngouabi, Brazzaville, Republic of Congo
| | | | - Jolivet Mayela
- Fondation Congolaise pour la Recherche Médicale, Brazzaville, Republic of Congo
| | | | - Etienne Nguimbi
- Fondation Congolaise pour la Recherche Médicale, Brazzaville, Republic of Congo
- Faculté des Sciences et Techniques, Université Marien Ngouabi, Brazzaville, Republic of Congo
| | - Francine Ntoumi
- Fondation Congolaise pour la Recherche Médicale, Brazzaville, Republic of Congo.
- Institute for Tropical Medicine, University of Tübingen, Tübingen, Germany.
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3
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Ansah F, Nyame K, Laryea R, Owusu R, Amon D, Boyetey MJB, Ayeke D, Razak N, Kornu VE, Ashitei S, Owusu-Appiah C, Chirawurah JD, Abugri J, Aniweh Y, Opoku N, Sutherland CJ, Binka FN, Kweku M, Awandare GA, Dinko B. The temporal dynamics of Plasmodium species infection after artemisinin-based combination therapy (ACT) among asymptomatic children in the Hohoe municipality, Ghana. Malar J 2023; 22:271. [PMID: 37710288 PMCID: PMC10500816 DOI: 10.1186/s12936-023-04712-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 09/11/2023] [Indexed: 09/16/2023] Open
Abstract
BACKGROUND The routine surveillance of asymptomatic malaria using nucleic acid-based amplification tests is essential in obtaining reliable data that would inform malaria policy formulation and the implementation of appropriate control measures. METHODS In this study, the prevalence rate and the dynamics of Plasmodium species among asymptomatic children (n = 1697) under 5 years from 30 communities within the Hohoe municipality in Ghana were determined. RESULTS AND DISCUSSION The observed prevalence of Plasmodium parasite infection by polymerase chain reaction (PCR) was 33.6% (571/1697), which was significantly higher compared to that obtained by microscopy [26.6% (451/1697)] (P < 0.0001). Based on species-specific analysis by nested PCR, Plasmodium falciparum infection [33.6% (570/1697)] was dominant, with Plasmodium malariae, Plasmodium ovale and Plasmodium vivax infections accounting for 0.1% (1/1697), 0.0% (0/1697), and 0.0% (0/1697), respectively. The prevalence of P. falciparum infection among the 30 communities ranged from 0.0 to 82.5%. Following artesunate-amodiaquine (AS + AQ, 25 mg/kg) treatment of a sub-population of the participants (n = 184), there was a substantial reduction in Plasmodium parasite prevalence by 100% and 79.2% on day 7 based on microscopy and nested PCR analysis, respectively. However, there was an increase in parasite prevalence from day 14 to day 42, with a subsequent decline on day 70 by both microscopy and nested PCR. For parasite clearance rate analysis, we found a significant proportion of the participants harbouring residual Plasmodium parasites or parasite genomic DNA on day 1 [65.0% (13/20)], day 2 [65.0% (13/20)] and day 3 [60.0% (12/20)] after initiating treatment. Of note, gametocyte carriage among participants was low before and after treatment. CONCLUSION Taken together, the results indicate that a significant number of individuals could harbour residual Plasmodium parasites or parasite genomic DNA after treatment. The study demonstrates the importance of routine surveillance of asymptomatic malaria using sensitive nucleic acid-based amplification techniques.
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Affiliation(s)
- Felix Ansah
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), College of Basic and Applied Sciences, University of Ghana, Legon, Accra, Ghana
- Department of Biochemistry, Cell and Molecular Biology, College of Basic and Applied Sciences, University of Ghana, Legon, Accra, Ghana
| | - Kwamina Nyame
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), College of Basic and Applied Sciences, University of Ghana, Legon, Accra, Ghana
- Department of Biochemistry, Cell and Molecular Biology, College of Basic and Applied Sciences, University of Ghana, Legon, Accra, Ghana
| | - Rukaya Laryea
- Department of Epidemiology and Biostatistics, Fred Newton Binka School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Richard Owusu
- Department of Epidemiology and Biostatistics, Fred Newton Binka School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Denick Amon
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), College of Basic and Applied Sciences, University of Ghana, Legon, Accra, Ghana
| | - Mark-Jefferson Buer Boyetey
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), College of Basic and Applied Sciences, University of Ghana, Legon, Accra, Ghana
| | - Dzidzor Ayeke
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), College of Basic and Applied Sciences, University of Ghana, Legon, Accra, Ghana
| | - Nasibatu Razak
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), College of Basic and Applied Sciences, University of Ghana, Legon, Accra, Ghana
| | - Victor E Kornu
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), College of Basic and Applied Sciences, University of Ghana, Legon, Accra, Ghana
| | - Sarah Ashitei
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), College of Basic and Applied Sciences, University of Ghana, Legon, Accra, Ghana
| | - Caleb Owusu-Appiah
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), College of Basic and Applied Sciences, University of Ghana, Legon, Accra, Ghana
| | - Jersley D Chirawurah
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), College of Basic and Applied Sciences, University of Ghana, Legon, Accra, Ghana
- Department of Biochemistry, Cell and Molecular Biology, College of Basic and Applied Sciences, University of Ghana, Legon, Accra, Ghana
| | - James Abugri
- Department of Biochemistry and Forensic Sciences, School of Chemical and Biochemical Sciences, C. K. Tedam University of Technology and Applied Sciences, Navrongo, Ghana
| | - Yaw Aniweh
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), College of Basic and Applied Sciences, University of Ghana, Legon, Accra, Ghana
| | - Nicholas Opoku
- Department of Epidemiology and Biostatistics, Fred Newton Binka School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Colin J Sutherland
- Department of Infection Biology, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Fred N Binka
- Department of Epidemiology and Biostatistics, Fred Newton Binka School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Margaret Kweku
- Department of Epidemiology and Biostatistics, Fred Newton Binka School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Gordon A Awandare
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), College of Basic and Applied Sciences, University of Ghana, Legon, Accra, Ghana
- Department of Biochemistry, Cell and Molecular Biology, College of Basic and Applied Sciences, University of Ghana, Legon, Accra, Ghana
| | - Bismarck Dinko
- Department of Infection Biology, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.
- Department of Biomedical Sciences, School of Basic and Biomedical Sciences, University of Health and Allied Sciences, Ho, Ghana.
- Department of Clinical Microbiology, School of Medicine and Dentistry College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ashanti Region, Ghana.
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Baina MT, Lissom A, Assioro Doulamo NV, Djontu JC, Umuhoza DM, Mbama-Ntabi JD, Diafouka-Kietela S, Mayela J, Missontsa G, Wondji C, Adegnika AA, Nguimbi E, Borrmann S, Ntoumi F. Comparative study of Plasmodium falciparum msp-1 and msp-2 Genetic Diversity in Isolates from Rural and Urban Areas in the South of Brazzaville, Republic of Congo. Pathogens 2023; 12:pathogens12050742. [PMID: 37242412 DOI: 10.3390/pathogens12050742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 05/09/2023] [Accepted: 05/09/2023] [Indexed: 05/28/2023] Open
Abstract
Polymorphisms in the genes encoding the merozoite surface proteins msp-1 and msp-2 are widely used markers for characterizing the genetic diversity of Plasmodium falciparum. This study aimed to compare the genetic diversity of circulating parasite strains in rural and urban settings in the Republic of Congo after the introduction of artemisinin-based combination therapy (ACT) in 2006. A cross-sectional survey was conducted from March to September 2021 in rural and urban areas close to Brazzaville, during which Plasmodium infection was detected using microscopy (and nested-PCR for submicroscopic infection). The genes coding for merozoite proteins-1 and -2 were genotyped by allele-specific nested PCR. Totals of 397 (72.4%) and 151 (27.6%) P. falciparum isolates were collected in rural and urban areas, respectively. The K1/msp-1 and FC27/msp-2 allelic families were predominant both in rural (39% and 64%, respectively) and urban (45.4% and 54.5% respectively) areas. The multiplicity of infection (MOI) was higher (p = 0.0006) in rural areas (2.9) compared to urban settings (2.4). The rainy season and the positive microscopic infection were associated with an increase in MOI. These findings reveal a higher P. falciparum genetic diversity and MOI in the rural setting of the Republic of Congo, which is influenced by the season and the participant clinical status.
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Affiliation(s)
- Marcel Tapsou Baina
- Fondation Congolaise Pour la Recherche Médicale, Villa D6-Cité OMS-Djoué, Brazzaville BP69, Brazzaville BP69, Congo
- Département de Biologie Cellulaire et Moléculaire, Faculté des Sciences et Techniques, Université Marien Ngouabi, Brazzaville BP69, Congo
| | - Abel Lissom
- Fondation Congolaise Pour la Recherche Médicale, Villa D6-Cité OMS-Djoué, Brazzaville BP69, Brazzaville BP69, Congo
- Department of Zoology, Faculty of Science, University of Bamenda, Bambili P.O. Box 39, Cameroon
| | - Naura Veil Assioro Doulamo
- Fondation Congolaise Pour la Recherche Médicale, Villa D6-Cité OMS-Djoué, Brazzaville BP69, Brazzaville BP69, Congo
- Département de Biologie Cellulaire et Moléculaire, Faculté des Sciences et Techniques, Université Marien Ngouabi, Brazzaville BP69, Congo
| | - Jean Claude Djontu
- Fondation Congolaise Pour la Recherche Médicale, Villa D6-Cité OMS-Djoué, Brazzaville BP69, Brazzaville BP69, Congo
| | - Dieu Merci Umuhoza
- Fondation Congolaise Pour la Recherche Médicale, Villa D6-Cité OMS-Djoué, Brazzaville BP69, Brazzaville BP69, Congo
- Département de Biologie Cellulaire et Moléculaire, Faculté des Sciences et Techniques, Université Marien Ngouabi, Brazzaville BP69, Congo
| | - Jacques Dollon Mbama-Ntabi
- Fondation Congolaise Pour la Recherche Médicale, Villa D6-Cité OMS-Djoué, Brazzaville BP69, Brazzaville BP69, Congo
- Département de Biologie Cellulaire et Moléculaire, Faculté des Sciences et Techniques, Université Marien Ngouabi, Brazzaville BP69, Congo
| | - Steve Diafouka-Kietela
- Fondation Congolaise Pour la Recherche Médicale, Villa D6-Cité OMS-Djoué, Brazzaville BP69, Brazzaville BP69, Congo
| | - Jolivet Mayela
- Fondation Congolaise Pour la Recherche Médicale, Villa D6-Cité OMS-Djoué, Brazzaville BP69, Brazzaville BP69, Congo
| | - Georges Missontsa
- Fondation Congolaise Pour la Recherche Médicale, Villa D6-Cité OMS-Djoué, Brazzaville BP69, Brazzaville BP69, Congo
| | - Charles Wondji
- Department of Parasitology and Medical Entomology, Centre for Research in Infectious Diseases (CRID), Centre Region, Yaoundé P.O. Box 13501, Cameroon
- Department of Vector Biology, Liverpool School of Tropical Medicine, Pembroke Place, L3 5QA Liverpool, UK
| | - Ayola Akim Adegnika
- Institute of Tropical Medicine, University Hospital of Tübingen, 72074 Tübingen, Germany
- Centre de Recherches Médicales de Lambaréné, Lambaréné BP242, Gabon
- German Center for Infection Research (DZIF), partner site Tübingen, 72074 Tübingen, Germany
| | - Etienne Nguimbi
- Fondation Congolaise Pour la Recherche Médicale, Villa D6-Cité OMS-Djoué, Brazzaville BP69, Brazzaville BP69, Congo
- Département de Biologie Cellulaire et Moléculaire, Faculté des Sciences et Techniques, Université Marien Ngouabi, Brazzaville BP69, Congo
| | - Steffen Borrmann
- Institute of Tropical Medicine, University Hospital of Tübingen, 72074 Tübingen, Germany
- Centre de Recherches Médicales de Lambaréné, Lambaréné BP242, Gabon
| | - Francine Ntoumi
- Fondation Congolaise Pour la Recherche Médicale, Villa D6-Cité OMS-Djoué, Brazzaville BP69, Brazzaville BP69, Congo
- Institute of Tropical Medicine, University Hospital of Tübingen, 72074 Tübingen, Germany
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Simpson SV, Nundu SS, Arima H, Kaneko O, Mita T, Culleton R, Yamamoto T. The diversity of Plasmodium falciparum isolates from asymptomatic and symptomatic school-age children in Kinshasa Province, Democratic Republic of Congo. Malar J 2023; 22:102. [PMID: 36941587 PMCID: PMC10025789 DOI: 10.1186/s12936-023-04528-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 03/10/2023] [Indexed: 03/22/2023] Open
Abstract
BACKGROUND Understanding Plasmodium falciparum population diversity and transmission dynamics provides information on the intensity of malaria transmission, which is needed for assessing malaria control interventions. This study aimed to determine P. falciparum allelic diversity and multiplicity of infection (MOI) among asymptomatic and symptomatic school-age children in Kinshasa Province, Democratic Republic of Congo (DRC). METHODS A total of 438 DNA samples (248 asymptomatic and 190 symptomatic) were characterized by nested PCR and genotyping the polymorphic regions of pfmsp1 block 2 and pfmsp2 block 3. RESULTS Nine allele types were observed in pfmsp1 block2. The K1-type allele was predominant with 78% (229/293) prevalence, followed by the MAD20-type allele (52%, 152/293) and RO33-type allele (44%, 129/293). Twelve alleles were detected in pfmsp2, and the 3D7-type allele was the most frequent with 84% (256/304) prevalence, followed by the FC27-type allele (66%, 201/304). Polyclonal infections were detected in 63% (95% CI 56, 69) of the samples, and the MOI (SD) was 1.99 (0.97) in P. falciparum single-species infections. MOIs significantly increased in P. falciparum isolates from symptomatic parasite carriers compared with asymptomatic carriers (2.24 versus 1.69, adjusted b: 0.36, (95% CI 0.01, 0.72), p = 0.046) and parasitaemia > 10,000 parasites/µL compared to parasitaemia < 5000 parasites/µL (2.68 versus 1.63, adjusted b: 0.89, (95% CI 0.46, 1.25), p < 0.001). CONCLUSION This survey showed low allelic diversity and MOI of P. falciparum, which reflects a moderate intensity of malaria transmission in the study areas. MOIs were more likely to be common in symptomatic infections and increased with the parasitaemia level. Further studies in different transmission zones are needed to understand the epidemiology and parasite complexity in the DRC.
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Affiliation(s)
- Shirley V Simpson
- Programme for Nurturing Global Leaders in Tropical and Emerging Communicable Diseases, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, 852-8523, Japan
- Department of International Health and Medical Anthropology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, 852-8523, Japan
| | - Sabin S Nundu
- Programme for Nurturing Global Leaders in Tropical and Emerging Communicable Diseases, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, 852-8523, Japan.
- Department of International Health and Medical Anthropology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, 852-8523, Japan.
- Institut National de Recherche Biomédicale (INRB), Kinshasa-Gombe, Democratic Republic of Congo.
| | - Hiroaki Arima
- Department of International Health and Medical Anthropology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, 852-8523, Japan
| | - Osamu Kaneko
- Programme for Nurturing Global Leaders in Tropical and Emerging Communicable Diseases, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, 852-8523, Japan
- Department of Protozoology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, 852-8523, Japan
| | - Toshihiro Mita
- Department of Tropical Medicine and Parasitology, Faculty of Medicine, Juntendo University, Tokyo, 113-8421, Japan
| | - Richard Culleton
- Department of Protozoology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, 852-8523, Japan
- Division of Molecular Parasitology, Proteo-Science Centre, Ehime University, Ehime, 790-8577, Japan
| | - Taro Yamamoto
- Programme for Nurturing Global Leaders in Tropical and Emerging Communicable Diseases, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, 852-8523, Japan
- Department of International Health and Medical Anthropology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, 852-8523, Japan
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6
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Leung T, Francis Z, Forgu EL, Honore A, Bigoga JD, Nsagha DS. The Effects of HIV Infection on the Immune Response to Malaria Among Pregnant Women in Kumba, Southwest Cameroon: Protocol for a Cross-sectional Study. JMIR Res Protoc 2023; 12:e38213. [PMID: 36692923 PMCID: PMC9906321 DOI: 10.2196/38213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 07/29/2022] [Accepted: 09/30/2022] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Malaria and HIV, 2 of the world's deadliest diseases, share a lot of territory in sub-Saharan Africa. OBJECTIVE This study seeks to investigate the effect of HIV on the immune response to malaria infection among pregnant women in Kumba in the southwest region (SWR) of Cameroon. The study aims to determine the prevalence of malaria infection, assess the occurrence of Plasmodium falciparum genetic diversity, and evaluate the antibody (immunoglobulin [Ig]G and IgM: apical membrane antigen-1 [AMA1], merozoite surface protein [MSP]1, MSP2, MSP3, and erythrocyte-binding antigen [EBA]175) and cytokine (interleukin [IL]-10, tumor necrosis factor alpha [TNF-α], and interferon gamma [IFNγ]) response to malaria infection among pregnant women with and without HIV in Kumba. METHODS The study will be a hospital-based cross-sectional design that will run from March 2022 to February 2023. It will recruit pregnant women with and without HIV who are in their third trimester of pregnancy. The study will be carried out in 5 health institutions in Kumba: General Hospital Kumba, Presbyterian Hospital Kumba, District Hospital Kumba-town, Kossala Integrated Health Center Kumba, and Catholic Hospital Kumba. About 3 mL of the mother's venous blood, placental blood, and baby cord blood will be collected from each pregnant women at the point of delivery. Microscopy, rapid diagnostic tests (RDTs), and nested polymerase chain reaction (PCR) will be performed to identify the malaria parasite in all the samples, and nested PCR targeting the different genetic diversity markers for P. falciparum will also be performed. Furthermore, sequencing will be performed to study the nucleotide sequence of different alleles, and the genetic diversity of the alleles responsible for malaria infection among pregnant women will be assessed. A multiplex assay will be conducted to analyze the peripheral blood plasma and cord blood plasma for the cytokine and total antibody response to malaria infection among pregnant women with and without HIV. The questionnaire for data collection will be pretested at the Kumba District Hospital, and ethical clearance will be obtained from the University of Buea and the Regional Delegation of Public Health for the SWR. Data will be analyzed using SPSS Statistics and STATA. All P values <.05 will be considered statistically significant. BioEdit 7.0.0 software will be used to align the nucleotide sequences of different genes after sequencing. Phylogenetic tree searching will be conducted using the maximum-likelihood (ML) method in MEGA V6.0. RESULTS The project started in March 2022 and will end in February 2023. Presently, three-fourth of the project funding has been disbursed to date. A total of 218 participants have been enrolled: 193 (88.5%) women without HIV and 25 (11.5%) women with HIV. Between February 2023 and March 2024, the following results will be ready for publication: maternal-neonatal malaria prevalence among pregnant women and babies in Kumba, the effect of HIV on (1) P. falciparum genetic diversity among pregnant women in Kumba, (2) the maternal and neonatal immune response to MSP1, MSP2, and EBA175 IgG antibody response to P. falciparum-caused malaria infection among pregnant women, and (3) the maternal and neonatal pro-inflammatory and anti-inflammatory cytokine response to malaria infection. CONCLUSIONS HIV infection increases the prevalence of malaria infection among pregnant women and also influences the genetic diversity of P. falciparum, with MSP1 alleles being the most prevalent. HIV infection also reduces the antibody response to malaria infection, as well as altering the level of pro-inflammatory and anti-inflammatory responses to malaria infection. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/38213.
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Affiliation(s)
| | - Zeukeng Francis
- The Biotechnology Center, University of Yaoundé I, Yaoundé, Cameroon.,Department of Biochemistry and Biotechnology, Faculty of Science, University of Buea, Buea, Cameroon
| | - Esemu Livo Forgu
- The Biotechnology Center, University of Yaoundé I, Yaoundé, Cameroon.,Centre for Research on Emerging and Reemerging Diseases, Institute of Medical Research and Medicinal Plant Studies, Yaoundé, Cameroon
| | - Awanakam Honore
- The Biotechnology Center, University of Yaoundé I, Yaoundé, Cameroon.,Centre for Research on Emerging and Reemerging Diseases, Institute of Medical Research and Medicinal Plant Studies, Yaoundé, Cameroon
| | - Jude Daiga Bigoga
- The Biotechnology Center, University of Yaoundé I, Yaoundé, Cameroon
| | - Dickson S Nsagha
- Department of Public Health and Hygiene, Faculty of Health Sciences, University of Buea, Buea, Cameroon
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Motta V, Verdenelli S, Sparavelli R, L'Episcopia M, Severini C, Bruschi F, Fabiani S, Mangano V. Artesunate and dihydroartemisinin-piperaquine treatment failure in a severe Plasmodium falciparum malaria case imported from Republic of Côte d'Ivoire. Int J Infect Dis 2022; 122:352-355. [PMID: 35691551 DOI: 10.1016/j.ijid.2022.06.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 06/06/2022] [Accepted: 06/07/2022] [Indexed: 11/30/2022] Open
Abstract
A 68-year-old man returning from Republic of Côte d'Ivoire (Ivory Coast) was diagnosed with severe Plasmodium falciparum malaria and treated with intravenous artesunate followed by oral dihydroartemisinin-piperaquine (DHA-PPQ). A month later the patient experienced a new P. falciparum episode; analysis of pfmsp-1 and pfmsp-2 revealed that the infection was caused by a genetic strain identical to the strain that caused the initial episode, indicating resurgence of the previous infection. No mutations in genes associated with resistance to artemisinin derivatives (pfk13) or piperaquine (pfexonuclease, pfplasmepsin 2/3) were detected, suggesting that treatment failure could have been caused by drug malabsorption or poor drug manufacturing practices. A second treatment with atovaquone-proguanil was successful in eliminating the infection, with no further relapses. To our knowledge, this is the first description of a treatment failure with both artesunate and DHA-PPQ in a traveler returning from a malaria-endemic region. Analysis of molecular markers of resistance to antimalarial drugs revealed mutations associated with resistance to sulfadoxine (pfdhps) and pyrimethamine (pfdhfr), highlighting the important contribution of surveillance of imported malaria cases to the monitoring of drug resistance globally.
