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Diarra B, Guindo I, Koné B, Dembélé M, Cissé I, Thiam S, Konaté K, Tékété M, Maīga A, Maīga O, Timbiné L, Djimde A. High frequency of antimicrobial resistance in Salmonella and Escherichia coli causing diarrheal diseases at the Yirimadio community health facility, Mali. BMC Microbiol 2024; 24:35. [PMID: 38262985 PMCID: PMC10804725 DOI: 10.1186/s12866-024-03198-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 01/14/2024] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND Diarrhoea is a public health problem, especially in developing countries where it is the second leading cause of child mortality. In Low Income Countries like in Mali, self-medication and inappropriate use of antibiotics due to the scarcity of complementary diagnostic systems can lead to the development of multidrug-resistant bacteria causing diarrhoea. The objective of this work was to determine the microorganisms responsible for diarrhoea in children under 15 years of age and to characterize their sensitivity to a panel of antibiotics used in a peri-urban community in Mali. The study involved outpatient children visiting the Yirimadio Community Health Centre and diagnosed with diarrhoea. Stool samples from those patients were collected and analysed by conventional stools culture and the susceptibility to antibiotics of detected bacteria was determined by the disc diffusion method in an agar medium. RESULT Overall, 554 patients were included. Children under the age of 3 years accounted for 88.8% (492 of 554) of our study population. Two bacterial species were isolated in this study, Escherichia coli 31.8% (176 of 554) and Salmonella 2.9% (16 of 554). In the 176, E. coli strains resistance to amoxicillin and to cotrimoxazole was seen in 93.8% (165 of 176) and 92.6% ( 163 of 176), respectively. The ESBL resistance phenotype accounted for 39,8% (70 of 176) of E. coli. Sixteen (16) strains of Salmonella were found, of which one strain (6.3%) was resistant to amoxicillin and to amoxicillin + clavulanic acid. Another one was resistant to chloramphenicol (6.3%). Two strains of Salmonella were resistant to cotrimoxazole (12.5%) and two others were resistant to cefoxitin (12.5%). CONCLUSIONS The data suggest that E. coli is frequently involved in diarrhoea in children under 3 years of age in this peri-urban setting of Bamako, Mali, with a high rate of resistance to amoxicillin and cotrimoxazole, the most widely used antibiotics in the management of diarrhoea in this setting.
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Affiliation(s)
- Bintou Diarra
- Pathogens genomic Diversity Network Africa (PDNA), Sotuba, Bamako, Mali
- African Association for research and control of Antimicrobial Resistance (AAAMR), Koulouba, Bamako, Mali
- Malaria Research and Training Center - University of Science, Techniques and Technologies of Bamako, Bamako, Mali
| | - Ibréhima Guindo
- National Institute for Public Health Research (INSP), Bamako, Mali
| | - Boī Koné
- Pathogens genomic Diversity Network Africa (PDNA), Sotuba, Bamako, Mali
- African Association for research and control of Antimicrobial Resistance (AAAMR), Koulouba, Bamako, Mali
- Malaria Research and Training Center - University of Science, Techniques and Technologies of Bamako, Bamako, Mali
| | - Maīmouna Dembélé
- National Institute for Public Health Research (INSP), Bamako, Mali
| | | | | | | | - Mamadou Tékété
- Pathogens genomic Diversity Network Africa (PDNA), Sotuba, Bamako, Mali
- African Association for research and control of Antimicrobial Resistance (AAAMR), Koulouba, Bamako, Mali
- Malaria Research and Training Center - University of Science, Techniques and Technologies of Bamako, Bamako, Mali
| | | | - Oumou Maīga
- Kumasi Centre for Collaborative Research in Tropical Medicine, BNITM, Kumasi, Ghana
| | | | - Abdoulaye Djimde
- Pathogens genomic Diversity Network Africa (PDNA), Sotuba, Bamako, Mali.
- African Association for research and control of Antimicrobial Resistance (AAAMR), Koulouba, Bamako, Mali.
- Malaria Research and Training Center - University of Science, Techniques and Technologies of Bamako, Bamako, Mali.