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Affiliation(s)
- Vincenzo Motta
- Dipartimento di Ricerca Traslazionale e Nuove Tecnologie in Medicina e Chirurgia, Università di Pisa, Pisa, Italy
| | - Stefano Verdenelli
- Unità Operativa Malattie Infettive, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy
| | - Rebecca Sparavelli
- Dipartimento di Ricerca Traslazionale e Nuove Tecnologie in Medicina e Chirurgia, Università di Pisa, Pisa, Italy
| | | | - Carlo Severini
- Dipartimento Malattie Infettive, Istituto Superiore di Sanità, Roma, Italy
| | - Fabrizio Bruschi
- Dipartimento di Ricerca Traslazionale e Nuove Tecnologie in Medicina e Chirurgia, Università di Pisa, Pisa, Italy; Programma Monitoraggio delle Parassitosi, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy
| | - Silvia Fabiani
- Unità Operativa Malattie Infettive, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy.
| | - Valentina Mangano
- Dipartimento di Ricerca Traslazionale e Nuove Tecnologie in Medicina e Chirurgia, Università di Pisa, Pisa, Italy; Sezione Dipartimentale di Microbiologia Universitaria, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy.
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8
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Paton DG, Probst AS, Ma E, Adams KL, Shaw WR, Singh N, Bopp S, Volkman SK, Hien DFS, Paré PSL, Yerbanga RS, Diabaté A, Dabiré RK, Lefèvre T, Wirth DF, Catteruccia F. Using an antimalarial in mosquitoes overcomes Anopheles and Plasmodium resistance to malaria control strategies. PLoS Pathog 2022; 18:e1010609. [PMID: 35687594 PMCID: PMC9223321 DOI: 10.1371/journal.ppat.1010609] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 06/23/2022] [Accepted: 05/20/2022] [Indexed: 11/18/2022] Open
Abstract
The spread of insecticide resistance in Anopheles mosquitoes and drug resistance in Plasmodium parasites is contributing to a global resurgence of malaria, making the generation of control tools that can overcome these roadblocks an urgent public health priority. We recently showed that the transmission of Plasmodium falciparum parasites can be efficiently blocked when exposing Anopheles gambiae females to antimalarials deposited on a treated surface, with no negative consequences on major components of mosquito fitness. Here, we demonstrate this approach can overcome the hurdles of insecticide resistance in mosquitoes and drug resistant in parasites. We show that the transmission-blocking efficacy of mosquito-targeted antimalarials is maintained when field-derived, insecticide resistant Anopheles are exposed to the potent cytochrome b inhibitor atovaquone, demonstrating that this drug escapes insecticide resistance mechanisms that could potentially interfere with its function. Moreover, this approach prevents transmission of field-derived, artemisinin resistant P. falciparum parasites (Kelch13 C580Y mutant), proving that this strategy could be used to prevent the spread of parasite mutations that induce resistance to front-line antimalarials. Atovaquone is also highly effective at limiting parasite development when ingested by mosquitoes in sugar solutions, including in ongoing infections. These data support the use of mosquito-targeted antimalarials as a promising tool to complement and extend the efficacy of current malaria control interventions. Effective control of malaria is hampered by resistance to vector-targeted insecticides and parasite-targeted drugs. This situation is exacerbated by a critical lack of chemical diversity in both interventions and, as such, new interventions are urgently needed. Recent laboratory studies have shown that an alternative approach based on treating Anopheles mosquitoes directly with antimalarial compounds can make mosquitoes incapable of transmitting the Plasmodium parasites that cause malaria. While promising, showing that mosquito-targeted antimalarials remain effective against wild parasites and mosquitoes, including drug- and insecticide-resistant populations in malaria-endemic countries, is crucial to the future viability of this approach. In this study, carried out in the US and Burkina Faso, we show that insecticide-resistance mechanisms found in highly resistant, natural Anopheles mosquito populations do not interfere with the transmission blocking activity of tarsal exposure to the antimalarial atovaquone, and that mosquito-targeted antimalarial exposure can block transmission of parasites resistant to the main therapeutic antimalarial drug artemisinin. By combining lab, and field-based studies in this way we have demonstrated that this novel approach can be effective in areas where conventional control measures are no longer as effective.
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Affiliation(s)
- Douglas G. Paton
- Department of Immunology and Infectious Diseases, Harvard TH Chan School of Public Health, Boston, United States of America
- * E-mail: (DGP); (FC)
| | - Alexandra S. Probst
- Department of Immunology and Infectious Diseases, Harvard TH Chan School of Public Health, Boston, United States of America
| | - Erica Ma
- Department of Immunology and Infectious Diseases, Harvard TH Chan School of Public Health, Boston, United States of America
| | - Kelsey L. Adams
- Department of Immunology and Infectious Diseases, Harvard TH Chan School of Public Health, Boston, United States of America
| | - W. Robert Shaw
- Department of Immunology and Infectious Diseases, Harvard TH Chan School of Public Health, Boston, United States of America
| | - Naresh Singh
- Department of Immunology and Infectious Diseases, Harvard TH Chan School of Public Health, Boston, United States of America
| | - Selina Bopp
- Department of Immunology and Infectious Diseases, Harvard TH Chan School of Public Health, Boston, United States of America
| | - Sarah K. Volkman
- Department of Immunology and Infectious Diseases, Harvard TH Chan School of Public Health, Boston, United States of America
| | - Domombele F. S. Hien
- Institut de Recherche en Sciences de la Santé/Centre Muraz, Bobo-Dioulasso, Burkina Faso
| | - Prislaure S. L. Paré
- Institut de Recherche en Sciences de la Santé/Centre Muraz, Bobo-Dioulasso, Burkina Faso
| | - Rakiswendé S. Yerbanga
- Institut de Recherche en Sciences de la Santé/Centre Muraz, Bobo-Dioulasso, Burkina Faso
| | - Abdoullaye Diabaté
- Institut de Recherche en Sciences de la Santé/Centre Muraz, Bobo-Dioulasso, Burkina Faso
| | - Roch K. Dabiré
- Institut de Recherche en Sciences de la Santé/Centre Muraz, Bobo-Dioulasso, Burkina Faso
| | - Thierry Lefèvre
- MIVEGEC, IRD, CNRS, University of Montpellier, Montpellier, France
- Laboratoire mixte international sur les vecteurs (LAMIVECT), Bobo Dioulasso, Burkina Faso
- Centre de Recherche en Écologie et Évolution de la Santé (CREES), Montpellier, France
| | - Dyann F. Wirth
- Department of Immunology and Infectious Diseases, Harvard TH Chan School of Public Health, Boston, United States of America
| | - Flaminia Catteruccia
- Department of Immunology and Infectious Diseases, Harvard TH Chan School of Public Health, Boston, United States of America
- * E-mail: (DGP); (FC)
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Sathishkumar V, Nirmolia T, Bhattacharyya DR, Patgiri SJ. Genetic polymorphism of Plasmodium falciparum msp-1, msp-2 and glurp vaccine candidate genes in pre-artemisinin era clinical isolates from Lakhimpur district in Assam, Northeast India. Access Microbiol 2022; 4:000350. [PMID: 35812711 PMCID: PMC9260089 DOI: 10.1099/acmi.0.000350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 03/14/2022] [Indexed: 11/18/2022] Open
Abstract
Background Northeast India shares its international border with Southeast Asia and has a number of malaria endemic zones. Monitoring genetic diversity of malaria parasites is important in this area as drug resistance and increasing genetic diversity form a vicious cycle in which one favours the development of the other. This retrospective study was done to evaluate the genetic diversity patterns in Plasmodium falciparum strains circulating in North Lakhimpur area of Assam in the pre-artemisinin era and compare the findings with current diversity patterns. Methods Genomic DNA extraction was done from archived blood spot samples collected in 2006 from malaria-positive cases in Lakhimpur district of Assam, Northeast India. Three antigenic markers of genetic diversity were studied – msp-1 (block-2), msp-2 (block-3) and the glurp RII region of P. falciparum using nested PCR. Results Allelic diversity was examined in 71 isolates and high polymorphism was observed. In msp-1, eight genotypes were detected; K1 (single allele), MAD20 (six different alleles) and RO33 (single allele) allelic families were noted. Among msp-2 genotypes, 22 distinct alleles were observed out of which FC27 had six alleles and IC/3D7 had 16 alleles. In RII region of glurp, nine genotypes were obtained. Expected heterozygosity (HE) values of the three antigenic markers were 0.72, 0.81 and 0.88, respectively. Multiplicity of infection (MOI) values noted were 1.28, 1.84 and 1.04 for msp-1, msp-2 and glurp, respectively. Conclusion Results suggest a high level of genetic diversity in P. falciparum msp (block-2 of msp-1 and block-3 of msp-2) and the glurp RII region in Northeast India in the pre-artemisinin era when chloroqunine was the primary drug used for uncomplicated falciparum malaria. Comparison with current studies have revealed that the genetic diversity in these genes is still high in this region, complicating malaria vaccine research.
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Affiliation(s)
- Vinayagam Sathishkumar
- ICMR-Regional Medical Research Centre, North East Region, Dibrugarh 786001, Assam, India
| | - Tulika Nirmolia
- ICMR-Regional Medical Research Centre, North East Region, Dibrugarh 786001, Assam, India
| | | | - Saurav Jyoti Patgiri
- ICMR-Regional Medical Research Centre, North East Region, Dibrugarh 786001, Assam, India
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10
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File T, Golassa L, Dinka H. Plasmodium falciparum Clinical Isolates Reveal Analogous Circulation of 3D7 and FC27 Allelic Variants and Multiplicity of Infection in Urban and Rural Settings: The Case of Adama and Its Surroundings, Oromia, Ethiopia. J Parasitol Res 2022; 2022:5773593. [PMID: 35371564 PMCID: PMC8966748 DOI: 10.1155/2022/5773593] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 11/15/2021] [Accepted: 02/19/2022] [Indexed: 11/17/2022] Open
Abstract
Background Despite significant progress achieved globally in reducing malaria burden, still it is one of the major public health and economic problems in Ethiopia. Investigation of the local genetic polymorphism of P. falciparum, the most virulent and predominant malaria parasite primarily targeted in malaria control and elimination program, is paramount to assess intensity of parasite transmission. Analysis of the block 3 region of the msp-2 gene of P. falciparum provides strong molecular evidence to evaluate the real picture of malaria epidemiology to fine-tune the ongoing control and elimination programs in the region. Thus, this study was aimed at examining the status of such polymorphic gene and its implications in Adama and its surroundings. Methods 148 isolates from patients with uncomplicated falciparum malaria were collected in the study from September 2019 to August 2020. Tween® 20 and the Chelex method were employed for parasite DNA extraction. msp-2 allelic families were genotyped by using nested polymerase chain reaction targeting its 3D7 and FC27 allelic variants followed by gel electrophoresis for fragment analysis. Results Seventeen different polymorphic forms of msp-2 allelic fragments were detected in the study area. Moreover, 47 (31.8%) and 41(27.7%) were detected for 3D7 and FC27 allelic families, respectively. Furthermore, the multiclonal allele type accounted for 60 (40.5%). The mean MOI was 1.4, and the heterogeneity index (He) is 0.49 indicating nearly intermediate malaria transmission in the study area. Conclusions The study revealed nearly intermediate genetic diversity and mean MOI of P. falciparum in the study area, demanding further scale up of the ongoing control and elimination efforts.
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Affiliation(s)
- Temesgen File
- Department of Applied Biology, Adama Science and Technology University, P.O. Box 1888, Adama, Ethiopia
| | - Lemu Golassa
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, P.O. Box 1176, Addis Ababa, Ethiopia
| | - Hunduma Dinka
- Department of Applied Biology, Adama Science and Technology University, P.O. Box 1888, Adama, Ethiopia
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Ullah I, Khan A, Israr M, Shah M, Shams S, Khan W, Shah M, Siraj M, Akbar K, Naz T, Afridi SG. Genomic miscellany and allelic frequencies of Plasmodium falciparum msp-1, msp-2 and glurp in parasite isolates. PLoS One 2022; 17:e0264654. [PMID: 35259187 PMCID: PMC8903261 DOI: 10.1371/journal.pone.0264654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 02/14/2022] [Indexed: 11/18/2022] Open
Abstract
Introduction
The genomic miscellany of malaria parasites can help inform the intensity of malaria transmission and identify potential deficiencies in malaria control programs. This study was aimed at investigating the genomic miscellany, allele frequencies, and MOI of P. falciparum infection.
Methods
A total of 85 P. falciparum confirmed isolates out of 100 were included in this study that were collected from P. falciparum patients aged 4 months to 60 years in nine districts of Khyber Pakhtunkhwa Province. Parasite DNA was extracted from 200µL whole blood samples using the Qiagen DNA extraction kit following the manufacturer’s instructions. The polymorphic regions of msp-1, msp-2 and glurp loci were genotyped using nested PCR followed by gel electrophoresis for amplified fragments identification and subsequent data analysis.
Results
Out of 85 P. falciparum infections detected, 30 were msp-1 and 32 were msp-2 alleles specific. Successful amplification occurred in 88.23% (75/85) isolates for msp-1, 78.9% (67/85) for msp-2 and 70% (60/85) for glurp gene. In msp-1, the K1 allelic family was predominantly prevalent as 66.66% (50/75), followed by RO33 and MAD20. The frequency of samples with single infection having only K1, MAD20 and RO33 were 21.34% (16/75), 8% (6/75), and 10.67% (8/75), respectively. In msp-2, both the FC27 and 3D7 allelic families revealed almost the same frequencies as 70.14% (47/67) and 67.16% (45/67), respectively. Nine glurp RII region alleles were identified in 60 isolates. The overall mean multiplicity of infection for msp genes was 1.6 with 1.8 for msp-1 and 1.4 for msp-2, while for glurp the MOI was 1.03. There was no significant association between multiplicity of infection and age groups (Spearman’s rank coefficient = 0.050; P = 0.6) while MOI and parasite density correlated for only msp-2 allelic marker.
Conclusions
The study showed high genetic diversity and allelic frequency with multiple clones of msp-1, msp-2 and glurp in P. falciparum isolates in Khyber Pakhtunkhwa, Pakistan. In the present study the genotype data may provide valuable information essential for monitoring the impact of malaria eradication efforts in this region.
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Affiliation(s)
- Ibrar Ullah
- Department of Biochemistry, Abdul Wali Khan University Mardan, Mardan, Pakistan
| | - Asifullah Khan
- Department of Biochemistry, Abdul Wali Khan University Mardan, Mardan, Pakistan
| | - Muhammad Israr
- Department of Forensic Sciences, University of Swat, Swat, Pakistan
| | - Mohibullah Shah
- Department of Biochemistry, Bahauddin Zakariya University Multan, Multan, Pakistan
| | - Sulaiman Shams
- Department of Biochemistry, Abdul Wali Khan University Mardan, Mardan, Pakistan
| | - Waliullah Khan
- Department of Chemistry, Abdul Wali Khan University Mardan, Mardan, Pakistan
| | - Muzafar Shah
- Centre for Animal Sciences & Fisheries, University of Swat, Swat, Pakistan
| | - Muhammad Siraj
- Department of Zoology, Abbottabad University of Science and Technology, Abbottabad, Pakistan
| | - Kehkashan Akbar
- Department of Biochemistry, Abbottabad International Medical College, Abbottabad, Pakistan
| | - Tahira Naz
- Department of Biochemistry, Abdul Wali Khan University Mardan, Mardan, Pakistan
| | - Sahib Gul Afridi
- Department of Biochemistry, Abdul Wali Khan University Mardan, Mardan, Pakistan
- * E-mail:
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Khan SN, Ali R, Khan S, Rooman M, Norin S, Zareen S, Ali I, Ayaz S. Genetic Diversity of Polymorphic Marker Merozoite Surface Protein 1 ( Msp-1) and 2 ( Msp-2) Genes of Plasmodium falciparum Isolates From Malaria Endemic Region of Pakistan. Front Genet 2021; 12:751552. [PMID: 34868223 PMCID: PMC8635745 DOI: 10.3389/fgene.2021.751552] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Accepted: 10/04/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Understanding the genetic diversity of Plasmodium species through polymorphic studies can assist in designing more effective control strategies of malaria like new drug formulation and development of a vaccine. Pakistan is moderate endemic for Plasmodium falciparum, but little is known about the genetic diversity of this parasite. This study aimed to investigate the molecular diversity of P. falciparum based on msp-1 and msp-2 genes in the malaria-endemic regions of Khyber Pakhtunkhwa, Pakistan. Methods: A total of 199/723 blood samples, tested positive by microscopy for falciparum malaria, were collected from four districts (Dera Ismail Khan, Karak, Mardan, and Peshawar) of Khyber Pakhtunkhwa. Nested PCR amplification technique was employed to target block 2 of msp-1 and the central domain of msp-2 genes, including their respective allelic families K1, MAD20, RO33, FC27, and 3D7/IC, and to detect the extent of genetic diversity of P. falciparum clinical isolates. Results: Among the 199 microscopy-positive P. falciparum samples, a total of 192 were confirmed using PCR. Ninety-seven amplicons were observed for msp-1 and 95 for msp-2. A total of 33 genotypes, 17 for msp-1 (eight K1, six MAD20, and three RO33) and 16 for msp-2 (nine FC27 and seven 3D7/IC), were identified. The specific allelic frequency of the K1 family was higher (44.3%) than that of MAD20 (33.0%) and RO33 (23.0%) for msp-1, while the FC27 allelic family was dominant (60.0%) compared with 3D7/IC (40.0%) for msp-2. No polyclonal infection was observed in msp-1 and msp-2. The expected heterozygosity was 0.98 and 0.97 for msp-1 and msp-2, respectively. Conclusion: It was concluded that the P. falciparum populations are highly polymorphic, and diverse allelic variants of msp-1 and msp-2 are present in Khyber Pakhtunkhwa, Pakistan.
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Affiliation(s)
- Shahid Niaz Khan
- Department of Zoology, Faculty of Biological Sciences, Kohat University of Science and Technology, Kohat, Pakistan
| | - Rehman Ali
- Department of Zoology, Faculty of Biological Sciences, Kohat University of Science and Technology, Kohat, Pakistan
| | - Sanaullah Khan
- Department of Zoology, University of Peshawar, Peshawar, Pakistan
| | - Muhammad Rooman
- Department of Zoology, Hazara University, Mansehra, Pakistan
| | - Sadia Norin
- Department of Zoology, Faculty of Biological Sciences, Kohat University of Science and Technology, Kohat, Pakistan
| | - Shehzad Zareen
- Department of Zoology, Faculty of Biological Sciences, Kohat University of Science and Technology, Kohat, Pakistan
| | - Ijaz Ali
- Department of Biosciences, COMSATS University Islamabad, Islamabad, Pakistan
| | - Sultan Ayaz
- College of Veterinary Sciences and Animal Husbandry, Abdul Wali Khan University Garden Campus Mardan, Mardan, Pakistan
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Usman-Yamman H, Omalu C J I, Abubakar A, Abolarinwa S O, Eke S S, Otuu CA. Genetic diversity of plasmodium falciparum isolates in Minna, North Central Nigeria inferred by PCR genotyping of Merozoite surface protein 1 and 2. INFECTION, GENETICS AND EVOLUTION : JOURNAL OF MOLECULAR EPIDEMIOLOGY AND EVOLUTIONARY GENETICS IN INFECTIOUS DISEASES 2021; 96:105143. [PMID: 34800712 DOI: 10.1016/j.meegid.2021.105143] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 11/01/2021] [Accepted: 11/13/2021] [Indexed: 10/19/2022]
Abstract
North Central Nigeria is one region in Nigeria with a significant incidence of malaria caused majorly by Plasmodium falciparum. This study utilizes the msp1 and msp2 genes of P. falciparum to examine its diversity and multiplicity of infection (MOI). Blood samples were collected from 247 children across selected healthcare facilities in Minna, from infants and children aged 6 months to 17 years. Of the total collection, 143 (58%) of the children were infected with P. falciparum with parasite density ≥ 1000 μl, and from which fifty (50) samples was randomly selected and presented for PCR for the characterization of msp1 and msp2 gene using nested-PCR method. Overall, 57 msp1 genotypes, including K1, MAD20 and RO33 were identified, ranging from (250-1000 bp), (100-500 bp) and (400-500 bp), respectively. In addition, 54 different msp2 genotypes of FC27 and 3D7 alleles ranging from (100-900 bp) and (100-800 bp), respectively were selected. A monoclonal infection of 39% and a polyclonal infection of 61% was recorded, however, a particularity about this study is the polyclonal nature of RO33. Determination of gene diversity revealed MAD20 as the predominant allele for msp1 with a mean MOI of 1.35 and FC27 for msp2 with 1.72 MOI. The overall MOI recorded for the study was 1.60. There was, however, no statistical significance difference between MOI and age of the child (P > 0.05). Meanwhile, findings from this study revealed P. falciparum populations were not genetically diverse with Heterozygosity (He) index of 0.0636. However, a significant level gene diversity within the antigenic markers of msp1 and msp2 was observed with He index of 0.714 and 0.830, respectively. This study has demonstrated the potential of gene diversity and MOI of P. falciparum, as important markers for assessing differences in malaria transmission intensity. Continuous malaria genetic surveillance is therefore recommended as a fundamental tool for monitoring changes in gene types and for intervention programs' effectiveness.
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Affiliation(s)
- Hadijah Usman-Yamman
- Department of Animal Biology, Federal University of Technology, Minna, Niger State, Nigeria.
| | - Innocent Omalu C J
- Department of Animal Biology, Federal University of Technology, Minna, Niger State, Nigeria.
| | - Abdulkadir Abubakar
- Department of Biochemistry, Federal University of Technology, Minna, Niger State, Nigeria.
| | - Abolarinwa S O
- Department of Animal Biology, Federal University of Technology, Minna, Niger State, Nigeria.
| | - Samuel Eke S
- Department of Biology, Air Force Institute of Technology, Kaduna, Nigeria.
| | - Chidiebere A Otuu
- Parasitology and Public Health Research Unit, Department of Zoology and Environmental Biology, University of Nigeria, Nsukka, Nigeria.
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14
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File T, Chekol T, Solomon G, Dinka H, Golassa L. Detection of high frequency of MAD20 allelic variants of Plasmodium falciparum merozoite surface protein 1 gene from Adama and its surroundings, Oromia, Ethiopia. Malar J 2021; 20:385. [PMID: 34579727 PMCID: PMC8477549 DOI: 10.1186/s12936-021-03914-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 09/09/2021] [Indexed: 11/20/2022] Open
Abstract
Background One of the major challenges in developing an effective vaccine against asexual stages of Plasmodium falciparum is genetic polymorphism within parasite population. Understanding the genetic polymorphism like block 2 region of merozoite surface protein-1 (msp-1) gene of P. falciparum enlighten mechanisms underlining disease pathology, identification of the parasite clone profile from the isolates, transmission intensity and potential deficiencies of the ongoing malaria control and elimination efforts in the locality. Detailed understanding of local genetic polymorphism is an input to pave the way for better management, control and elimination of malaria. The aim of this study was to detect the most frequent allelic variant of the msp-1 gene of P. falciparum clinical isolates from selected health facilities in Adama town and its surroundings, Oromia, Ethiopia. Methods One hundred thirty-nine clinical isolates were successfully amplified for msp-1 gene using specific primers. Nested PCR amplification was conducted targeting K1, MAD20, and R033 alleles followed by gel electrophoresis for fragment analysis. Based on the detection of a PCR fragment, infections were classified as monoclonal or multiple infections. Results 19 different size polymorphism of msp-1 gene were identified in the study, with 67(48%) MAD20, 18 (13%) K-1 and 18 (13%) RO33 allelic family. Whereas, the multiple infections were 21(15%), 8 (5.8%), 4(2.9%), 3(2.2%) for MAD20 + K-1, MAD20 + RO33, K-1 + RO33, and MAD20 + K-1, RO33, respectively. The overall Multiplicity of infection (MOI) was 1.3 and the expected heterozygosity (He) was 0.39 indicating slightly low falciparum malaria transmission. Conclusion The status of msp-1 allele size polymorphism, MOI and He observed in the study revealed the presence of slightly low genetic diversity of P. falciparum clinical isolates. However, highly frequent MAD20 allelic variant was detected from clinical isolates in the study area. Moreover, the driving force that led to high predominance of MAD20 allelic variant revealed in such malaria declining region demands further research. Supplementary Information The online version contains supplementary material available at 10.1186/s12936-021-03914-9.
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Affiliation(s)
- Temesgen File
- Department of Applied Biology, Adama Science and Technology University, P.O.Box 1888, Adama, Ethiopia.
| | - Tsegaye Chekol
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, P.O.Box 1176, Addis Ababa, Ethiopia
| | - Gezahegn Solomon
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, P.O.Box 1176, Addis Ababa, Ethiopia
| | - Hunduma Dinka
- Department of Applied Biology, Adama Science and Technology University, P.O.Box 1888, Adama, Ethiopia
| | - Lemu Golassa
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, P.O.Box 1176, Addis Ababa, Ethiopia
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15
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Sondo P, Bihoun B, Kabore B, Tahita MC, Derra K, Rouamba T, Diallo SN, Kazienga A, Ilboudo H, Valea I, Tarnagda Z, Sorgho H, Lefevre T, Tinto H. [Polymorphisms in Plasmodium falciparum parasites and mutations in the resistance genes Pfcrt and Pfmdr1 in Nanoro area, Burkina Faso]. Pan Afr Med J 2021; 39:118. [PMID: 34512854 PMCID: PMC8396377 DOI: 10.11604/pamj.2021.39.118.26959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 06/01/2021] [Indexed: 11/17/2022] Open
Abstract
Introduction sur le plan génétique, Plasmodium falciparum(P. falciparum) est une espèce extrêmement polymorphe. Il existe une diversité de souches parasitaires qui infestent les individus vivant en zone d´endémie palustre. La présente étude vise à étudier la relation entre le polymorphisme de P. falciparum et les mutations au niveau des gènes Pfcrt et Pfmdr1 dans la zone de Nanoro au Burkina Faso. Méthodes les échantillons sanguins de porteurs de plasmodiums résidant dans le district sanitaire de Nanoro ont fait l´objet d´un génotypage par PCR nichée. Les mutations au niveau des gènes de résistance du parasite aux antipaludiques ont été détectées par la technique PCR-RFLP. Résultats les échantillons de 672 patients ont été génotypés avec succès. Aucune famille allélique des gènes msp1et msp2n´avaient une susceptibilité accrue à développer des mutations au niveau des gènes de résistance. Par contre, les souches mutantes de ces gènes étaient significativement plus importantes dans les infections monoclonales que dans les infections multi clonales. Conclusion cette étude fournit un aperçu global de la relation entre le polymorphisme de P. falciparum et les mutations au niveau des gènes de résistance. Ces données contribueront sans doute à améliorer les connaissances sur la biologie du parasite et de ses mécanismes de résistance aux antipaludiques.
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Affiliation(s)
- Paul Sondo
- Institut de Recherche en Sciences de la Santé, Unité de Recherche Clinique de Nanoro (IRSS-URCN), Bobo-Dioulasso, Burkina Faso
| | - Biebo Bihoun
- Institut de Recherche en Sciences de la Santé, Unité de Recherche Clinique de Nanoro (IRSS-URCN), Bobo-Dioulasso, Burkina Faso
| | - Bérenger Kabore
- Institut de Recherche en Sciences de la Santé, Unité de Recherche Clinique de Nanoro (IRSS-URCN), Bobo-Dioulasso, Burkina Faso
| | - Marc Christian Tahita
- Institut de Recherche en Sciences de la Santé, Unité de Recherche Clinique de Nanoro (IRSS-URCN), Bobo-Dioulasso, Burkina Faso
| | - Karim Derra
- Institut de Recherche en Sciences de la Santé, Unité de Recherche Clinique de Nanoro (IRSS-URCN), Bobo-Dioulasso, Burkina Faso
| | - Toussaint Rouamba
- Institut de Recherche en Sciences de la Santé, Unité de Recherche Clinique de Nanoro (IRSS-URCN), Bobo-Dioulasso, Burkina Faso
| | - Seydou Nakanabo Diallo
- Institut National de Santé Publique, Centre Muraz de Bobo-Dioulasso, Bobo-Dioulasso, Burkina Faso
| | - Adama Kazienga
- Institut de Recherche en Sciences de la Santé, Unité de Recherche Clinique de Nanoro (IRSS-URCN), Bobo-Dioulasso, Burkina Faso
| | - Hamidou Ilboudo
- Institut de Recherche en Sciences de la Santé, Unité de Recherche Clinique de Nanoro (IRSS-URCN), Bobo-Dioulasso, Burkina Faso
| | - Innocent Valea
- Institut de Recherche en Sciences de la Santé, Unité de Recherche Clinique de Nanoro (IRSS-URCN), Bobo-Dioulasso, Burkina Faso
| | - Zekiba Tarnagda
- Institut de Recherche en Sciences de la Santé, Unité de Recherche Clinique de Nanoro (IRSS-URCN), Bobo-Dioulasso, Burkina Faso
| | - Hermann Sorgho
- Institut de Recherche en Sciences de la Santé, Unité de Recherche Clinique de Nanoro (IRSS-URCN), Bobo-Dioulasso, Burkina Faso
| | - Thierry Lefevre
- Laboratoire Mixte International sur les Vecteurs (LAMIVECT), Bobo Dioulasso, Burkina Faso.,Maladies Infectieuses et Vecteurs, Ecologie, Génétique, Evolution et Contrôle (MIVEGEC), Université de Montpellier, Institut de Recherche pour le Développement (IRD), Centre National pour la Recherche Scientifique (CNRS), Montpellier, France.,Centre de Recherche en Écologie et Évolution de la Santé (CREES), Montpellier, France
| | - Halidou Tinto
- Institut de Recherche en Sciences de la Santé, Unité de Recherche Clinique de Nanoro (IRSS-URCN), Bobo-Dioulasso, Burkina Faso
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16
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L'Episcopia M, Bartoli TA, Corpolongo A, Mariano A, D'Abramo A, Vulcano A, Paglia MG, Perrotti E, Menegon M, Nicastri E, Severini C. Artemisinin resistance surveillance in African Plasmodium falciparum isolates from imported malaria cases to Italy. J Travel Med 2021; 28:6028740. [PMID: 33295621 DOI: 10.1093/jtm/taaa231] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 12/01/2020] [Indexed: 11/14/2022]
Abstract
BACKGROUND Plasmodium falciparum (P. falciparum) malaria is a significant public health problem in returning travellers, and artemisinin combination therapy (ACT) remains the first choice for treatment. Several single nucleotide polymorphisms (SNPs) in the P. falciparum kelch 13 (Pfk13) gene have been associated with artemisinin (ART) resistance. Moreover, the increase in the P. falciparum plasmepsin 2 (Pfpm2) gene copy number was shown to be linked with reduced susceptibility of P. falciparum to piperaquine (PPQ), a partner drug in an ACT regimen. Active molecular surveillance for imported drug-resistant malaria parasites is a pivotal activity to provide adequate chemoprophylaxis and treatment guidelines. METHODS A retrospective study to review imported P. falciparum malaria in patients admitted to Spallanzani Institute between 2014 and 2015 was conducted. Information collected included clinic and epidemiological characteristics such as age, gender, country of origin, time since arrival to our country, travel history. All P.falciparum isolates were analysed for SNPs in the Pfk13 gene and for copy number variations in the Pfpm2 gene. RESULTS P. falciparum malaria was identified in 54 travellers. The mean age was 37 years, 44 were males. All cases were imported from non-EU countries. In the Pfk13 gene two mutations (R561R and F673L) were detected. Six P. falciparum isolates carried two copies of Pfpm2 gene, and one three copies, representing ≈16% of the analysed isolates. CONCLUSIONS None of the SNPs known to be associated with ART resistance were detected in the examined parasites. Our results provide evidence that Pfpm2 duplications (associated with piperaquine resistance) occur in Africa, emphasizing the necessity to better decode the genetic background associated with PPQ resistance. Further epidemiological investigations in Pfpm2 amplification along with mutations in the Pfk13 gene will be useful for developing and updating anti-malarial guidance in travellers.
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Affiliation(s)
- Mariangela L'Episcopia
- Department of Infectious Diseases, Istituto Superiore di Sanità, viale Regina Elena 299, 00161, Rome, Italy
| | - Tommaso Ascoli Bartoli
- National Institute for Infectious Diseases, IRCCS "Lazzaro Spallanzani", Via Portuense 292, 00149 Rome, Italy
| | - Angela Corpolongo
- National Institute for Infectious Diseases, IRCCS "Lazzaro Spallanzani", Via Portuense 292, 00149 Rome, Italy
| | - Andrea Mariano
- National Institute for Infectious Diseases, IRCCS "Lazzaro Spallanzani", Via Portuense 292, 00149 Rome, Italy
| | - Alessandra D'Abramo
- National Institute for Infectious Diseases, IRCCS "Lazzaro Spallanzani", Via Portuense 292, 00149 Rome, Italy
| | - Antonella Vulcano
- National Institute for Infectious Diseases, IRCCS "Lazzaro Spallanzani", Via Portuense 292, 00149 Rome, Italy
| | - Maria G Paglia
- National Institute for Infectious Diseases, IRCCS "Lazzaro Spallanzani", Via Portuense 292, 00149 Rome, Italy
| | - Edvige Perrotti
- Department of Infectious Diseases, Istituto Superiore di Sanità, viale Regina Elena 299, 00161, Rome, Italy
| | - Michela Menegon
- Department of Infectious Diseases, Istituto Superiore di Sanità, viale Regina Elena 299, 00161, Rome, Italy
| | - Emanuele Nicastri
- National Institute for Infectious Diseases, IRCCS "Lazzaro Spallanzani", Via Portuense 292, 00149 Rome, Italy
| | - Carlo Severini
- Department of Infectious Diseases, Istituto Superiore di Sanità, viale Regina Elena 299, 00161, Rome, Italy
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Jamil KF, Pratama NR, Marantina SS, Harapan H, Kurniawan MR, Zanaria TM, Hutagalung J, Rozi IE, Asih PBS, Supargiyono, Syafruddin D. Allelic diversity of merozoite surface protein genes (msp1 and msp2) and clinical manifestations of Plasmodium falciparum malaria cases in Aceh, Indonesia. Malar J 2021; 20:182. [PMID: 33849556 PMCID: PMC8042635 DOI: 10.1186/s12936-021-03719-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 03/30/2021] [Indexed: 11/25/2022] Open
Abstract
Background The malaria control programme in Indonesia has successfully brought down malaria incidence in many parts in Indonesia, including Aceh Province. Clinical manifestation of reported malaria cases in Aceh varied widely from asymptomatic, mild uncomplicated to severe and fatal complications. The present study aims to explore the allelic diversity of merozoite surface protein 1 gene (msp1) and msp2 among the Plasmodium falciparum isolates in Aceh Province and to determine their potential correlation with the severity of malaria clinical manifestation. Methods Screening of over 500 malaria cases admitted to the hospitals in 11 districts hospital within Aceh Province during 2013–2015, identified 90 cases of P. falciparum mono-infection without any co-morbidity. The subjects were clinically phenotyped and parasite DNA was extracted and polymerase chain reaction (PCR) amplified for the msp1 and msp2 allelic subfamilies. Results Analysis of clinical manifestation revealed that fever-chill is the most frequent symptom. Based on WHO criteria showed 19 cases were classified as severe and 71 as mild malaria. Analysis of msp1 gene revealed the presence of K1 allele subfamily in 34 subjects, MAD20 in 42 subjects, RO33 in 1 subject, and mixed allelic of K1 + MAD20 in 5 subjects, K1 + RO33 in 4 subjects, and MAD20 + RO33 in 4 subjects. Analysis of msp2 gene revealed 34 subjects carried the FC27 allelic subfamily, 37 subjects carried the 3D7 and 19 subjects carried the mixed FC27 + 3D7. Analysis of multiplicity of infection revealed that msp1 alleles is slightly higher than msp2 with the mean of MOI were 2.69 and 2.27, respectively. Statistical analysis to determine the association between each clinical manifestation and msp1 and msp2 alleles revealed that liver function abnormal value was associated with the msp2 mixed alleles (odds ratio (OR):0.13; 95%CI: 0.03–0.53). Mixed msp1 of K1 + RO33 was associated with severe malaria (OR: 28.50; 95%CI: 1.59–1532.30). Conclusion This study found a strong association between severe malaria in Aceh with subjects carrying the msp1 mixed alleles of K1 and RO33. The liver function abnormal value associated with the msp2 mixed allelic subfamilies. Further study in different geographic areas is recommended.
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Affiliation(s)
- Kurnia Fitri Jamil
- Division of Tropical Medicine & Infectious Disease, Department of Internal Medicine Faculty of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia.
| | - Nandha Rizki Pratama
- Malaria and Vector Resistance Unit, Eijkman Institute for Molecular Biology, Jakarta, Indonesia
| | - Sylvia Sance Marantina
- Malaria and Vector Resistance Unit, Eijkman Institute for Molecular Biology, Jakarta, Indonesia
| | - Harapan Harapan
- Medical Research Unit, Faculty of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia
| | - Muhammad Riza Kurniawan
- Recident of Internal Medicine Education Specialist Program Faculty of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia
| | - Tjut Mariam Zanaria
- Department of Parasitology School of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia
| | - Jontari Hutagalung
- National Institute of Health Research and Development (NIHRD), Ministry of Health, Jakarta, Indonesia
| | - Ismail Ekoprayitno Rozi
- Malaria and Vector Resistance Unit, Eijkman Institute for Molecular Biology, Jakarta, Indonesia
| | - Puji Budi Setia Asih
- Malaria and Vector Resistance Unit, Eijkman Institute for Molecular Biology, Jakarta, Indonesia
| | - Supargiyono
- Center for Tropical Medicine/Department of Parasitology, Faculty of Medicine, Gadjah Mada University, Yogyakarta, Indonesia
| | - Din Syafruddin
- Malaria and Vector Resistance Unit, Eijkman Institute for Molecular Biology, Jakarta, Indonesia.,Department of Parasitology, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
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18
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Mohammed H, Assefa A, Chernet M, Wuletaw Y, Commons RJ. Genetic polymorphisms of Plasmodium falciparum isolates from Melka-Werer, North East Ethiopia based on the merozoite surface protein-2 (msp-2) gene as a molecular marker. Malar J 2021; 20:85. [PMID: 33579293 PMCID: PMC7881608 DOI: 10.1186/s12936-021-03625-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Accepted: 02/04/2021] [Indexed: 11/21/2022] Open
Abstract
Background The characterization of parasite populations circulating in malaria endemic areas is necessary to evaluate the success of ongoing interventions and malaria control strategies. This study was designed to investigate the genetic diversity of Plasmodium falciparum isolates from the semi-arid area in North East Ethiopia, using the highly polymorphic merozoite surface protein-2 (msp2) gene as a molecular marker. Methods Dried blood spot isolates were collected from patients with P. falciparum infection between September 2014 and January 2015 from Melka-Werer, North East Ethiopia. Parasite DNA was extracted and genotyped using allele-specific nested polymerase chain reactions for msp2. Results 52 isolates were collected with msp2 identified in 41 (78.8%) isolates. Allele typing of the msp2 gene detected the 3D7/IC allelic family in 54% and FC27 allelic family in 46%. A total of 14 different msp2 genotypes were detected including 6 belonging to the 3D7/IC family and 8 to the FC27 family. Forty percent of isolates had multiple genotypes and the overall mean multiplicity of infections (MOI) was 1.2 (95%CI 0.96–1.42). The heterozygosity index was 0.50 for the msp2 locus. There was no difference in MOI between age groups. A negative correlation between parasite density and multiplicity of infection was found (p = 0.02). Conclusion Plasmodium falciparum isolates from the semi-arid area of North East Ethiopia are mainly monoclonal with low MOI and limited genetic diversity in the study population.