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Dicko A, Ouedraogo JB, Zongo I, Sagara I, Cairns M, Yerbanga RS, Issiaka D, Zoungrana C, Sidibe Y, Tapily A, Nikièma F, Sompougdou F, Sanogo K, Kaya M, Yalcouye H, Dicko OM, Diarra M, Diarra K, Thera I, Haro A, Sienou AA, Traore S, Mahamar A, Dolo A, Kuepfer I, Snell P, Grant J, Webster J, Milligan P, Lee C, Ockenhouse C, Ofori-Anyinam O, Tinto H, Djimde A, Chandramohan D, Greenwood B. Seasonal vaccination with RTS,S/AS01 E vaccine with or without seasonal malaria chemoprevention in children up to the age of 5 years in Burkina Faso and Mali: a double-blind, randomised, controlled, phase 3 trial. Lancet Infect Dis 2024; 24:75-86. [PMID: 37625434 DOI: 10.1016/s1473-3099(23)00368-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 05/31/2023] [Accepted: 06/01/2023] [Indexed: 08/27/2023]
Abstract
BACKGROUND Seasonal vaccination with the RTS,S/AS01E vaccine combined with seasonal malaria chemoprevention (SMC) prevented malaria in young children more effectively than either intervention given alone over a 3 year period. The objective of this study was to establish whether the added protection provided by the combination could be sustained for a further 2 years. METHODS This was a double-blind, individually randomised, controlled, non-inferiority and superiority, phase 3 trial done at two sites: the Bougouni district and neighbouring areas in Mali and Houndé district, Burkina Faso. Children who had been enrolled in the initial 3-year trial when aged 5-17 months were initially randomly assigned individually to receive SMC with sulphadoxine-pyrimethamine and amodiaquine plus control vaccines, RTS,S/AS01E plus placebo SMC, or SMC plus RTS,S/AS01E. They continued to receive the same interventions until the age of 5 years. The primary trial endpoint was the incidence of clinical malaria over the 5-year trial period in both the modified intention-to-treat and per-protocol populations. Over the 5-year period, non-inferiority was defined as a 20% increase in clinical malaria in the RTS,S/AS01E-alone group compared with the SMC alone group. Superiority was defined as a 12% difference in the incidence of clinical malaria between the combined and single intervention groups. The study is registered with ClinicalTrials.gov, NCT04319380, and is complete. FINDINGS In April, 2020, of 6861 children originally recruited, 5098 (94%) of the 5433 children who completed the initial 3-year follow-up were re-enrolled in the extension study. Over 5 years, the incidence of clinical malaria per 1000 person-years at risk was 313 in the SMC alone group, 320 in the RTS,S/AS01E-alone group, and 133 in the combined group. The combination of RTS,S/AS01E and SMC was superior to SMC (protective efficacy 57·7%, 95% CI 53·3 to 61·7) and to RTS,S/AS01E (protective efficacy 59·0%, 54·7 to 62·8) in preventing clinical malaria. RTS,S/AS01E was non-inferior to SMC (hazard ratio 1·03 [95% CI 0·95 to 1·12]). The protective efficacy of the combination versus SMC over the 5-year period of the study was very similar to that seen in the first 3 years with the protective efficacy of the combination versus SMC being 57·7% (53·3 to 61·7) and versus RTS/AS01E-alone being 59·0% (54·7 to 62·8). The comparable figures for the first 3 years of the study were 62·8% (58·4 to 66·8) and 59·6% (54·7 to 64·0%), respectively. Hospital admissions for WHO-defined severe malaria were reduced by 66·8% (95% CI 40·3 to 81·5), for malarial anaemia by 65·9% (34·1 to 82·4), for blood transfusion by 68·1% (32·6 to 84·9), for all-cause deaths by 44·5% (2·8 to 68·3), for deaths excluding external causes or surgery by 41·1% (-9·2 to 68·3), and for deaths from malaria by 66·8% (-2·7 to 89·3) in the combined group compared with the SMC alone group. No safety signals were detected. INTERPRETATION Substantial protection against malaria was sustained over 5 years by combining seasonal malaria vaccination with seasonal chemoprevention, offering a potential new approach to malaria control in areas with seasonal malaria transmission. FUNDING UK Joint Global Health Trials and PATH's Malaria Vaccine Initiative (through a grant from the Bill & Melinda Gates Foundation). TRANSLATION For the French translation of the abstract see Supplementary Materials section.