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Affiliation(s)
- Hussein Mohammed
- Malaria, Neglected Tropical Diseases Research Team, Bacterial, Parasitic, Zoonotic Diseases Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia.
| | - Ashenafi Assefa
- Malaria, Neglected Tropical Diseases Research Team, Bacterial, Parasitic, Zoonotic Diseases Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Melkie Chernet
- Malaria, Neglected Tropical Diseases Research Team, Bacterial, Parasitic, Zoonotic Diseases Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Yonas Wuletaw
- Malaria, Neglected Tropical Diseases Research Team, Bacterial, Parasitic, Zoonotic Diseases Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Robert J Commons
- Global Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Australia.,Internal Medicine Services, Ballarat Health Services, Ballarat, Australia
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19
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Wang QB, Du YT, Liu F, Sun XD, Sun X, Chen G, Pang W, Cao YM. Adaptive immune responses mediated age-related Plasmodium yoelii 17XL and 17XNL infections in 4 and 8-week-old BALB/c mice. BMC Immunol 2021; 22:6. [PMID: 33430765 PMCID: PMC7798208 DOI: 10.1186/s12865-020-00391-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Accepted: 11/12/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUD It is important to expound the opposite clinical outcomes between children and adulthood for eradicate malaria. There remains unknown about the correlation between adaptive immune response and age-related in malaria. METHODS 4 and 8-week-old mice were used to mimic children and adulthood, respectively. Parasitemia and the survival rate were monitored. The proportion and function of Th1 and Th2 cells were detected by FACS. The levels of IFN-γ, IL-4, total IgG, IgG1, IgG2a and Plasmodium yoelii MSP-1-specific IgG were measured by ELISA. RESULTS The adult group showed greater resistance to P. yoelii 17XL infection, with lower parasitemia. Compared with 4-week-old mice, the percentage of CD4+T-bet+IFN-γ+ Th1 cells as well as IFN-γ production were significantly increased on day 5 p.i. in the 8-week-old mice after P. yoelii 17XNL infection. The percentage of CD4+GATA3+IL-4+ Th2 cells and CD4+CXCR5+ Tfh cells, and IL-4 production in the 8-week-old mice significantly increased on day 5 and day 10 after P. yoelii 17XNL infection. Notably, the levels of total IgG, IgG1, IgG2a and P. yoelii MSP-1-specific IgG were also significantly increased in the 8-week-old mice. PD-1, a marker of exhaustion, was up-regulated on CD4+ or activated CD4+ T cells in the 8-week-old mice as compared to the 4-week-old group. CONCLUSIONS Thus, we consider that enhanced cellular and humoral adaptive immunity might contribute to rapid clearance of malaria among adults, likely in a PD-1-dependent manner due to induction of CD4+ T cells exhaustion in P. yoelii 17XNL infected 8-week-old mice.
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Affiliation(s)
- Qiu-Bo Wang
- Department of Immunology, College of Basic Medical Sciences, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, 110122, China.,Department of Clinical Laboratory, Wuxi 9th Affiliated Hospital of Soochow University, No. 999 Liang Xi Road, Binhu District, Wuxi, 214000, China
| | - Yun-Ting Du
- Department of Laboratory Medicine, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, NO. 44 Xiaoheyan Road, Dadong District, Shenyang, 110042, China
| | - Fei Liu
- Department of Immunology, College of Basic Medical Sciences, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, 110122, China
| | - Xiao-Dan Sun
- Department of Immunology, College of Basic Medical Sciences, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, 110122, China
| | - Xun Sun
- Department of Immunology, College of Basic Medical Sciences, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, 110122, China
| | - Guang Chen
- Department of Basic Medical Sciences, Taizhou University Medical School, No 1139 Shifu Road, Jiaojiang District, Taizhou, 317700, China.
| | - Wei Pang
- Department of Immunology, College of Basic Medical Sciences, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, 110122, China.
| | - Ya-Ming Cao
- Department of Immunology, College of Basic Medical Sciences, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, 110122, China.
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20
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Sondo P, Bihoun B, Tahita MC, Derra K, Rouamba T, Nakanabo Diallo S, Kazienga A, Ilboudo H, Valea I, Tarnagda Z, Sorgho H, Lefèvre T, Tinto H. Plasmodium falciparum gametocyte carriage in symptomatic patients shows significant association with genetically diverse infections, anaemia, and asexual stage density. Malar J 2021; 20:31. [PMID: 33413393 PMCID: PMC7791700 DOI: 10.1186/s12936-020-03559-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 12/18/2020] [Indexed: 11/17/2022] Open
Abstract
Background Multi-genotype malaria infections are frequent in endemic area, and people commonly harbour several genetically distinct Plasmodium falciparum variants. The influence of genetic multiplicity and whether some specific genetic variants are more or less likely to invest into gametocyte production is not clearly understood. This study explored host and parasite-related risk factors for gametocyte carriage, and the extent to which some specific P. falciparum genetic variants are associated with gametocyte carriage. Methods Gametocytes and asexual forms were detected by light microscopy on thick smears collected between 2010 and 2012 in Nanoro, Burkina Faso. Merozoite surface protein 1 and 2 were genotyped by nested PCR on clinical samples. Associations between gametocyte carriage and factors, including multiplicity of infection, parasite density, patient age, gender, haemoglobin (Hb) level, and body temperature were assessed. The relationship between the presence of a particular msp1 and msp2 genetic variants and gametocyte carriage was also explored. Results Of the 724 samples positive to P. falciparum and successfully genotyped, gametocytes were found in 48 samples (6.63%). There was no effect of patient gender, age and body temperature on gametocyte carriage. However, the probability of gametocyte carriage significantly increased with increasing values of multiplicity of infection (MOI). Furthermore, there was a negative association between parasite density and gametocyte carriage. MOI decreased with parasite density in gametocyte-negative patients, but increased in gametocyte carriers. The probability of gametocyte carriage decreased with Hb level. Finally, the genetic composition of the infection influenced gametocyte carriage. In particular, the presence of RO33 increased the odds of developing gametocytes by 2 while the other allelic families K1, MAD20, FC27, and 3D7 had no significant impact on the occurrence of gametocytes in infected patients. Conclusion This study provides insight into potential factors influencing gametocyte production in symptomatic patients. The findings contribute to enhance understanding of risk factors associated with gametocyte carriage in humans. Trial registration NCT01232530.
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Affiliation(s)
- Paul Sondo
- Institut de Recherche en Sciences de La Santé/ Clinical Research Unit of Nanoro (IRSS-URCN), Nanoro, Burkina Faso.
| | - Biebo Bihoun
- Institut de Recherche en Sciences de La Santé/ Clinical Research Unit of Nanoro (IRSS-URCN), Nanoro, Burkina Faso
| | - Marc Christian Tahita
- Institut de Recherche en Sciences de La Santé/ Clinical Research Unit of Nanoro (IRSS-URCN), Nanoro, Burkina Faso
| | - Karim Derra
- Institut de Recherche en Sciences de La Santé/ Clinical Research Unit of Nanoro (IRSS-URCN), Nanoro, Burkina Faso
| | - Toussaint Rouamba
- Institut de Recherche en Sciences de La Santé/ Clinical Research Unit of Nanoro (IRSS-URCN), Nanoro, Burkina Faso
| | - Seydou Nakanabo Diallo
- Institut de Recherche en Sciences de La Santé/ Clinical Research Unit of Nanoro (IRSS-URCN), Nanoro, Burkina Faso.,Institut National de Santé Publique/Centre Muraz de Bobo-Dioulasso, Bobo-Dioulasso, Burkina Faso
| | - Adama Kazienga
- Institut de Recherche en Sciences de La Santé/ Clinical Research Unit of Nanoro (IRSS-URCN), Nanoro, Burkina Faso
| | - Hamidou Ilboudo
- Institut de Recherche en Sciences de La Santé/ Clinical Research Unit of Nanoro (IRSS-URCN), Nanoro, Burkina Faso
| | - Innocent Valea
- Institut de Recherche en Sciences de La Santé/ Clinical Research Unit of Nanoro (IRSS-URCN), Nanoro, Burkina Faso.,Institut National de Santé Publique/Centre Muraz de Bobo-Dioulasso, Bobo-Dioulasso, Burkina Faso
| | - Zekiba Tarnagda
- Institut de Recherche en Sciences de La Santé/ Clinical Research Unit of Nanoro (IRSS-URCN), Nanoro, Burkina Faso
| | - Hermann Sorgho
- Institut de Recherche en Sciences de La Santé/ Clinical Research Unit of Nanoro (IRSS-URCN), Nanoro, Burkina Faso
| | - Thierry Lefèvre
- Laboratoire Mixte International Sur Les Vecteurs (LAMIVECT), Bobo Dioulasso, Burkina Faso.,MIVEGEC, Université de Montpellier, IRD, CNRS, Montpellier, France.,Centre de Recherche en Écologie Et Évolution de La Santé (CREES), Montpellier, France
| | - Halidou Tinto
- Institut de Recherche en Sciences de La Santé/ Clinical Research Unit of Nanoro (IRSS-URCN), Nanoro, Burkina Faso
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Ndiaye T, Sy M, Gaye A, Siddle KJ, Park DJ, Bei AK, Deme AB, Mbaye A, Dieye B, Ndiaye YD, Ndiaye IM, Diallo MA, Diongue K, Volkman SK, Badiane AS, Ndiaye D. Molecular epidemiology of Plasmodium falciparum by multiplexed amplicon deep sequencing in Senegal. Malar J 2020; 19:403. [PMID: 33172455 PMCID: PMC7654156 DOI: 10.1186/s12936-020-03471-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 10/30/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Molecular epidemiology can provide important information regarding the genetic diversity and transmission of Plasmodium falciparum, which can assist in designing and monitoring elimination efforts. However, malaria molecular epidemiology including understanding the genetic diversity of the parasite and performing molecular surveillance of transmission has been poorly documented in Senegal. Next Generation Sequencing (NGS) offers a practical, fast and high-throughput approach to understand malaria population genetics. This study aims to unravel the population structure of P. falciparum and to estimate the allelic diversity, multiplicity of infection (MOI), and evolutionary patterns of the malaria parasite using the NGS platform. METHODS Multiplex amplicon deep sequencing of merozoite surface protein 1 (PfMSP1) and merozoite surface protein 2 (PfMSP2) in fifty-three P. falciparum isolates from two epidemiologically different areas in the South and North of Senegal, was carried out. RESULTS A total of 76 Pfmsp1 and 116 Pfmsp2 clones were identified and 135 different alleles were found, 56 and 79 belonged to the pfmsp1 and pfmsp2 genes, respectively. K1 and IC3D7 allelic families were most predominant in both sites. The local haplotype diversity (Hd) and nucleotide diversity (π) were higher in the South than in the North for both genes. For pfmsp1, a high positive Tajima's D (TD) value was observed in the South (D = 2.0453) while negative TD value was recorded in the North (D = - 1.46045) and F-Statistic (Fst) was 0.19505. For pfmsp2, non-directional selection was found with a highly positive TD test in both areas and Fst was 0.02111. The mean MOI for both genes was 3.07 and 1.76 for the South and the North, respectively, with a statistically significant difference between areas (p = 0.001). CONCLUSION This study revealed a high genetic diversity of pfmsp1 and pfmsp2 genes and low genetic differentiation in P. falciparum population in Senegal. The MOI means were significantly different between the Southern and Northern areas. Findings also showed that multiplexed amplicon deep sequencing is a useful technique to investigate genetic diversity and molecular epidemiology of P. falciparum infections.
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Affiliation(s)
- Tolla Ndiaye
- Laboratoire de Parasitologie-Mycologie, Université Cheikh Anta Diop de Dakar (UCAD), Hôpital Aristide Le Dantec, Dakar, Senegal.
| | - Mouhamad Sy
- Laboratoire de Parasitologie-Mycologie, Université Cheikh Anta Diop de Dakar (UCAD), Hôpital Aristide Le Dantec, Dakar, Senegal
| | - Amy Gaye
- Laboratoire de Parasitologie-Mycologie, Université Cheikh Anta Diop de Dakar (UCAD), Hôpital Aristide Le Dantec, Dakar, Senegal
| | | | - Daniel J Park
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Amy K Bei
- Yale School of Public Health, 60 College Street, New Haven, CT, 06510, USA
| | - Awa B Deme
- Laboratoire de Parasitologie-Mycologie, Université Cheikh Anta Diop de Dakar (UCAD), Hôpital Aristide Le Dantec, Dakar, Senegal
| | - Aminata Mbaye
- Laboratoire de Parasitologie-Mycologie, Université Cheikh Anta Diop de Dakar (UCAD), Hôpital Aristide Le Dantec, Dakar, Senegal
| | - Baba Dieye
- Laboratoire de Parasitologie-Mycologie, Université Cheikh Anta Diop de Dakar (UCAD), Hôpital Aristide Le Dantec, Dakar, Senegal
| | - Yaye Die Ndiaye
- Laboratoire de Parasitologie-Mycologie, Université Cheikh Anta Diop de Dakar (UCAD), Hôpital Aristide Le Dantec, Dakar, Senegal
| | - Ibrahima Mbaye Ndiaye
- Laboratoire de Parasitologie-Mycologie, Université Cheikh Anta Diop de Dakar (UCAD), Hôpital Aristide Le Dantec, Dakar, Senegal
| | - Mamadou Alpha Diallo
- Laboratoire de Parasitologie-Mycologie, Université Cheikh Anta Diop de Dakar (UCAD), Hôpital Aristide Le Dantec, Dakar, Senegal
| | - Khadim Diongue
- Laboratoire de Parasitologie-Mycologie, Université Cheikh Anta Diop de Dakar (UCAD), Hôpital Aristide Le Dantec, Dakar, Senegal
| | - Sarah K Volkman
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Department of Immunology and Infectious Diseases, Harvard University, Cambridge, MA, USA
| | - Aida Sadikh Badiane
- Laboratoire de Parasitologie-Mycologie, Université Cheikh Anta Diop de Dakar (UCAD), Hôpital Aristide Le Dantec, Dakar, Senegal
| | - Daouda Ndiaye
- Laboratoire de Parasitologie-Mycologie, Université Cheikh Anta Diop de Dakar (UCAD), Hôpital Aristide Le Dantec, Dakar, Senegal
- Department of Immunology and Infectious Diseases, Harvard University, Cambridge, MA, USA
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Sondo P, Derra K, Rouamba T, Nakanabo Diallo S, Taconet P, Kazienga A, Ilboudo H, Tahita MC, Valéa I, Sorgho H, Lefèvre T, Tinto H. Determinants of Plasmodium falciparum multiplicity of infection and genetic diversity in Burkina Faso. Parasit Vectors 2020; 13:427. [PMID: 32819420 PMCID: PMC7441709 DOI: 10.1186/s13071-020-04302-z] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 08/10/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Investigating malaria transmission dynamics is essential to inform policy decision making. Whether multiplicity of infection (MOI) dynamic from individual infections could be a reliable malaria metric in high transmission settings with marked variation in seasons of malaria transmission has been poorly assessed. This study aimed at investigating factors driving Plasmodium falciparum MOI and genetic diversity in a hyperendemic area of Burkina Faso. METHODS Blood samples collected from a pharmacovigilance trial were used for polymerase chain reaction genotyping of the merozoite surface proteins 1 and 2. MOI was defined as the number of distinct parasite genotypes co-existing within a particular infection. Monthly rainfall data were obtained from satellite data of the Global Precipitation Measurement Database while monthly malaria incidence aggregated data were extracted from District Health Information Software 2 medical data of the Center-West health regional direction. RESULTS In the study area, infected people harboured an average of 2.732 (± 0.056) different parasite genotypes. A significant correlation between the monthly MOI and the monthly malaria incidence was observed, suggesting that MOI could be a good predictor of transmission intensity. A strong effect of season on MOI was observed, with infected patients harbouring higher number of parasite genotypes during the rainy season as compared to the dry season. There was a negative relationship between MOI and host age. In addition, MOI decreased with increasing parasite densities, suggesting that there was a within-host competition among co-infecting genetically distinct P. falciparum variants. Each allelic family of the msp1 and msp2 genes was present all year round with no significant monthly fluctuation. CONCLUSIONS In high malaria endemic settings with marked variation in seasons of malaria transmission, MOI represents an appropriate malaria metric which provides useful information about the longitudinal changes in malaria transmission in a given area. Besides transmission season, patient age and parasite density are important factors to consider for better understanding of variations in MOI. All allelic families of msp1 and msp2 genes were found in both dry and rainy season. The approach offers the opportunity of translating genotyping data into relevant epidemiological information for malaria control.
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Affiliation(s)
- Paul Sondo
- Institut de Recherche en Sciences de la Santé/Clinical Research Unit of Nanoro (IRSS-URCN), Nanoro, Burkina Faso.
| | - Karim Derra
- Institut de Recherche en Sciences de la Santé/Clinical Research Unit of Nanoro (IRSS-URCN), Nanoro, Burkina Faso
| | - Toussaint Rouamba
- Institut de Recherche en Sciences de la Santé/Clinical Research Unit of Nanoro (IRSS-URCN), Nanoro, Burkina Faso
| | - Seydou Nakanabo Diallo
- Institut National de Santé Publique/Centre Muraz de Bobo-Dioulasso, Bobo-Dioulasso, Burkina Faso
| | - Paul Taconet
- Centre de Recherche en Écologie et Évolution de la Santé (CREES), Montpellier, France
| | - Adama Kazienga
- Institut de Recherche en Sciences de la Santé/Clinical Research Unit of Nanoro (IRSS-URCN), Nanoro, Burkina Faso
| | - Hamidou Ilboudo
- Institut de Recherche en Sciences de la Santé/Clinical Research Unit of Nanoro (IRSS-URCN), Nanoro, Burkina Faso
| | - Marc Christian Tahita
- Institut de Recherche en Sciences de la Santé/Clinical Research Unit of Nanoro (IRSS-URCN), Nanoro, Burkina Faso
| | - Innocent Valéa
- Institut de Recherche en Sciences de la Santé/Clinical Research Unit of Nanoro (IRSS-URCN), Nanoro, Burkina Faso
| | - Hermann Sorgho
- Institut de Recherche en Sciences de la Santé/Clinical Research Unit of Nanoro (IRSS-URCN), Nanoro, Burkina Faso
| | - Thierry Lefèvre
- Centre de Recherche en Écologie et Évolution de la Santé (CREES), Montpellier, France.,Laboratoire Mixte International sur les Vecteurs (LAMIVECT), Bobo-Dioulasso, Burkina Faso.,Institut de Recherche pour le Développement (IRD), Centre National pour la Recherche Scientifique (CNRS), Maladies Infectieuses et Vecteurs: Ecologie, Génétique, Evolution et Contrôle (MIVEGEC), Université de Montpellier, Montpellier, France
| | - Halidou Tinto
- Institut de Recherche en Sciences de la Santé/Clinical Research Unit of Nanoro (IRSS-URCN), Nanoro, Burkina Faso
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Boccolini D, Menegon M, Di Luca M, Toma L, Severini F, Marucci G, D'Amato S, Caraglia A, Maraglino FP, Rezza G, Romi R, Gradoni L, Severini C. Non-imported malaria in Italy: paradigmatic approaches and public health implications following an unusual cluster of cases in 2017. BMC Public Health 2020; 20:857. [PMID: 32503526 PMCID: PMC7275312 DOI: 10.1186/s12889-020-08748-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 04/21/2020] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND The European region achieved interruption of malaria transmission during the 1970s. Since then, malaria control programs were replaced by surveillance systems in order to prevent possible re-emergence of this disease. Sporadic cases of non-imported malaria were recorded in several European countries in the past decade and locally transmitted outbreaks of Plasmodium vivax, most probably supported by Anopheles sacharovi, have been repeatedly reported from Greece since 2009. The possibility of locally-transmitted malaria has been extensively studied in Italy where the former malaria vector An. labranchiae survived the control campaign which led to malaria elimination. In this study, we present paradigmatic cases that occurred during a 2017 unusual cluster, which caused strong concern in public opinion and were carefully investigated after the implementation of the updated malaria surveillance system. METHODS For suspected locally-transmitted malaria cases, alerts to Ministry of Health (MoH) and the National Institute of Health (ISS) were mandated by the Local Health Services (LHS). Epidemiological investigations on the transmission modes and the identification of possible infection's source were carried out by LHS, MoH and ISS. Entomological investigations were implemented locally for all suspected locally-transmitted cases that occurred in periods suitable to anopheline activity. Molecular diagnosis by nested-PCR for the five human Plasmodium species was performed to support microscopic diagnosis. In addition, genotyping of P. falciparum isolate was carried out to investigate putative sources of infection and transmission modalities. RESULTS In 2017, a cluster of seven non-imported cases was recorded from August through October. Among them, P. ovale curtisi was responsible of one case whereas six cases were caused by P. falciparum. Two cases were proved to be nosocomial while the other five were recorded as cryptic at the end of epidemiological investigations. CONCLUSIONS The epidemiological evidence shows that the locally acquired events are sporadic, often remain unresolved and classified as cryptic ones despite investigative efforts. The "cluster" of seven non-imported cases that occurred in 2017 in different regions of Italy therefore represents a conscious alert that should lead us to maintain a constant level of surveillance in a former malaria endemic country.