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Affiliation(s)
- Alassane Dicko
- The Malaria Research and Training Center, University of Science, Technology and Techniques of Bamako, Bamako, Mali
| | - Jean-Bosco Ouedraogo
- Institut des Sciences et Techniques-Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso
| | - Issaka Zongo
- Institut des Sciences et Techniques-Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso
| | - Issaka Sagara
- The Malaria Research and Training Center, University of Science, Technology and Techniques of Bamako, Bamako, Mali
| | - Matthew Cairns
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Rakiswendé Serge Yerbanga
- Institut des Sciences et Techniques-Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso
| | - Djibrilla Issiaka
- The Malaria Research and Training Center, University of Science, Technology and Techniques of Bamako, Bamako, Mali
| | - Charles Zoungrana
- Institut des Sciences et Techniques-Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso
| | - Youssoufa Sidibe
- The Malaria Research and Training Center, University of Science, Technology and Techniques of Bamako, Bamako, Mali
| | - Amadou Tapily
- The Malaria Research and Training Center, University of Science, Technology and Techniques of Bamako, Bamako, Mali
| | - Frédéric Nikièma
- Institut des Sciences et Techniques-Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso
| | - Frédéric Sompougdou
- Institut des Sciences et Techniques-Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso
| | - Koualy Sanogo
- The Malaria Research and Training Center, University of Science, Technology and Techniques of Bamako, Bamako, Mali
| | - Mahamadou Kaya
- The Malaria Research and Training Center, University of Science, Technology and Techniques of Bamako, Bamako, Mali
| | - Hama Yalcouye
- The Malaria Research and Training Center, University of Science, Technology and Techniques of Bamako, Bamako, Mali
| | - Oumar Mohamed Dicko
- The Malaria Research and Training Center, University of Science, Technology and Techniques of Bamako, Bamako, Mali
| | - Modibo Diarra
- The Malaria Research and Training Center, University of Science, Technology and Techniques of Bamako, Bamako, Mali
| | - Kalifa Diarra
- The Malaria Research and Training Center, University of Science, Technology and Techniques of Bamako, Bamako, Mali
| | - Ismaila Thera
- The Malaria Research and Training Center, University of Science, Technology and Techniques of Bamako, Bamako, Mali
| | - Alassane Haro
- Institut des Sciences et Techniques-Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso
| | - Abdoul Aziz Sienou
- Institut des Sciences et Techniques-Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso
| | - Seydou Traore
- The Malaria Research and Training Center, University of Science, Technology and Techniques of Bamako, Bamako, Mali
| | - Almahamoudou Mahamar
- The Malaria Research and Training Center, University of Science, Technology and Techniques of Bamako, Bamako, Mali
| | - Amagana Dolo
- The Malaria Research and Training Center, University of Science, Technology and Techniques of Bamako, Bamako, Mali
| | - Irene Kuepfer
- Department of Disease Control, London School of Hygiene & Tropical Medicine, London, UK
| | - Paul Snell
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Jane Grant
- Department of Disease Control, London School of Hygiene & Tropical Medicine, London, UK
| | - Jayne Webster
- Department of Disease Control, London School of Hygiene & Tropical Medicine, London, UK
| | - Paul Milligan
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | | | | | | | - Halidou Tinto
- Institut des Sciences et Techniques-Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso
| | - Abdoulaye Djimde
- The Malaria Research and Training Center, University of Science, Technology and Techniques of Bamako, Bamako, Mali
| | - Daniel Chandramohan
- Department of Disease Control, London School of Hygiene & Tropical Medicine, London, UK
| | - Brian Greenwood
- Department of Disease Control, London School of Hygiene & Tropical Medicine, London, UK.