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Affiliation(s)
- Daniela Boccolini
- Dipartimento Malattie Infettive, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy.
| | - Michela Menegon
- Dipartimento Malattie Infettive, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Marco Di Luca
- Dipartimento Malattie Infettive, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Luciano Toma
- Dipartimento Malattie Infettive, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Francesco Severini
- Dipartimento Malattie Infettive, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Gianluca Marucci
- Dipartimento Malattie Infettive, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Stefania D'Amato
- Ministero della Salute, Direzione Generale della Prevenzione Sanitari, Ufficio 5 - Prevenzione delle Malattie Trasmissibili e Profilassi Internazionale, Rome, Italy
| | - Anna Caraglia
- Ministero della Salute, Direzione Generale della Prevenzione Sanitaria, Ufficio 1 - Affari generali e segreteria tecnico-organizzativa, Rome, Italy
| | - Francesco Paolo Maraglino
- Ministero della Salute, Direzione Generale della Prevenzione Sanitari, Ufficio 5 - Prevenzione delle Malattie Trasmissibili e Profilassi Internazionale, Rome, Italy
| | - Giovanni Rezza
- Dipartimento Malattie Infettive, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Roberto Romi
- Dipartimento Malattie Infettive, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Luigi Gradoni
- Dipartimento Malattie Infettive, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Carlo Severini
- Dipartimento Malattie Infettive, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy.
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Metoh TN, Chen JH, Fon-Gah P, Zhou X, Moyou-Somo R, Zhou XN. Genetic diversity of Plasmodium falciparum and genetic profile in children affected by uncomplicated malaria in Cameroon. Malar J 2020; 19:115. [PMID: 32188442 PMCID: PMC7081701 DOI: 10.1186/s12936-020-03161-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 02/12/2020] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Malaria is a major public health problem in Cameroon. The study of the genetic diversity within parasite population is essential for understanding the mechanism underlying malaria pathology and to determine parasite clones profile in an infection, for proper malaria control strategies. The objective of this study was to perform a molecular characterization of highly polymorphic genetic markers of Plasmodium falciparum, and to determine allelic distribution with their influencing factors valuable to investigate malaria transmission dynamics in Cameroon. METHODS A total of 350 P. falciparum clinical isolates were characterized by genotyping block 2 of msp-1, block 3 of msp-2, and region II of glurp gene using nested PCR and DNA sequencing between 2012 and 2013. RESULTS A total of 5 different genotypes with fragment sizes ranging from 597 to 817 bp were recorded for GLURP. Overall, 16 MSP-1 genotypes, including K1, MAD20 and RO33 were identified, ranging from 153 to 335 bp. A peculiarity about this study is the RO33 monomorphic pattern revealed among the Pfmsp-1 allelic type. Again, this study identified 27 different Pfmsp-2 genotypes, ranging from 140 to 568 bp in size, including 15 belonging to the 3D7-type and 12 to the FC27 allelic families. The analysis of the MSP-1 and MSP-2 peptides indicates that the region of the alignment corresponding K1 polymorphism had the highest similarity in the MSP1and MSP2 clade followed by MAD20 with 93% to 100% homology. Therefore, population structure of P. falciparum isolates is identical to that of other areas in Africa, suggesting that vaccine developed with K1 and MAD20 of Pfmsp1 allelic variant could be protective for Africa children but these findings requires further genetic and immunological investigations. The multiplicity of infection (MOI) was significantly higher (P < 0.05) for Pfmsp-2 loci (3.82), as compare with Pfmsp-1 (2.51) and heterozygotes ranged from 0.55 for Pfmsp-1 to 0.96 for Pfmsp-2. CONCLUSION High genetic diversity and allelic frequencies in P. falciparum isolates indicate a persisting high level of transmission. This study advocate for an intensification of the malaria control strategies in Cameroon. Trial registration This study was approved by Cameroon National Ethics Committee. It is a randomized controlled trial retrospectively registered in NIH U.S. National Library of Medicine, ClinicalTrials.gov on the 28/11/2016 at https://clinicaltrials.gov/ct2/show/NCT02974348 with the registration number NCT02974348.
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Affiliation(s)
- Theresia Njuabe Metoh
- Department of Biochemistry, Faculty of Science, The University of Bamenda, P. O. Box 39 Bambili, Bamenda, Cameroon. .,National Institute of Parasitic Diseases, Chinese Centre for Disease Control and Prevention, Shanghai, 200025, People's Republic of China. .,WHO Collaborating Centre for Malaria, Schistosomiasis and Filariasis, Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, 200025, People's Republic of China.
| | - Jun-Hu Chen
- National Institute of Parasitic Diseases, Chinese Centre for Disease Control and Prevention, Shanghai, 200025, People's Republic of China.,WHO Collaborating Centre for Malaria, Schistosomiasis and Filariasis, Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, 200025, People's Republic of China
| | - Philip Fon-Gah
- ITC Enschede, University of Twenty, Hengelosestraat 99, 7514 AE, Enschede, The Netherlands.,Department of Geoscience-Remote Sensing and GIS, The University of Bamenda, P. O. Box 39 Bambili, Bamenda, Cameroon
| | - Xia Zhou
- National Institute of Parasitic Diseases, Chinese Centre for Disease Control and Prevention, Shanghai, 200025, People's Republic of China.,WHO Collaborating Centre for Malaria, Schistosomiasis and Filariasis, Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, 200025, People's Republic of China
| | - Roger Moyou-Somo
- Institute of Medical Research and Medicinal Plants-IMPM, P. O. 6123, Yaoundé, Cameroon.,Faculty of Medicines and Biomedical Sciences, The University of Yaoundé I, P. O. Box 812, Yaoundé, Cameroon
| | - Xiao-Nong Zhou
- National Institute of Parasitic Diseases, Chinese Centre for Disease Control and Prevention, Shanghai, 200025, People's Republic of China.,WHO Collaborating Centre for Malaria, Schistosomiasis and Filariasis, Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, 200025, People's Republic of China
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Ndiaye T, Sy M, Gaye A, Ndiaye D. Genetic polymorphism of Merozoite Surface Protein 1 (msp1) and 2 (msp2) genes and multiplicity of Plasmodium falciparum infection across various endemic areas in Senegal. Afr Health Sci 2019; 19:2446-2456. [PMID: 32127816 PMCID: PMC7040301 DOI: 10.4314/ahs.v19i3.19] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Despite a significant decline in Senegal, malaria remains a burden in various parts of the country. Assessment of multiplicity of Plasmodium falciparum infection and genetic diversity of parasites population could help in monitoring of malaria control. OBJECTIVE To assess genetic diversity and multiplicity of infection in P. falciparum isolates from three areas in Senegal with different malaria transmissions. METHODS 136 blood samples were collected from patients with uncomplicated P. falciparum malaria in Pikine, Kedougou and Thies. Polymorphic loci of msp1 and 2 (Merozoite surface protein-1 and 2) genes were amplified by nested PCR. RESULTS For msp1gene, K1 allelic family was predominant with frequency of 71%. Concerning msp2 gene, IC3D7 allelic family was the most represented with frequency of 83%. Multiclonal isolates found were 36% and 31% for msp1et msp2 genes respectively. The MOI found in all areas was 2.56 and was statistically different between areas (P=0.024). Low to intermediate genetic diversity were found with heterozygosity range (He=0,394-0,637) and low genetic differentiation (Fst msp1= 0.011; Fst msp2=0.017) were observed between P. falciparum population within the country. CONCLUSION Low to moderate genetic diversity of P.falciparum strains and MOI disparities were found in Senegal.
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Affiliation(s)
- Tolla Ndiaye
- Laboratory of Parasitology/Mycology HALD, Cheikh Anta Diop University of Dakar, PO Box 5005, Dakar, Senegal
| | - Mouhamad Sy
- Laboratory of Parasitology/Mycology HALD, Cheikh Anta Diop University of Dakar, PO Box 5005, Dakar, Senegal
| | - Amy Gaye
- Laboratory of Parasitology/Mycology HALD, Cheikh Anta Diop University of Dakar, PO Box 5005, Dakar, Senegal
| | - Daouda Ndiaye
- Laboratory of Parasitology/Mycology HALD, Cheikh Anta Diop University of Dakar, PO Box 5005, Dakar, Senegal
- Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, MA, USA
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Gnagne AP, Konate A, Bedia-Tanoh AV, Amiah-Droh M, Menan HIE, N'Guetta ASP, Yavo W. Dynamics of Plasmodium falciparum genetic diversity among asymptomatic and symptomatic children in three epidemiological areas in Cote d'Ivoire. Pathog Glob Health 2019; 113:133-142. [PMID: 31144611 DOI: 10.1080/20477724.2019.1624076] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Asymptomatic carriers of Plasmodium are considered a reservoir of the parasite in humans. Therefore, in order to be effective, new malaria elimination strategies must take these targets into account. The aim of this study was to analyse genetic diversity of Plasmodium falciparum among schoolchildren in three epidemiological areas in Côte d'Ivoire. This was a cross-sectional study carried out from May 2015 to April 2016 in a primary school in rural and urban areas of San Pedro, Grand-Bassam and Abengourou, during the rainy season and the dry season. A total of 282 Plasmodium falciparum isolates were genotyped using Nested PCR of Pfmsp1 and Pfmsp2 genes. The overall frequency of K1, Mad20 and RO33 alleles was 81.6%, 53.4% and 57% for Pfmsp1 respectively. For Pfmsp2, this frequency was 84.3% and 72.2% for 3D7 and FC27. K1, Mad20 and FC27 Frequencies were significantly higher in Abengourou compared to other sites. Overall, the frequency of MIs was significantly higher in Abengourou for Pfmsp1 and Pfmsp2. However, Mad20 and RO33 alleles were significantly higher in the rainy season. No significant difference was observed between Pfmsp2 alleles in both seasons. Frequency of the 3D7 allele was significantly higher in symptomatic patients. MIs and COI increased with parasitemia for Pfmsp1and Pfmsp2. The data can be added to that available for monitoring and control of P. falciparum malaria. Further studies combining the entomological inoculation rate and the genetic diversity of P. falciparum will allow us to shed light on our understanding of the epidemiology of this parasite.
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Affiliation(s)
- Akpa Paterne Gnagne
- a Centre de Recherche et de Lutte contre le Paludisme , Institut National de Santé Publique , Abidjan , Côte d'Ivoire.,b Laboratoire de Génétique , Université Félix Houphouët Boigny , Abidjan , Côte d'Ivoire
| | - Abibatou Konate
- a Centre de Recherche et de Lutte contre le Paludisme , Institut National de Santé Publique , Abidjan , Côte d'Ivoire.,c Département de Parasitologie-Mycologie , UFR Sciences Pharmaceutiques et Biologique , Abidjan , Côte d'Ivoire
| | - Akoua Valérie Bedia-Tanoh
- a Centre de Recherche et de Lutte contre le Paludisme , Institut National de Santé Publique , Abidjan , Côte d'Ivoire.,c Département de Parasitologie-Mycologie , UFR Sciences Pharmaceutiques et Biologique , Abidjan , Côte d'Ivoire
| | - Mireille Amiah-Droh
- a Centre de Recherche et de Lutte contre le Paludisme , Institut National de Santé Publique , Abidjan , Côte d'Ivoire.,b Laboratoire de Génétique , Université Félix Houphouët Boigny , Abidjan , Côte d'Ivoire
| | - Hervé Ignace Eby Menan
- c Département de Parasitologie-Mycologie , UFR Sciences Pharmaceutiques et Biologique , Abidjan , Côte d'Ivoire
| | | | - William Yavo
- a Centre de Recherche et de Lutte contre le Paludisme , Institut National de Santé Publique , Abidjan , Côte d'Ivoire.,c Département de Parasitologie-Mycologie , UFR Sciences Pharmaceutiques et Biologique , Abidjan , Côte d'Ivoire
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Low genetic diversity and complexity of submicroscopic Plasmodium falciparum infections among febrile patients in low transmission areas in Senegal. PLoS One 2019; 14:e0215755. [PMID: 31022221 PMCID: PMC6483351 DOI: 10.1371/journal.pone.0215755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 04/08/2019] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION Submicroscopic Plasmodium infections are common in malaria endemic countries, but very little studies have been done in Senegal. This study investigates the genetic diversity and complexity of submicroscopic P. falciparum infections among febrile patients in low transmission areas in Senegal. MATERIALS AND METHODS Hundred and fifty blood samples were collected from febrile individuals living in Dielmo and Ndiop (Senegal) between August 2014 and January 2015, tested for microscopic and sub-microscopic P. falciparum infections and characterized for their genetic diversity and complexity of infections using msp-1 and msp-2 genotyping. RESULTS Submicroscopic P. falciparum infections were 19.6% and 25% in Dielmo and Ndiop, respectively. K1 and 3D7 were the predominant msp-1 and msp-2 allelic types with respective frequencies of 67.36% and 67.10% in microscopic isolates and 58.24% and 78% in submicroscopic ones. Frequencies of msp-1 allelic types were statistically comparable between the studied groups (p>0.05), and were respectively 93.54% vs 87.5% for K1, 60% vs 54.83% for MAD20 and 41.93% vs 22.5% for RO33 while frequencies of msp-2 allelic types were significantly highest in the microscopy group for FC27 (41.93% vs 10%, Fisher's Exact Test, p = 0.001) and 3D7 (61.29% vs 32.5%, Fisher's Exact Test, p = 0.02). Multiplicities of infection were lowest in submicroscopic P. falciparum isolates. CONCLUSIONS The study revealed a high submicroscopic P. falciparum carriage among patients in the study areas, and that submicroscopic P. falciparum isolates had a lower genetic diversity and complexity of malaria infections.
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Romani L, Pane S, Severini C, Menegon M, Foglietta G, Bernardi S, Tchidjou HK, Onetti Muda A, Palma P, Putignani L. Challenging diagnosis of congenital malaria in non-endemic areas. Malar J 2018; 17:470. [PMID: 30551740 PMCID: PMC6295090 DOI: 10.1186/s12936-018-2614-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Accepted: 12/05/2018] [Indexed: 01/19/2023] Open
Abstract
Background Congenital malaria is usually defined as the detection of asexual forms of Plasmodium spp. in a blood sample of a neonate during perinatal age if there is no possibility of postpartum infection by a mosquito bite. The incidence of congenital malaria is highly variable and seems related to several factors, such as different diagnostic methods for Plasmodium spp. detection, and area in which the epidemiologic analyses are performed. In non-endemic countries, cases of congenital malaria are rare. Hereby, a case of a congenital malaria in an HIV exposed child is reported. Case presentation A 2-month-old male child was admitted to Bambino Gesù Children’s Hospital due to anaemia and exposure to HIV. He was born prematurely in Italy by cesarean section at 34 weeks’ gestation after a bicorial, biamniotic pregnancy by a migrant woman from Nigeria. He was the first of non-identical twins. Combined with anaemia, spleen and liver enlargement was noted, malaria was hypothesized. Malaria laboratory panel was performed on the newborn, mother and other twin blood samples, as follows: (i) malaria rapid diagnostic test (RDT); (ii) Giemsa-stained thick and thin blood smears for Plasmodium spp. identification and parasitaemia titration; (iii) molecular screening and typing of Plasmodium spp. by multiplex qualitative PCR assay based on 18S rRNA gene. Genotyping of Plasmodium falciparum isolates from mother and child was performed by neutral microsatellite and highly polymorphic marker amplification. Conclusions The maternal RDT sample was negative, while the infant RDT was positive; in both cases microscopy of blood smears and PCR showed infection with P. falciparum. Two of the genotypic molecular markers displayed different allelic variants between the two samples. This difference could imply infection multiplicity of the mother during the pregnancy, possibly harbouring more than one isolate, only one of them being transmitted to the newborn while the other persisting in the mother’s blood. Because of the increasing number of pregnant women coming from endemic areas for malaria, an accurate anamnesis of infant’s mother, and the inclusion of Plasmodium spp. research into TORCH screenings for mother-infant pair at birth, aiming at reducing morbidity and mortality associated to the disease might be suitable.
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Affiliation(s)
- Lorenza Romani
- Division of Immunology and Infectious Diseases, Research Unit in Congenital and Perinatal Infections, University-Hospital, Pediatric Department (DPUO), Bambino Gesù Children's Hospital, Piazza Sant'Onofrio 4, 00165, Rome, Italy
| | - Stefania Pane
- Unit of Parasitology, Bambino Gesù Children's Hospital, Piazza Sant'Onofrio 4, 00165, Rome, Italy
| | - Carlo Severini
- Istituto Superiore di Sanità (ISS), Viale Regina Elena 299, 00161, Rome, Italy
| | - Michela Menegon
- Istituto Superiore di Sanità (ISS), Viale Regina Elena 299, 00161, Rome, Italy
| | - Gianluca Foglietta
- Unit of Parasitology, Bambino Gesù Children's Hospital, Piazza Sant'Onofrio 4, 00165, Rome, Italy
| | - Stefania Bernardi
- Division of Immunology and Infectious Diseases, Research Unit in Congenital and Perinatal Infections, University-Hospital, Pediatric Department (DPUO), Bambino Gesù Children's Hospital, Piazza Sant'Onofrio 4, 00165, Rome, Italy
| | - Hyppolite K Tchidjou
- Division of Immunology and Infectious Diseases, Research Unit in Congenital and Perinatal Infections, University-Hospital, Pediatric Department (DPUO), Bambino Gesù Children's Hospital, Piazza Sant'Onofrio 4, 00165, Rome, Italy
| | - Andrea Onetti Muda
- Department of Laboratories, Bambino Gesù Children's Hospital, Piazza Sant'Onofrio 4, 00165, Rome, Italy
| | - Paolo Palma
- Division of Immunology and Infectious Diseases, Research Unit in Congenital and Perinatal Infections, University-Hospital, Pediatric Department (DPUO), Bambino Gesù Children's Hospital, Piazza Sant'Onofrio 4, 00165, Rome, Italy.
| | - Lorenza Putignani
- Unit of Parasitology, Bambino Gesù Children's Hospital, Piazza Sant'Onofrio 4, 00165, Rome, Italy. .,Unit of Human Microbiome, Bambino Gesù Children's Hospital, Viale San Paolo 15, 00146, Rome, Italy.
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Lamptey H, Ofori MF, Kusi KA, Adu B, Owusu-Yeboa E, Kyei-Baafour E, Arku AT, Bosomprah S, Alifrangis M, Quakyi IA. The prevalence of submicroscopic Plasmodium falciparum gametocyte carriage and multiplicity of infection in children, pregnant women and adults in a low malaria transmission area in Southern Ghana. Malar J 2018; 17:331. [PMID: 30223841 PMCID: PMC6142636 DOI: 10.1186/s12936-018-2479-y] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 09/10/2018] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The gametocyte stage of Plasmodium falciparum is considered an important target for disrupting malaria transmission. Indications are that various demographic groups, such as children and pregnant women may differ in risk of harbouring gametocytes, which may be crucial for targeted control. In this study, the relationship between the prevalence and multiplicity of P. falciparum, asexual parasite infections and gametocytaemia was assessed in three different demographic groups in an area of southern Ghana with low malaria endemicity. Levels of antibody responses to Pfs230 were also assessed as a proxy for the presence of gametocytes. METHODS The study involved multiple cross-sectional sampling of children (N = 184, aged 2-15 years), male and non-pregnant female adults (N = 154, aged 16-65 years) and pregnant women (N = 125, aged 18-45 years) from Asutsuare in the Shai Osudoku District of Greater Accra Region in Ghana. Asexual parasitaemia was detected by microscopy and PCR, and gametocytaemia was assessed by Pfs25-real time PCR. Multiclonal P. falciparum infections were estimated by msp2 genotyping and an indirect ELISA was used to measure plasma IgG antibodies to Pfs230 antigen. RESULTS Overall, children and pregnant women had higher prevalence of submicroscopic gametocytes (39.5% and 29.7%, respectively) compared to adults (17.4%). Multiplicity of infection observed amongst children (3.1) and pregnant women (3.9) were found to be significantly higher (P = 0.006) compared with adults (2.7). Risk of gametocyte carriage was higher in individuals infected with P. falciparum having both Pfmsp2 3D7 and FC27 parasite types (OR = 5.92, 95% CI 1.56-22.54, P = 0.009) compared with those infected with only 3D7 or FC27 parasite types. In agreement with the parasite prevalence data, anti-Pfs230 antibody levels were lower in gametocyte positive adults (β = - 0.57, 95% CI - 0.81, - 0.34, P < 0.001) compared to children. CONCLUSIONS These findings suggest that children and pregnant women are particularly important as P. falciparum submicroscopic gametocyte reservoirs and represent important focus groups for control interventions. The number of clones increased in individuals carrying gametocytes compared to those who did not carry gametocytes. The higher anti-gametocyte antibody levels in children suggests recent exposure and may be a marker of gametocyte carriage.
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Affiliation(s)
- Helena Lamptey
- Immunology Department, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Ghana.
| | - Michael Fokuo Ofori
- Immunology Department, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Ghana
| | - Kwadwo Asamoah Kusi
- Immunology Department, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Ghana
| | - Bright Adu
- Immunology Department, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Ghana
| | - Eunice Owusu-Yeboa
- Immunology Department, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Ghana
| | - Eric Kyei-Baafour
- Immunology Department, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Ghana
| | - Andrea Twumwaa Arku
- Immunology Department, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Ghana
| | - Samuel Bosomprah
- Department of Biostatistics, School of Public Health, College of Health Sciences, University of Ghana, Legon, Ghana
| | - Michael Alifrangis
- Centre for Medical Parasitology, Department of Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark
- Department of Infectious Disease, National University Hospital (Rigshospitalet), Copenhagen, Denmark
| | - Isabella A Quakyi
- Department of Biological, Environmental and Occupational Health Sciences, School of Public Health, College of Health Sciences, University of Ghana, Legon, Ghana
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Russo G, L'Episcopia M, Menegon M, Souza SS, Dongho BGD, Vullo V, Lucchi NW, Severini C. Dihydroartemisinin-piperaquine treatment failure in uncomplicated Plasmodium falciparum malaria case imported from Ethiopia. Infection 2018; 46:867-870. [PMID: 29980936 DOI: 10.1007/s15010-018-1174-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 07/04/2018] [Indexed: 12/15/2022]
Abstract
Dihydroartemisinin-piperaquine (DHA-PPQ) is the artemisinin combination therapy that was recently introduced for the treatment of Plasmodium falciparum uncomplicated malaria, but emerging resistance in South-East Asia is threatening its use. This report describes a case of DHA-PPQ treatment failure in uncomplicated malaria occurring in an immigrant living in Italy, after a travel to Ethiopia. Thirty days after malaria recovery following DHA-PPQ therapy, the patient had malaria recrudescence. According to the genotyping analysis, the same P. falciparum was responsible for both episodes. Thus, it seems important to consider possible malaria recrudescence occurring after DHA-PPQ therapy in patients from African countries.
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Affiliation(s)
- Gianluca Russo
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185, Rome, Italy.
| | - Mariangela L'Episcopia
- Department of Infectious Diseases, Istituto Superiore di Sanità, Viale Regina Elena Rome 299, 00161, Rome, Italy
| | - Michela Menegon
- Department of Infectious Diseases, Istituto Superiore di Sanità, Viale Regina Elena Rome 299, 00161, Rome, Italy
| | - Samaly Santos Souza
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Malaria Branch, 1600 Clifton Rd, Atlanta, GA, 30333, USA
| | | | - Vincenzo Vullo
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185, Rome, Italy
| | - Naomi W Lucchi
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Malaria Branch, 1600 Clifton Rd, Atlanta, GA, 30333, USA
| | - Carlo Severini
- Department of Infectious Diseases, Istituto Superiore di Sanità, Viale Regina Elena Rome 299, 00161, Rome, Italy
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31
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Gueye NSG, Ntoumi F, Vouvoungui C, Kobawila SC, NKombo M, Mouanga AM, Deibert J, Koukouikila-Koussounda F. Plasmodium falciparum merozoite protein-1 genetic diversity and multiplicity of infection in isolates from Congolese children consulting in a pediatric hospital in Brazzaville. Acta Trop 2018; 183:78-83. [PMID: 29626433 DOI: 10.1016/j.actatropica.2018.04.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2017] [Revised: 04/01/2018] [Accepted: 04/03/2018] [Indexed: 11/27/2022]
Abstract
As in many sub-Saharan African countries, the burden of malaria has been reduced in the Republic of Congo as a result of massive deployment of insecticide treated nets and availability of artemisinin-combinations therapies (ACTs). High to moderate genetic diversity of msp-1 gene of Plasmodium falciparum (P. falciparum) has been reported from different parts of the world but limited data are available from Central Africa including the Republic of Congo. For this reason, the aim of study was to investigate the P. falciparum genetic diversity and to determine the multiplicity of infection in P. falciparum isolates from Congolese children in order to dispose of an additional parameter to measure the impact malaria control intervention. A total of 229 blood samples were collected from September 2014 to February 2015 in children aged from one to ten years presenting a paediatric hospital Marien NGOUABI located in Northern part of Brazzaville. Inclusion criterion was fever (axillary temperature ≥ 37.5 °C) or history of fever in the preceding 48 h before inclusion in this study. Then thick and thin blood smears were done to detect malaria parasites, to determine parasite density and to identify plasmodial species. Sub-microscopic infection was detected by PCR using the P. falciparum msp-1 gene as molecular marker. The prevalence of microscopic and sub-microscopic infection in this cohort was 10% and 27.5%, respectively. The K1 allelic family was predominant (45% of isolates) whereas the RO33 and MAD20 represented 35% and 20%, respectively of isolates. In this study 48% (38/79) of isolates harbored more than one parasite clone. Overall the multiplicity of infection (MOI) was 1.7. According to type of infection, the MOI was significantly higher in children with microscopic infection (2.5 vs 1.4 for submicroscopic infection, P = .001). When considering age, hemoglobin genotype (AA or AS) and level and parasite density, no association was observed with the MOI. This study reveals that the P. falciparum genetic diversity in isolates from Congolese children is high but with low multiplicity of infection.
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Somé AF, Bazié T, Zongo I, Yerbanga RS, Nikiéma F, Neya C, Taho LK, Ouédraogo JB. Plasmodium falciparum msp1 and msp2 genetic diversity and allele frequencies in parasites isolated from symptomatic malaria patients in Bobo-Dioulasso, Burkina Faso. Parasit Vectors 2018; 11:323. [PMID: 29843783 PMCID: PMC5975679 DOI: 10.1186/s13071-018-2895-4] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 05/14/2018] [Indexed: 12/18/2022] Open
Abstract
Background In Burkina Faso, malaria remains the overall leading cause of morbidity and mortality accounting for 35.12% of consultations, 40.83% of hospitalizations and 37.5% of deaths. Genotyping of malaria parasite populations remains an important tool to determine the types and number of parasite clones in an infection. The present study aimed to evaluate the merozoite surface protein 1 (msp1) and merozoite surface protein 2 (msp2) genetic diversity and allele frequencies in Bobo-Dioulasso, Burkina Faso. Method Dried blood spots (DBS) were collected at baseline from patients with uncomplicated malaria in urban health centers in Bobo-Dioulasso. Parasite DNA was extracted using chelex-100 and species were identified using nested PCR. Plamodium falciparum msp1 and msp2 genes were amplified by nested polymerase chain reaction (PCR) and PCR products were analyzed by electrophoresis on a 2.5% agarose gel. Alleles were categorized according to their molecular weight. Results A total of 228 blood samples were analyzed out of which 227 (99.9%) were confirmed as P. falciparum-positive and one sample classified as mixed infection for P. malaria and P. falciparum. In msp1, the K1 allelic family was predominant with 77.4% (162/209) followed respectively by the MAD20 allelic family with 41.3% and R033 allelic family with 36%. In msp2, the 3D7 allelic family was the most frequently detected with 93.1 % compared to FC27 with 41.3%. Twenty-one different alleles were observed in msp1 with 9 alleles for K1, 8 alleles for MAD20 and 4 alleles for R033. In msp2, 25 individual alleles were detected with 10 alleles for FC27 and 15 alleles for 3D7. The mean multiplicity of falciparum infection was 1.95 with respectively 1.8 (1.76–1.83) and 2.1 (2.03–2.16) for msp1 and msp2 (P = 0.01). Conclusions Our study showed high genetic diversity and allelic frequencies of msp1 and msp2 in Plasmodium falciparum isolates from symptomatic malaria patients in Bobo-Dioulasso.
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Affiliation(s)
- Anyirékun Fabrice Somé
- Institut de Recherche en Sciences de la Santé, Direction Régionale de l'Ouest, 399 Avenue de la Liberté, 01 BP 545, Bobo-Dioulasso, 01, Burkina Faso.
| | - Thomas Bazié
- Institut de Recherche en Sciences de la Santé, Direction Régionale de l'Ouest, 399 Avenue de la Liberté, 01 BP 545, Bobo-Dioulasso, 01, Burkina Faso
| | - Issaka Zongo
- Institut de Recherche en Sciences de la Santé, Direction Régionale de l'Ouest, 399 Avenue de la Liberté, 01 BP 545, Bobo-Dioulasso, 01, Burkina Faso
| | - R Serge Yerbanga
- Institut de Recherche en Sciences de la Santé, Direction Régionale de l'Ouest, 399 Avenue de la Liberté, 01 BP 545, Bobo-Dioulasso, 01, Burkina Faso
| | - Frédéric Nikiéma
- Institut de Recherche en Sciences de la Santé, Direction Régionale de l'Ouest, 399 Avenue de la Liberté, 01 BP 545, Bobo-Dioulasso, 01, Burkina Faso
| | - Cathérine Neya
- Institut de Recherche en Sciences de la Santé, Direction Régionale de l'Ouest, 399 Avenue de la Liberté, 01 BP 545, Bobo-Dioulasso, 01, Burkina Faso
| | - Liz Karen Taho
- Institut de Recherche en Sciences de la Santé, Direction Régionale de l'Ouest, 399 Avenue de la Liberté, 01 BP 545, Bobo-Dioulasso, 01, Burkina Faso
| | - Jean-Bosco Ouédraogo
- Institut de Recherche en Sciences de la Santé, Direction Régionale de l'Ouest, 399 Avenue de la Liberté, 01 BP 545, Bobo-Dioulasso, 01, Burkina Faso
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Swana EK, Yav TI, Ngwej LM, Mupemba BN, Suprianto, Mukeng CK, Hattingh I, Luboya ON, Kakoma JBS, Bangs MJ. School-based malaria prevalence: informative systematic surveillance measure to assess epidemiological impact of malaria control interventions in the Democratic Republic of the Congo. Malar J 2018; 17:141. [PMID: 29615041 PMCID: PMC5883584 DOI: 10.1186/s12936-018-2297-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Accepted: 03/24/2018] [Indexed: 11/28/2022] Open
Abstract
Background In southern Democratic Republic of the Congo, malaria transmission is stable with seasonal fluctuations. Different measurements can be used to monitor disease burden and estimate the performance of control programmes. Repeated school-based malaria prevalence surveys (SMPS) were conducted from 2007 to 2014 to generate up-to-date surveillance data and evaluate the impact of an integrated vector control programme. Methods Biannual SMPS used a stratified, randomized and proportional sampling method. Schools were randomly selected from the entire pool of facilities within each Health Area (HA). Subsequently, school-children from 6 to 12 years of age were randomly selected in a proportional manner. Initial point-of-care malaria diagnosis was made using a rapid detection test. A matching stained blood film was later examined by expert microscopy and used in the final analysis. Data was stratified and analysed based on age, survey time and location. Results The baseline SMPS (pre-control in 2007) prevalence was approximately 77%. From 2009 to 2014, 11,628 school-children were randomly screened. The mean age was 8.7 years with a near equal sex ratio. After exclusion, analysis of 10,493 students showed an overall malaria prevalence ratio of 1.92 in rural compared to urbanized areas. The distribution of Plasmodium falciparum malaria was significantly different between rural and urban HAs and between end of wet season and end of dry season surveys. The combined prevalence of single P. falciparum, Plasmodium malariae and Plasmodium ovale infections were 29.9, 1.8 and 0.3% of those examined, respectively. Only 1.8% were mixed Plasmodium species infections. From all microscopically detected infections (3545 of 10,493 samples examined), P. falciparum represented 88.5%, followed by P. malariae (5.4%) and P. ovale (0.8%). Cases with multiple species represented 5.3% of patent infections. Malaria prevalence was independent of age and gender. Control programme performance contributed to a significant decrease in mean P. falciparum infection density in urban compared to rural locations. Some rural areas remained highly refractory to control measures (insecticide-treated bed nets, periodic indoor residual spraying). Conclusion The SMPS is a useful longitudinal measurement for estimating population malaria prevalence and demonstrating disease burden and impact of control interventions. SMPS can identify refractory areas of transmission and thus prioritize control strategies accordingly.
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Affiliation(s)
- Edouard K Swana
- China Molybdenum Company International, Ltd/International SOS, Public Health Programme, Tenke Fungurume Mining Project, Lualaba, Democratic Republic of the Congo. .,Faculty of Medicine, University of Lubumbashi, Lubumbashi, Democratic Republic of the Congo. .,School of Public Health, University of Lubumbashi, Lubumbashi, Democratic Republic of the Congo.
| | - Thierry I Yav
- China Molybdenum Company International, Ltd/International SOS, Public Health Programme, Tenke Fungurume Mining Project, Lualaba, Democratic Republic of the Congo.,Faculty of Medicine, University of Lubumbashi, Lubumbashi, Democratic Republic of the Congo.,School of Public Health, University of Lubumbashi, Lubumbashi, Democratic Republic of the Congo
| | - Leonard M Ngwej
- China Molybdenum Company International, Ltd/International SOS, Public Health Programme, Tenke Fungurume Mining Project, Lualaba, Democratic Republic of the Congo.,School of Public Health, University of Lubumbashi, Lubumbashi, Democratic Republic of the Congo
| | - Betty N Mupemba
- Public Health Referral Laboratory, Lubumbashi, Haut Katanga Province, Democratic Republic of the Congo
| | - Suprianto
- Public Health & Malaria Control, International SOS, P.T. Freeport Indonesia, Kuala Kencana, Papua, 99920, Indonesia
| | - Clarence K Mukeng
- School of Public Health, University of Lubumbashi, Lubumbashi, Democratic Republic of the Congo
| | - Izak Hattingh
- China Molybdenum Company International, Ltd/International SOS, Public Health Programme, Tenke Fungurume Mining Project, Lualaba, Democratic Republic of the Congo
| | - Oscar N Luboya
- Faculty of Medicine, University of Lubumbashi, Lubumbashi, Democratic Republic of the Congo.,School of Public Health, University of Lubumbashi, Lubumbashi, Democratic Republic of the Congo
| | - Jean-Baptiste S Kakoma
- Faculty of Medicine, University of Lubumbashi, Lubumbashi, Democratic Republic of the Congo.,School of Public Health, University of Lubumbashi, Lubumbashi, Democratic Republic of the Congo
| | - Michael J Bangs
- School of Public Health, University of Lubumbashi, Lubumbashi, Democratic Republic of the Congo.,Public Health & Malaria Control, International SOS, P.T. Freeport Indonesia, Kuala Kencana, Papua, 99920, Indonesia
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Huang B, Tuo F, Liang Y, Wu W, Wu G, Huang S, Zhong Q, Su XZ, Zhang H, Li M, Bacar A, Abdallah KS, Mliva AMSA, Wang Q, Yang Z, Zheng S, Xu Q, Song J, Deng C. Temporal changes in genetic diversity of msp-1, msp-2, and msp-3 in Plasmodium falciparum isolates from Grande Comore Island after introduction of ACT. Malar J 2018; 17:83. [PMID: 29458365 PMCID: PMC5819244 DOI: 10.1186/s12936-018-2227-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 02/08/2018] [Indexed: 11/26/2022] Open
Abstract
Background Malaria is still one of the serious public health problems in Grande Comore Island, although the number of annual cases has been greatly reduced in recent years. A better understanding of malaria parasite population diversity and transmission dynamics is critical for assessing the effectiveness of malaria control measures. The objective of this study is to investigate temporal changes in genetic diversity of Plasmodium falciparum populations and multiplicity of infection (MOI) in Grande Comore 10 years after introduction of ACT. Methods A total of 232 P. falciparum clinical isolates were collected from the Grande Comore Island during two sampling periods (118 for 2006‒2007 group, and 114 for 2013‒2016 group). Parasite isolates were characterized for genetic diversity and complexity of infection by genotyping polymorphic regions in merozoite surface protein gene 1 (msp-1), msp-2, and msp-3 using nested PCR and DNA sequencing. Results Three msp-1 alleles (K1, MAD20, and RO33), two msp-2 alleles (FC27 and 3D7), and two msp-3 alleles (K1 and 3D7) were detected in parasites of both sampling periods. The RO33 allele of msp-1 (84.8%), 3D7 allele of msp-2 (90.8%), and K1 allele of msp-3 (66.7%) were the predominant allelic types in isolates from 2006–2007 group. In contrast, the RO33 allele of msp-1 (63.4%), FC27 allele of msp-2 (91.1%), and 3D7 allele of msp-3 (53.5%) were the most prevalent among isolates from the 2013–2016 group. Compared with the 2006‒2007 group, polyclonal infection rates of msp-1 (from 76.7 to 29.1%, P < 0.01) and msp-2 (from 62.4 to 28.3%, P < 0.01) allelic types were significantly decreased in those from 2013‒2016 group. Similarly, the MOIs for both msp-1 and msp-2 were higher in P. falciparum isolates in the 2006–2007 group than those in 2013–2016 group (MOI = 3.11 vs 1.63 for msp-1; MOI = 2.75 vs 1.35 for msp-2). DNA sequencing analyses also revealed reduced numbers of distinct sequence variants in the three genes from 2006‒2007 to 2013‒2016: msp-1, from 32 to 23 (about 28% decline); msp-2 from 29 to 21 (about 28% decline), and msp-3 from 11 to 3 (about 72% decline). Conclusions The present data showed dramatic reduction in genetic diversity and MOI among Grande Comore P. falciparum populations over the course of the study, suggesting a trend of decreasing malaria transmission intensity and genetic diversity in Grande Comore Island. These data provide valuable information for surveillance of P. falciparum infection and for assessing the appropriateness of the current malarial control strategies in the endemic area.
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Affiliation(s)
- Bo Huang
- Institute of Tropical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, 510006, Guangdong, People's Republic of China.,Science and Technology Park, Guangzhou University of Chinese Medicine, Guangzhou, 510445, Guangdong, People's Republic of China
| | - Fei Tuo
- Science and Technology Park, Guangzhou University of Chinese Medicine, Guangzhou, 510445, Guangdong, People's Republic of China
| | - Yuan Liang
- Science and Technology Park, Guangzhou University of Chinese Medicine, Guangzhou, 510445, Guangdong, People's Republic of China
| | - Wanting Wu
- Science and Technology Park, Guangzhou University of Chinese Medicine, Guangzhou, 510445, Guangdong, People's Republic of China
| | - Guangchao Wu
- Science and Technology Park, Guangzhou University of Chinese Medicine, Guangzhou, 510445, Guangdong, People's Republic of China
| | - Shiguang Huang
- School of Stomatology, Jinan University, Guangzhou, 510632, Guangdong, People's Republic of China
| | - Qirun Zhong
- Artepharm, Co., Ltd, Guangzhou, 510405, Guangdong, People's Republic of China
| | - Xin-Zhuan Su
- Laboratory of Malaria and Vector Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Hongying Zhang
- Science and Technology Park, Guangzhou University of Chinese Medicine, Guangzhou, 510445, Guangdong, People's Republic of China
| | - Mingqiang Li
- Artepharm, Co., Ltd, Guangzhou, 510405, Guangdong, People's Republic of China
| | - Affane Bacar
- National Malaria Control Programme, BP 500, Moroni, Comoros
| | | | | | - Qi Wang
- Science and Technology Park, Guangzhou University of Chinese Medicine, Guangzhou, 510445, Guangdong, People's Republic of China
| | - Zhaoli Yang
- Science and Technology Park, Guangzhou University of Chinese Medicine, Guangzhou, 510445, Guangdong, People's Republic of China
| | - Shaoqin Zheng
- Science and Technology Park, Guangzhou University of Chinese Medicine, Guangzhou, 510445, Guangdong, People's Republic of China
| | - Qin Xu
- Institute of Tropical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, 510006, Guangdong, People's Republic of China
| | - Jianping Song
- Institute of Tropical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, 510006, Guangdong, People's Republic of China. .,Science and Technology Park, Guangzhou University of Chinese Medicine, Guangzhou, 510445, Guangdong, People's Republic of China.
| | - Changsheng Deng
- Institute of Tropical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, 510006, Guangdong, People's Republic of China. .,Science and Technology Park, Guangzhou University of Chinese Medicine, Guangzhou, 510445, Guangdong, People's Republic of China.
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Ndong Ngomo J, M’Bondoukwe N, Yavo W, Bongho Mavoungou L, Bouyou-Akotet M, Mawili-Mboumba D. Spatial and temporal distribution of Pfmsp1 and Pfmsp2 alleles and genetic profile change of Plasmodium falciparum populations in Gabon. Acta Trop 2018; 178:27-33. [PMID: 28993182 DOI: 10.1016/j.actatropica.2017.09.026] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Revised: 09/26/2017] [Accepted: 09/28/2017] [Indexed: 11/25/2022]
Abstract
Plasmodium population dynamics analysis may help to assess the impact of malaria control strategies deployment. In Gabon, new strategies have been introduced, but malaria is still a public health problem marked by a rebound of the prevalence in 2011. The aim of the study was to investigate the spatial and temporal distribution of P. falciparum strains in different areas in Gabon during a period of malaria transmission transition, between 2008 and 2011. A total of 109P. falciparum isolates were genotyped using nested-PCR of Pfmsp1 and Pfmsp2 genes. 3D7, FC27 and K1 allele frequencies were comparable between sites (p=0.9); those of Ro33 (93.6%; 44/47) and Mad20 (60%; 12/20) were significantly higher in isolates from Oyem (p<0.01) and Port-Gentil (p=0.02), respectively. The frequency of multiples infections (77%) and the complexity of infection (2.66±1.44) were the highest at Oyem. Pfmsp1 gene analysis highlighted a trend of a decreasing frequency of K1 family, in Libreville and Oyem between 2008 and 2011; while that of Ro33 (p<0.01) and Mad20 (p<0.01) increased. The prevalence of multiple infections was comparable between both periods in each site: 42.2% vs 47.6% (p=0.6) in Libreville and 57.7% vs 61.7% in Oyem (p=0.8). In contrast, in 2011, the COI tends to be higher in Libreville and did not vary in Oyem. These data confirm an extended genetic diversity of P. falciparum isolates over time and according to geographic location in Gabon. Nevertheless, the impact of the deployment of malaria control strategies on the parasites genetic profile is not clearly established here.
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Mohammed H, Kassa M, Assefa A, Tadesse M, Kebede A. Genetic polymorphism of Merozoite Surface Protein-2 (MSP-2) in Plasmodium falciparum isolates from Pawe District, North West Ethiopia. PLoS One 2017; 12:e0177559. [PMID: 28542247 PMCID: PMC5438166 DOI: 10.1371/journal.pone.0177559] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Accepted: 04/28/2017] [Indexed: 12/13/2022] Open
Abstract
Background In malaria endemic regions, Plasmodium falciparum infection is characterized by extensive genetic diversity. Describing this diversity provides important information about the local malaria situation. This study was conducted to evaluate the extent of genetic diversity of P. falciparum in Pawe district, North West Ethiopia, using the highly polymorphic merozoite surface protein 2 gene. Methods Atotal of 92 isolates from patients with uncomplicated P. falciparum attending Pawe Health Centre were collected from September to December 2013. Genomic DNA was extracted using the Chelex method and analyzed by length polymorphism following gel electrophoresis of DNA products from nested PCR of msp2 (block 3), targeting allelic families of FC27 and 3D7/IC. Results There were twenty-two different msp2 alleles, 11 corresponding to the 3D7/ IC and 11 to the FC27 allelic family. The frequency of isolates of the msp2 3D7/IC allelic familywas higher (51%) compared to FC27 (49%). The majority of the isolates (76%) contained multiple infections andthe overall mean multiplicity of infection was 2.8 (CI 95% 2.55–3.03). The heterozygosity index was 0.66 for msp2. There was no statically significant difference in the multiplicity of infection by age or parasite density. Conclusions The results of this study show that P.falciparum polymorphismsare extensive in Northwest Ethiopia and most of the infections are composed of multiple clones.
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Affiliation(s)
- Hussein Mohammed
- Bacterial, Parasitic and Zoonotic Diseases Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
- * E-mail:
| | - Moges Kassa
- Bacterial, Parasitic and Zoonotic Diseases Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Ashenafi Assefa
- Bacterial, Parasitic and Zoonotic Diseases Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Mekonnen Tadesse
- Bacterial, Parasitic and Zoonotic Diseases Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Amha Kebede
- Bacterial, Parasitic and Zoonotic Diseases Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
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Das S, Muleba M, Stevenson JC, Pringle JC, Norris DE. Beyond the entomological inoculation rate: characterizing multiple blood feeding behavior and Plasmodium falciparum multiplicity of infection in Anopheles mosquitoes in northern Zambia. Parasit Vectors 2017; 10:45. [PMID: 28122597 PMCID: PMC5267472 DOI: 10.1186/s13071-017-1993-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2016] [Accepted: 01/19/2017] [Indexed: 11/16/2022] Open
Abstract
Background A commonly used measure of malaria transmission intensity is the entomological inoculation rate (EIR), defined as the product of the human biting rate (HBR) and sporozoite infection rate (SIR). The EIR excludes molecular parameters that may influence vector control and surveillance strategies. The purpose of this study was to investigate Anopheles multiple blood feeding behavior (MBF) and Plasmodium falciparum multiplicity of infection (MOI) within the mosquito host in Nchelenge District, northern Zambia. Mosquitoes were collected from light traps and pyrethroid spray catch in Nchelenge in the 2013 wet season. All anophelines were tested for blood meal host, P. falciparum, and MOI using PCR. Circumsporozoite (CSP) ELISA and microsatellite analysis were performed to detect parasites in the mosquito and MBF, respectively. Statistical analyses used regression models to assess MBF and MOI and exact binomial test for human sex bias. Both MBF and MOI can enhance our understanding of malaria transmission dynamics beyond what is currently understood through conventional EIR estimates alone. Results The dominant malaria vectors collected in Nchelenge were Anopheles funestus (sensu stricto) and An. gambiae (s.s.) The EIRs of An. funestus (s.s.) and An. gambiae (s.s.) were 39.6 infectious bites/person/6 months (ib/p/6mo) and 5.9 ib/p/6mo, respectively, and took multiple human blood meals at high rates, 23.2 and 25.7% respectively. There was no bias in human host sex preference in the blood meals. The SIR was further characterized for parasite genetic diversity. The overall P. falciparum MOI was 6.4 in infected vectors, exceeding previously reported average MOIs in humans in Africa. Conclusions Both Anopheles MBF rates and P. falciparum MOI in Nchelenge were among some of the highest reported in sub-Saharan Africa. The results suggest an underestimation of the EIR and large numbers of circulating parasite clones. Together, the results describe important molecular aspects of transmission excluded from the traditional EIR measurement. These elements may provide more sensitive measures with which to assess changes in transmission intensity and risk in vector and parasite surveillance programs.
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Affiliation(s)
- Smita Das
- The W. Harry Feinstone Department of Molecular Microbiology and Immunology, The Johns Hopkins Malaria Research Institute, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD, 21205, USA
| | - Mbanga Muleba
- Tropical Disease Research Centre, P.O. Box 71769, Ndola, Zambia
| | - Jennifer C Stevenson
- The W. Harry Feinstone Department of Molecular Microbiology and Immunology, The Johns Hopkins Malaria Research Institute, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD, 21205, USA.,Macha Research Trust, P.O. Box 630166, Choma, Zambia
| | - Julia C Pringle
- The W. Harry Feinstone Department of Molecular Microbiology and Immunology, The Johns Hopkins Malaria Research Institute, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD, 21205, USA
| | - Douglas E Norris
- The W. Harry Feinstone Department of Molecular Microbiology and Immunology, The Johns Hopkins Malaria Research Institute, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD, 21205, USA.
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Niang M, Thiam LG, Loucoubar C, Sow A, Sadio BD, Diallo M, Sall AA, Toure-Balde A. Spatio-temporal analysis of the genetic diversity and complexity of Plasmodium falciparum infections in Kedougou, southeastern Senegal. Parasit Vectors 2017; 10:33. [PMID: 28103905 PMCID: PMC5244544 DOI: 10.1186/s13071-017-1976-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Accepted: 01/10/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Genetic analyses of the malaria parasite population and its temporal and spatial dynamics could provide an assessment of the effectiveness of disease control strategies. The genetic diversity of Plasmodium falciparum has been poorly documented in Senegal, and limited data are available from the Kedougou Region. This study examines the spatial and temporal variation of the genetic diversity and complexity of P. falciparum infections in acute febrile patients in Kedougou, southeastern Senegal. A total of 263 sera from patients presenting with acute febrile illness and attending Kedougou health facilities between July 2009 and July 2013 were obtained from a collection established as part of arbovirus surveillance in Kedougou. Samples identified as P. falciparum by nested PCR were characterized for their genetic diversity and complexity using msp-1 and msp-2 polymorphic markers. RESULTS Samples containing only P. falciparum accounted for 60.83% (160/263) of the examined samples. All three msp-1 allelic families (K1, MAD20 and RO33) and two msp-2 allelic families (FC27 and 3D7) were detected in all villages investigated over the 5-year collection period. The average genotype per allelic family was comparable between villages. Frequencies of msp-1 and msp-2 allelic types showed no correlation with age (Fisher's exact test, P = 0.59) or gender (Fisher's exact test, P = 0.973), and were similarly distributed throughout the 5-year sampling period (Fisher's exact test, P = 0.412) and across villages (Fisher's exact test, P = 0.866). Mean multiplicity of infection (MOI) for both msp-1 and msp-2 was highest in Kedougou village (2.25 and 2.21, respectively) and among younger patients aged ≤ 15 years (2.12 and 2.00, respectively). The mean MOI was highest in 2009 and decreased progressively onward. CONCLUSION Characterization of the genetic diversity and complexity of P. falciparum infections in Kedougou revealed no spatio-temporal variation in the genetic diversity of P. falciparum isolates. However, mean MOI varied with time of sera collection and decreased over the course of the study (July 2009 to July 2013). This suggests a slow progressive decrease of malaria transmission intensity in Kedougou Region despite the limited impact of preventive and control measures implemented by the National Malaria Control Programme on malaria morbidity and mortality.
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Affiliation(s)
- Makhtar Niang
- Institut Pasteur Dakar, Immunology Unit, 36 Avenue Pasteur, BP 220, Dakar, Senegal.
| | - Laty G Thiam
- Institut Pasteur Dakar, Immunology Unit, 36 Avenue Pasteur, BP 220, Dakar, Senegal.,Department of Animal Biology, Cheikh Anta Diop University of Dakar, Dakar, Senegal
| | - Cheikh Loucoubar
- Institut Pasteur Dakar, Biostatistics, Bioinformatics and Modeling Group, 36 Avenue Pasteur, BP 220, Dakar, Senegal
| | - Abdourahmane Sow
- Institut Pasteur Dakar, Arbovirus and Viral Hemorrhagic Fevers Unit, 36 Avenue Pasteur, BP 220, Dakar, Senegal
| | - Bacary D Sadio
- Institut Pasteur Dakar, Arbovirus and Viral Hemorrhagic Fevers Unit, 36 Avenue Pasteur, BP 220, Dakar, Senegal
| | - Mawlouth Diallo
- Institut Pasteur Dakar, Medical Entomology Unit, 36 Avenue Pasteur, BP 220, Dakar, Senegal
| | - Amadou A Sall
- Institut Pasteur Dakar, Arbovirus and Viral Hemorrhagic Fevers Unit, 36 Avenue Pasteur, BP 220, Dakar, Senegal
| | - Aissatou Toure-Balde
- Institut Pasteur Dakar, Immunology Unit, 36 Avenue Pasteur, BP 220, Dakar, Senegal
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Gómez-Díaz E, Yerbanga RS, Lefèvre T, Cohuet A, Rowley MJ, Ouedraogo JB, Corces VG. Epigenetic regulation of Plasmodium falciparum clonally variant gene expression during development in Anopheles gambiae. Sci Rep 2017; 7:40655. [PMID: 28091569 PMCID: PMC5238449 DOI: 10.1038/srep40655] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Accepted: 12/09/2016] [Indexed: 12/17/2022] Open
Abstract
P. falciparum phenotypic plasticity is linked to the variant expression of clonal multigene families such as the var genes. We have examined changes in transcription and histone modifications that occur during sporogonic development of P. falciparum in the mosquito host. All var genes are silenced or transcribed at low levels in blood stages (gametocyte/ring) of the parasite in the human host. After infection of mosquitoes, a single var gene is selected for expression in the oocyst, and transcription of this gene increases dramatically in the sporozoite. The same PF3D7_1255200 var gene was activated in 4 different experimental infections. Transcription of this var gene during parasite development in the mosquito correlates with the presence of low levels of H3K9me3 at the binding site for the PF3D7_1466400 AP2 transcription factor. This chromatin state in the sporozoite also correlates with the expression of an antisense long non-coding RNA (lncRNA) that has previously been shown to promote var gene transcription during the intraerythrocytic cycle in vitro. Expression of both the sense protein-coding transcript and the antisense lncRNA increase dramatically in sporozoites. The findings suggest a complex process for the activation of a single particular var gene that involves AP2 transcription factors and lncRNAs.
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Guerra M, Neres R, Salgueiro P, Mendes C, Ndong-Mabale N, Berzosa P, de Sousa B, Arez AP. Plasmodium falciparum Genetic Diversity in Continental Equatorial Guinea before and after Introduction of Artemisinin-Based Combination Therapy. Antimicrob Agents Chemother 2017; 61:e02556-15. [PMID: 27795385 PMCID: PMC5192141 DOI: 10.1128/aac.02556-15] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Accepted: 10/17/2016] [Indexed: 11/20/2022] Open
Abstract
Efforts to control malaria may affect malaria parasite genetic variability and drug resistance, the latter of which is associated with genetic events that promote mechanisms to escape drug action. The worldwide spread of drug resistance has been a major obstacle to controlling Plasmodium falciparum malaria, and thus the study of the origin and spread of associated mutations may provide some insights into the prevention of its emergence. This study reports an analysis of P. falciparum genetic diversity, focusing on antimalarial resistance-associated molecular markers in two socioeconomically different villages in mainland Equatorial Guinea. The present study took place 8 years after a previous one, allowing the analysis of results before and after the introduction of an artemisinin-based combination therapy (ACT), i.e., artesunate plus amodiaquine. Genetic diversity was assessed by analysis of the Pfmsp2 gene and neutral microsatellite loci. Pfdhps and Pfdhfr alleles associated with sulfadoxine-pyrimethamine (SP) resistance and flanking microsatellite loci were investigated, and the prevalences of drug resistance-associated point mutations of the Pfcrt, Pfmdr1, Pfdhfr, and Pfdhps genes were estimated. Further, to monitor the use of ACT, we provide the baseline prevalences of K13 propeller mutations and Pfmdr1 copy numbers. After 8 years, noticeable differences occurred in the distribution of genotypes conferring resistance to chloroquine and SP, and the spread of mutated genotypes differed according to the setting. Regarding artemisinin resistance, although mutations reported as being linked to artemisinin resistance were not present at the time, several single nucleotide polymorphisms (SNPs) were observed in the K13 gene, suggesting that closer monitoring should be maintained to prevent the possible spread of artemisinin resistance in Africa.
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Affiliation(s)
- Mónica Guerra
- Global Health and Tropical Medicine (GHTM), Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisboa (UNL), Lisbon, Portugal
| | - Rita Neres
- Global Health and Tropical Medicine (GHTM), Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisboa (UNL), Lisbon, Portugal
| | - Patrícia Salgueiro
- Global Health and Tropical Medicine (GHTM), Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisboa (UNL), Lisbon, Portugal
| | - Cristina Mendes
- Global Health and Tropical Medicine (GHTM), Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisboa (UNL), Lisbon, Portugal
| | - Nicolas Ndong-Mabale
- Centro de Referencia para el Control de Endemias, Instituto de Salud Carlos III, Bata, Equatorial Guinea
| | - Pedro Berzosa
- Centro Nacional de Medicina Tropical, Instituto de Salud Carlos III, Madrid, Spain
| | - Bruno de Sousa
- Faculdade de Psicologia e de Ciências da Educação, Universidade de Coimbra, Coimbra, Portugal
| | - Ana Paula Arez
- Global Health and Tropical Medicine (GHTM), Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisboa (UNL), Lisbon, Portugal
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Mahdi Abdel Hamid M, Elamin AF, Albsheer MMA, Abdalla AAA, Mahgoub NS, Mustafa SO, Muneer MS, Amin M. Multiplicity of infection and genetic diversity of Plasmodium falciparum isolates from patients with uncomplicated and severe malaria in Gezira State, Sudan. Parasit Vectors 2016; 9:362. [PMID: 27350250 PMCID: PMC4924276 DOI: 10.1186/s13071-016-1641-z] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 06/13/2016] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Multiplicity and genetic diversity of Plasmodium falciparum infection might play a role in determining the clinical outcome of malaria infection and could be a fair reflection of the disease transmission rate. This study investigated the genetic diversity of P. falciparum and multiplicity of infection in relation to the severity of malaria and age of patients in Gezira State, Sudan. METHODS A cross-sectional health facilities-based survey was conducted in Gezira State, Sudan in January 2012. A total of 140 P. falciparum malaria patients diagnosed with microscopy and confirmed using nested PCR were recruited and classified into uncomplicated malaria and severe malaria states according to the standard WHO criteria. DNA was extracted and MSP1 and MSP2 allelic families were determined using nested PCR. RESULTS The overall multiplicity of infection (MOI) was 2.25 and 2.30 and 2.15 for uncomplicated and severe malaria respectively. There were no statistically significant differences between uncomplicated and severe malaria (SM) patient groups in MOI with regard to MSP1, MSP2 and overall MOI (Mann-Whitney U-test; all P < 0.05). The predominant MSP1 allelic families were MAD20 for uncomplicated malaria and RO33 for severe malaria. The distribution of both FC27 and IC1/3D7 MSP2 allelic families were approximately the same across disease severity. One hundred and eleven P. falciparum isolates (81 %) consisted of multiple genotypes; 71/90 (78.9 %) in uncomplicated malaria and 40/50 (85.1 %) in severe malaria patient groups. Neither MSP1 nor MSP2 allelic families showed association with malaria severity. No statistically significant differences in multiplicity of infection were observed between different age groups. CONCLUSION In this study the majority of P. falciparum isolates from uncomplicated and severe malaria patients consisted of multiple genotypes. Further molecular epidemiological studies delineate the link between P. falciparum genotype with the malaria phenotype in different regions are encouraged.
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Affiliation(s)
- Muzamil Mahdi Abdel Hamid
- />Department of Parasitology and Medical Entomology, Institute of Endemic Diseases, University of Khartoum, Khartoum, Sudan
| | - Arwa F. Elamin
- />Department of Parasitology and Medical Entomology, Institute of Endemic Diseases, University of Khartoum, Khartoum, Sudan
| | - Musab M. Ali Albsheer
- />Department of Parasitology and Medical Entomology, Institute of Endemic Diseases, University of Khartoum, Khartoum, Sudan
| | | | - Nouh S. Mahgoub
- />Department of Parasitology and Medical Entomology, Institute of Endemic Diseases, University of Khartoum, Khartoum, Sudan
| | - Shaza O. Mustafa
- />Department of Parasitology and Medical Entomology, Institute of Endemic Diseases, University of Khartoum, Khartoum, Sudan
| | | | - Mutaz Amin
- />Faculty of Medicine, University of Khartoum, Khartoum, Sudan
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Genetic diversity and multiplicity of infection of Plasmodium falciparum isolates from Kolkata, West Bengal, India. INFECTION GENETICS AND EVOLUTION 2016; 43:239-44. [PMID: 27259367 DOI: 10.1016/j.meegid.2016.05.038] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Revised: 05/28/2016] [Accepted: 05/30/2016] [Indexed: 01/26/2023]
Abstract
The study of genetic diversity of Plasmodium falciparum is necessary to understand the distribution and dynamics of parasite populations. The genetic diversity of P. falciparum merozoite surface protein-1 and 2 has been extensively studied from different parts of world. However, limited data are available from India. This study was aimed to determine the genetic diversity and multiplicity of infection (MOI) of P. falciparum population in Kolkata, West Bengal, India. A total of 80day-zero blood samples from Kolkata were collected during a therapeutic efficacy study in 2008-2009. DNA was extracted; allelic frequency and diversity were investigated by PCR-genotyping method for msp1 and msp2 gene and fragment sizing was done by Bio-Rad Gel-Doc system using Image Lab (version 4.1) software. P. falciparum msp1 and msp2 markers were highly polymorphic with low allele frequencies. In Kolkata, 27 msp1 different genotypes (including 11of K1, 6 of MAD20 and 10 of Ro33 allelic families) and 30 different msp2 genotypes (of which 17 and 13 belonged to the FC27 and 3D7 allelic families, respectively) were recorded. The majority of these genotypes occurred at a frequency below 10%. The mean MOI for msp1 and msp2 gene were 2.05 and 3.72, respectively. The P. falciparum population of Kolkata was genetically diverse. As the frequencies of most of the msp1 and msp2 alleles were low, the probability of new infection with genotype identical to that in pretreatment infection was very rare. This information will serve as baseline data for evaluation of malaria control interventions as well as for monitoring the parasite population structure.
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Genetic Polymorphism of msp1 and msp2 in Plasmodium falciparum Isolates from Côte d'Ivoire versus Gabon. J Parasitol Res 2016; 2016:3074803. [PMID: 27110390 PMCID: PMC4823507 DOI: 10.1155/2016/3074803] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Revised: 03/01/2016] [Accepted: 03/07/2016] [Indexed: 11/30/2022] Open
Abstract
Introduction. The characterization of genetic profile of Plasmodium isolates from different areas could help in better strategies for malaria elimination. This study aimed to compare P. falciparum diversity in two African countries. Methods. Isolates collected from 100 and 73 falciparum malaria infections in sites of Côte d'Ivoire (West Africa) and Gabon (Central Africa), respectively, were analyzed by a nested PCR amplification of msp1 and msp2 genes. Results. The K1 allelic family was widespread in Côte d'Ivoire (64.6%) and in Gabon (56.6%). For msp2, the 3D7 alleles were more prevalent (>70% in both countries) compared to FC27 alleles. In Côte d'Ivoire, the frequencies of multiple infections with msp1 (45.1%) and msp2 (40.3%) were higher than those found for isolates from Gabon, that is, 30.2% with msp1 and 31.4% with msp2. The overall complexity of infection was 1.66 (SD = 0.79) in Côte d'Ivoire and 1.58 (SD = 0.83) in Gabon. It decreased with age in Côte d'Ivoire in contrast to Gabon. Conclusion. Differences observed in some allelic families and in complexity profile may suggest an impact of epidemiological facies as well as immunological response on genetic variability of P. falciparum.
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Niang M, Loucoubar C, Sow A, Diagne MM, Faye O, Faye O, Diallo M, Toure-Balde A, Sall AA. Genetic diversity of Plasmodium falciparum isolates from concurrent malaria and arbovirus co-infections in Kedougou, southeastern Senegal. Malar J 2016; 15:155. [PMID: 26969623 PMCID: PMC4788873 DOI: 10.1186/s12936-016-1208-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 03/02/2016] [Indexed: 11/24/2022] Open
Abstract
Background Concurrent malaria and arbovirus infections are common and represent an important public health concern in regions where both diseases are endemic. The present study investigates the genetic diversity and complexity of Plasmodium falciparum infection in concurrent malaria-arbovirus infections in Kedougou region, southeastern Senegal. Methods Parasite DNA was extracted from 60 to 27 sera samples collected from P. falciparum isolates of malaria and concurrent malaria-arbovirus infected patients, respectively, and followed by PCR-genotyping targeting the msp-1 (block2) and msp-2 (block3) allelic families. Results The mean number of genotype per allelic family was comparable between the two groups. K1 was the predominant msp-1 allelic type both in malaria (94.91 %) and arbovirus-malaria (92.59 %) groups, whereas IC/3D7 was the most prevalent msp-2 allelic type in malaria (94.91 %) and arbovirus-malaria (96.29 %) groups. Frequencies of msp-1 and msp-2 allelic types were statistically comparable between the two groups (Fisher exact test, P > 0.05) and were not associated with age. FC27 was strikingly the least prevalent in both groups and was absent in children under 5 years of age. The proportions of P. falciparum isolates from malaria-infected patients carrying the three msp-1 allelic types (67.44 %) or the two msp-2 allelic types (76.47 %) were significantly higher than those from arbovirus-malaria co-infected patients (Exact binomial test, P < 0.05). The multiplicities of infection (MOI) were low and comparable for msp-1 (1.19 vs 1.22) and msp-2 (1.11 vs 1.10), respectively between malaria and arbovirus-malaria groups. Conclusion The study showed no difference in the genetic diversity between P. falciparum isolates from malaria and concurrent malaria-arbovirus infected patients in Kedougou. The MOI was low despite intense malaria transmission in Kedougou. The overall results suggest a limited or no influence of arbovirus infections on P. falciparum diversity and complexity of malaria infection.
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Affiliation(s)
- Makhtar Niang
- Immunology Unit, Institut Pasteur Dakar, 36 Avenue Pasteur, 220, Dakar, Senegal.
| | - Cheikh Loucoubar
- Arbovirus and Viral Hemorrhagic Fevers Unit, Institut Pasteur Dakar, 36 Avenue Pasteur, 220, Dakar, Senegal
| | - Abdourahmane Sow
- Arbovirus and Viral Hemorrhagic Fevers Unit, Institut Pasteur Dakar, 36 Avenue Pasteur, 220, Dakar, Senegal
| | - Moussa Moise Diagne
- Arbovirus and Viral Hemorrhagic Fevers Unit, Institut Pasteur Dakar, 36 Avenue Pasteur, 220, Dakar, Senegal
| | - Oumar Faye
- Arbovirus and Viral Hemorrhagic Fevers Unit, Institut Pasteur Dakar, 36 Avenue Pasteur, 220, Dakar, Senegal
| | - Ousmane Faye
- Arbovirus and Viral Hemorrhagic Fevers Unit, Institut Pasteur Dakar, 36 Avenue Pasteur, 220, Dakar, Senegal
| | - Mawlouth Diallo
- Medical Entomology Unit, Institut Pasteur Dakar, 36 Avenue Pasteur, 220, Dakar, Senegal
| | | | - Amadou A Sall
- Arbovirus and Viral Hemorrhagic Fevers Unit, Institut Pasteur Dakar, 36 Avenue Pasteur, 220, Dakar, Senegal
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Adu B, Cherif MK, Bosomprah S, Diarra A, Arthur FKN, Dickson EK, Corradin G, Cavanagh DR, Theisen M, Sirima SB, Nebie I, Dodoo D. Antibody levels against GLURP R2, MSP1 block 2 hybrid and AS202.11 and the risk of malaria in children living in hyperendemic (Burkina Faso) and hypo-endemic (Ghana) areas. Malar J 2016; 15:123. [PMID: 26921176 PMCID: PMC4769494 DOI: 10.1186/s12936-016-1146-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2015] [Accepted: 02/04/2016] [Indexed: 12/31/2022] Open
Abstract
Background
Differences in parasite transmission intensity influence the process of acquisition of host immunity to Plasmodium falciparum malaria and ultimately, the rate of malaria related morbidity and mortality. Potential vaccines being designed to complement current intervention efforts therefore need to be evaluated against different malaria endemicity backgrounds. Methods The associations between antibody responses to the chimeric merozoite surface protein 1 block 2 hybrid (MSP1 hybrid), glutamate-rich protein region 2 (GLURP R2) and the peptide AS202.11, and the risk of malaria were assessed in children living in malaria hyperendemic (Burkina Faso, n = 354) and hypo-endemic (Ghana, n = 209) areas. Using the same reagent lots and standardized protocols for both study sites, immunoglobulin (Ig) M, IgG and IgG sub-class levels to each antigen were measured by ELISA in plasma from the children (aged 6–72 months). Associations between antibody levels and risk of malaria were assessed using Cox regression models adjusting for covariates. Results There was a significant association between GLURP R2 IgG3 and reduced risk of malaria after adjusting age of children in both the Burkinabe (hazard ratio 0.82; 95 % CI 0.74–0.91, p < 0.0001) and the Ghanaian (HR 0.48; 95 % CI 0.25–0.91, p = 0.02) cohorts. MSP1 hybrid IgM was associated (HR 0.85; 95 % CI 0.73–0.98, p = 0.02) with reduced risk of malaria in Burkina Faso cohort while IgG against AS202.11 in the Ghanaian children was associated with increased risk of malaria (HR 1.29; 95 % CI 1.01–1.65, p = 0.04). Conclusion These findings support further development of GLURP R2 and MSP1 block 2 hybrid, perhaps as a fusion vaccine antigen targeting malaria blood stage that can be deployed in areas of varying transmission intensity. Electronic supplementary material The online version of this article (doi:10.1186/s12936-016-1146-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Bright Adu
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana.
| | - Mariama K Cherif
- Polytechnic University of BoboDioulasso, Bobo-Dioulasso, Burkina Faso. .,Centre National de Recherche et de Formation sur le paludisme, Ouagadougou, Burkina Faso.
| | | | - Amidou Diarra
- Centre National de Recherche et de Formation sur le paludisme, Ouagadougou, Burkina Faso.
| | - Fareed K N Arthur
- Department of Biochemistry and Biotechnology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
| | - Emmanuel K Dickson
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana.
| | | | - David R Cavanagh
- Institute of Cell, Animal and Population Biology, School of Biological Sciences, University of Edinburgh, Edinburgh, Scotland, UK.
| | - Michael Theisen
- Department for Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark.
| | - Sodiomon B Sirima
- Centre National de Recherche et de Formation sur le paludisme, Ouagadougou, Burkina Faso.
| | - Issa Nebie
- Centre National de Recherche et de Formation sur le paludisme, Ouagadougou, Burkina Faso.
| | - Daniel Dodoo
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana.
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Plasmodium falciparum msp2 Genotypes and Multiplicity of Infections among Children under Five Years with Uncomplicated Malaria in Kibaha, Tanzania. J Parasitol Res 2015; 2015:721201. [PMID: 26770821 PMCID: PMC4684896 DOI: 10.1155/2015/721201] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Revised: 11/17/2015] [Accepted: 11/19/2015] [Indexed: 11/19/2022] Open
Abstract
Genetic diversity of Plasmodium falciparum may pose challenges in malaria treatment and prevention through chemotherapy and vaccination. We assessed Plasmodium falciparum genetic diversity and multiplicity of infection (MOI) of P. falciparum infections and sort relationship of parasitaemia with P. falciparum msp2 genotypes as well as with the number of infecting clones. The study was carried out in Kibaha, Tanzania. Ninety-nine children under five years with uncomplicated malaria were recruited. Genetic diversity was analyzed by genotyping the msp2 gene using PCR-Restriction Fragment Length Polymorphism. Thirty-two different msp2 alleles were obtained. The msp2 3D7 allelic frequency was higher (48.1%) and more prevalent than FC27 (27.3%) (p < 0.05). Twenty-four percent of the infections were mixed alleles. The individuals with FC27 had high parasitemia compared to those with 3D7 alleles (p = 0.038). The mean MOI was low (1.4 clones, 95% CI 1.2–1.5). The P. falciparum population among children at Kibaha is composed of distinct P. falciparum clones, and parasites having 3D7 are more frequent than those with FC27 alleles. Individuals with parasite having FC27 alleles have high parasite densities suggesting that parasites with FC27 alleles may associate with severity of disease in Kibaha. Low MOI at Kibaha suggests low malaria transmission rate.
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Clinical Variation of Plasmodium falciparum eba-175, ama-1, and msp-3 Genotypes in Young Children Living in a Seasonally High Malaria Transmission Setting in Burkina Faso. J Parasitol Res 2015; 2015:985651. [PMID: 26634149 PMCID: PMC4655070 DOI: 10.1155/2015/985651] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Revised: 10/08/2015] [Accepted: 10/15/2015] [Indexed: 11/17/2022] Open
Abstract
The association between P. falciparum eba-175, ama-1, and msp-3 polymorphism in the pathogenicity of malaria disease was investigated. We therefore compared the prevalence of different alleles between symptomatic and asymptomatic malarial children under five years of age living in Burkina Faso. Blood filter papers were collected during the 2008 malaria transmission season from 228 symptomatic and 199 asymptomatic children under five years of age. All patients were living in the rural area of Saponé at about 50 km from Ouagadougou, the capital city of Burkina Faso. P. falciparum parasite DNA was extracted using QIAGEN kits and the alleles diversity was assessed by a nested PCR. PCR products were then digested by restriction enzymes based on already described polymorphic regions of the eba-175, ama-1, and msp-3 genes. The individual alleles eba-175_FCR3 and msp-3_K1 frequencies were statistically higher (p < 0.0001) in the asymptomatic group compared to the symptomatic ones. No statistically significant difference was noted in the prevalence of ama-1-3D7, ama-1-K1, and ama-1-HB3 genotypes between the two groups (p > 0.05). The comparative analysis of P. falciparum genotypes indicated that the polymorphism in eba-175 and msp-3 genotypes varied between asymptomatic and symptomatic clinical groups and may contribute to the pathogenesis of malaria.
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Mvé-Ondo B, Nkoghe D, Arnathau C, Rougeron V, Bisvigou U, Mouele LY, Boundenga L, Durand P, Elguero E, Lemmers S, Délicat-Loembet LM, Diamella-Moukodoum N, Paupy C, Renaud F, Prugnolle F, Ollomo B. Genetic diversity of Plasmodium falciparum isolates from Baka Pygmies and their Bantu neighbours in the north of Gabon. Malar J 2015; 14:395. [PMID: 26450086 PMCID: PMC4599724 DOI: 10.1186/s12936-015-0862-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2015] [Accepted: 08/23/2015] [Indexed: 11/25/2022] Open
Abstract
Background There have been many reports on the population genetic structure of Plasmodium falciparum from different endemic regions especially sub-Saharan Africa. However, few studies have been performed on neglected populations, such as the Pygmy populations. In this study, the population genetic structure of P. falciparum was investigated in the Baka Pygmies of Gabon and compared to that observed in neighboring villages composed mostly of Bantu farmers. Methods A total of 342 blood samples were collected from 170 Baka Pygmies and 172 Bantus in the north of Gabon (Woleu Ntem Province). Plasmodium infections were characterized by sequencing a portion of the parasite cytochrome b gene. Population genetic structure of P. falciparum in the different villages was analysed using microsatellite markers and genes coding for antigenic proteins (MSP1, MSP2, GLURP, and EBA-175). Results Overall, prevalence of P. falciparum was around 57 % and no significant difference of prevalence was observed between Pygmies and Bantus. No significant differences of population genetic structure of P. falciparum was found between Pygmy and Bantu people except for one antigen-coding gene, glurp, for which genetic data suggested the existence of a potentially disruptive selection acting on this gene in the two types of populations. The genetic structure of P. falciparum followed a pattern of isolation by distance at the scale of the study. Conclusion The prevalence and genetic diversity of P. falciparum observed in Baka demonstrates a significant transmission of the parasite in this population, and some exchanges of parasites with Bantu neighbours. Despite that, some antigen-coding genes seem to have had a particular evolutionary trajectory in certain Pygmy populations due to specific local human and/or mosquito characteristics. Electronic supplementary material The online version of this article (doi:10.1186/s12936-015-0862-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Bertrand Mvé-Ondo
- Centre International de Recherches Médicales de Franceville (CIRMF), BP 769, Franceville, Gabon. .,Ecole Doctorale Régionale d'Afrique Centrale en Infectiologie Tropicale, BP 876, Franceville, Gabon.
| | - Dieudonné Nkoghe
- Centre International de Recherches Médicales de Franceville (CIRMF), BP 769, Franceville, Gabon. .,Ministry of Health, BP 50, Libreville, Gabon.
| | - Céline Arnathau
- Laboratoire Maladies Infectieuses et Vecteurs, Ecologie, Génétique, Evolution et Contrôle (MIVEGEC), UMR CNRS 5290/IRD 224, Université Montpellier, CHRU de Montpellier, 39 Avenue Charles Flahault, 34295, Montpellier, France.
| | - Virginie Rougeron
- Centre International de Recherches Médicales de Franceville (CIRMF), BP 769, Franceville, Gabon. .,Laboratoire Maladies Infectieuses et Vecteurs, Ecologie, Génétique, Evolution et Contrôle (MIVEGEC), UMR CNRS 5290/IRD 224, Université Montpellier, CHRU de Montpellier, 39 Avenue Charles Flahault, 34295, Montpellier, France.
| | | | - Lauriane Yacka Mouele
- Centre International de Recherches Médicales de Franceville (CIRMF), BP 769, Franceville, Gabon. .,Fac de Médecine, UMR-BIOMED, BP 8507, Libreville, Gabon.
| | - Larson Boundenga
- Centre International de Recherches Médicales de Franceville (CIRMF), BP 769, Franceville, Gabon. .,Département de Biologie Animale, Faculté des Sciences et Techniques, Laboratoire d'Écologie et Biologie évolutive, Université Cheikh AntaDiop de Dakar, BP 5005, Dakar, Senegal.
| | - Patrick Durand
- Laboratoire Maladies Infectieuses et Vecteurs, Ecologie, Génétique, Evolution et Contrôle (MIVEGEC), UMR CNRS 5290/IRD 224, Université Montpellier, CHRU de Montpellier, 39 Avenue Charles Flahault, 34295, Montpellier, France.
| | - Eric Elguero
- Laboratoire Maladies Infectieuses et Vecteurs, Ecologie, Génétique, Evolution et Contrôle (MIVEGEC), UMR CNRS 5290/IRD 224, Université Montpellier, CHRU de Montpellier, 39 Avenue Charles Flahault, 34295, Montpellier, France.
| | - Simone Lemmers
- Department of Anthropology, Durham University, Dawson Building, South Road, Durham, DH1 3LE, England, UK.
| | | | - Nancy Diamella-Moukodoum
- Centre International de Recherches Médicales de Franceville (CIRMF), BP 769, Franceville, Gabon.
| | - Christophe Paupy
- Laboratoire Maladies Infectieuses et Vecteurs, Ecologie, Génétique, Evolution et Contrôle (MIVEGEC), UMR CNRS 5290/IRD 224, Université Montpellier, CHRU de Montpellier, 39 Avenue Charles Flahault, 34295, Montpellier, France.
| | - François Renaud
- Laboratoire Maladies Infectieuses et Vecteurs, Ecologie, Génétique, Evolution et Contrôle (MIVEGEC), UMR CNRS 5290/IRD 224, Université Montpellier, CHRU de Montpellier, 39 Avenue Charles Flahault, 34295, Montpellier, France.
| | - Franck Prugnolle
- Centre International de Recherches Médicales de Franceville (CIRMF), BP 769, Franceville, Gabon. .,Laboratoire Maladies Infectieuses et Vecteurs, Ecologie, Génétique, Evolution et Contrôle (MIVEGEC), UMR CNRS 5290/IRD 224, Université Montpellier, CHRU de Montpellier, 39 Avenue Charles Flahault, 34295, Montpellier, France.
| | - Benjamin Ollomo
- Centre International de Recherches Médicales de Franceville (CIRMF), BP 769, Franceville, Gabon. .,Fac de Médecine, UMR-BIOMED, BP 8507, Libreville, Gabon.
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Mawili-Mboumba DP, Mbondoukwe N, Adande E, Bouyou-Akotet MK. Allelic Diversity of MSP1 Gene in Plasmodium falciparum from Rural and Urban Areas of Gabon. THE KOREAN JOURNAL OF PARASITOLOGY 2015; 53:413-9. [PMID: 26323839 PMCID: PMC4566513 DOI: 10.3347/kjp.2015.53.4.413] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Revised: 02/23/2015] [Accepted: 08/05/2015] [Indexed: 11/23/2022]
Abstract
The present study determined and compared the genetic diversity of Plasmodium falciparum strains infecting children living in 2 areas from Gabon with different malaria endemicity. Blood samples were collected from febrile children from 2008 to 2009 in 2 health centres from rural (Oyem) and urban (Owendo) areas. Genetic diversity was determined in P. falciparum isolates by analyzing the merozoite surface protein-1 (msp1) gene polymorphism using nested-PCR. Overall, 168 children with mild falciparum malaria were included. K1, Ro33, and Mad20 alleles were found in 110 (65.5%), 94 (55.9%), and 35 (20.8%) isolates, respectively, without difference according to the site (P>0.05). Allelic families' frequencies were comparable between children less than 5 years old from the 2 sites; while among the older children the proportions of Ro33 and Mad20 alleles were 1.7 to 2.0 fold higher at Oyem. Thirty-three different alleles were detected, 16 (48.5%) were common to both sites, and 10 out of the 17 specific alleles were found at Oyem. Furthermore, multiple infection carriers were frequent at Oyem (57.7% vs 42.2% at Owendo; P=0.04) where the complexity of infection was of 1.88 (±0.95) higher compared to that found at Owendo (1.55±0.75). Extended genetic diversity of P. falciparum strains infecting Gabonese symptomatic children and high multiplicity of infections were observed in rural area. Alleles common to the 2 sites were frequent; the site-specific alleles predominated in the rural area. Such distribution of the alleles should be taken into accounts when designing MSP1 or MSP2 malaria vaccine.
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Affiliation(s)
- Denise Patricia Mawili-Mboumba
- Department of Parasitology-Mycology, Faculty of Medicine, Université des Sciences de la Santé. BP4009, Libreville, Gabon
| | - Noé Mbondoukwe
- Department of Parasitology-Mycology, Faculty of Medicine, Université des Sciences de la Santé. BP4009, Libreville, Gabon
| | - Elvire Adande
- Department of Parasitology-Mycology, Faculty of Medicine, Université des Sciences de la Santé. BP4009, Libreville, Gabon
| | - Marielle Karine Bouyou-Akotet
- Department of Parasitology-Mycology, Faculty of Medicine, Université des Sciences de la Santé. BP4009, Libreville, Gabon
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Efficacy and Safety of Artesunate-Amodiaquine versus Artemether-Lumefantrine in the Treatment of Uncomplicated Plasmodium falciparum Malaria in Sentinel Sites across Côte d'Ivoire. Malar Res Treat 2015; 2015:878132. [PMID: 26347849 PMCID: PMC4549615 DOI: 10.1155/2015/878132] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Revised: 05/22/2015] [Accepted: 07/05/2015] [Indexed: 11/17/2022] Open
Abstract
Two years after the introduction of free Artesunate-Amodiaquine (ASAQ) and Artemether-Lumefantrine (AL) for the treatment of uncomplicated malaria in public health facilities in Côte d'Ivoire, we carried out this study to compare their efficacy and tolerability in three surveillance sites. It was a multicentre open randomised clinical trial of 3-day ASAQ treatment against AL for the treatment of 2 parallel groups of patients aged 2 years and above. The endpoints were (1) Adequate Clinical and Parasitological Response (ACPR) at day 28 and (2) the clinical and biological tolerability. Of the 300 patients who were enrolled 289, with 143 (49.5%) and 146 (50.5%) in the ASAQ and AL groups, respectively, correctly followed the WHO 2003 protocol we used. The PCR-corrected ACPR was 99.3% for each group. More than 94% of patients no longer showed signs of fever, 48 hours after treatment. Approximately 78% of the people in the ASAQ group had a parasite clearance time of 48 hours or less compared to 81% in the AL group (p = 0.496). Both drugs were found to be well tolerated by the patients. This study demonstrates the effectiveness and tolerability of ASAQ and AL supporting their continuous use for the treatment of uncomplicated P. falciparum malaria infection in Côte d'Ivoire.
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