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Djimde M, Kayentao K, Tshiongo JK, Fofana B, Arama C, Sirima SB, Ouedraogo JB, Beavogui AH, Sagara I, Dicko A, Mens PF, Schallig HD, Djimde A. Variation in neutrophil levels and artemisinin-based combination therapy efficacy in West-Africa. J Infect Dev Ctries 2023; 17:1337-1345. [PMID: 37824364 DOI: 10.3855/jidc.17089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Accepted: 03/04/2023] [Indexed: 10/14/2023] Open
Abstract
INTRODUCTION Polymorphonuclear neutrophils (PMN) are involved in pathogen clearance by phagocytosis. However, the role of PMNs in the efficacy of artemisinin-based combination therapy (ACT) is poorly understood. METHODOLOGY In a prospective longitudinal in vivo study, neutrophil rates were compared with malaria carriage after treatment with different ACTs: Artemether - lumefantrine (AL), Artesunate - amodiaquine (ASAQ), Dihydroartemisinin - piperaquine (DP) or Pyronaridine artesunate (PA). The study cases were classified as having neutropenia, normal neutrophil levels or neutrophilia depending on the level of neutrophils in the blood. This study included 3148 patients and was analyzed using R. RESULTS On day 7, only four patients in the neutropenia group and treated with AL had a malaria positive blood smear based on microscopy. On day 28, the rate of recurrent parasitemia in the AL arm was significantly higher in neutropenia patients (50.9%) than in patients with normal rates of neutrophils (43.1%) or in those with neutrophilia (6.0%) (p < 0.001). In ASAQ arm, the rate of recurrent Plasmodium falciparum parasitemia was 58.8% in the neutropenia group versus 29.4% in patients with normal rates of neutrophils and 11.8% in patients with neutrophilia (p < 0.001). No patient treated with DP with normal neutrophil counts or neutrophilia was carrying malaria parasites on day 28. Among the 15 patients with parasitemia on day 28 in the PA arm, 11 (73.33%) had neutropenia while 4 (26.67%) had a normal neutrophil count (p < 0.001). CONCLUSIONS Patients with neutropenia had higher rates of recurrent P. falciparum parasitemia after ACT.
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Affiliation(s)
- Moussa Djimde
- Malaria Research and Training Center (MRTC), University of Sciences of Techniques and Technologies of Bamako (USTTB), Mali
| | - Kassoum Kayentao
- Malaria Research and Training Center (MRTC), University of Sciences of Techniques and Technologies of Bamako (USTTB), Mali
| | - Japhet Kabalu Tshiongo
- Department of Tropical Medicine, University of Kinshasa (UNIKIN), Kinshasa, Democratic Republic of the Congo
| | - Bakary Fofana
- Malaria Research and Training Center (MRTC), University of Sciences of Techniques and Technologies of Bamako (USTTB), Mali
| | - Charles Arama
- Malaria Research and Training Center (MRTC), University of Sciences of Techniques and Technologies of Bamako (USTTB), Mali
| | - Sodiomon B Sirima
- Groupe de Recherche Action en Santé (GRAS), Ouagadougou, Burkina Faso
| | - Jean Bosco Ouedraogo
- Institut des Sciences et des Techniques Bobo Dioulasso (INSTech-Bobo), Burkina Faso
| | - Abdoul Habib Beavogui
- Centre National de Formation et de Recherche en Santé Rurale (CNFRSR), Mafinrinha, Guinea
| | - Issaka Sagara
- Malaria Research and Training Center (MRTC), University of Sciences of Techniques and Technologies of Bamako (USTTB), Mali
| | - Alassane Dicko
- Malaria Research and Training Center (MRTC), University of Sciences of Techniques and Technologies of Bamako (USTTB), Mali
| | - Petra F Mens
- Amsterdam University Medical Centre, Academic Medical Centre at the University of Amsterdam (AMC), Amsterdam, The Netherlands
| | - Henk Dfh Schallig
- Amsterdam University Medical Centre, Academic Medical Centre at the University of Amsterdam (AMC), Amsterdam, The Netherlands
| | - Abdoulaye Djimde
- Malaria Research and Training Center (MRTC), University of Sciences of Techniques and Technologies of Bamako (USTTB), Mali
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Kouriba B, Arama C, Ouologuem DT, Cissoko Y, Diakite M, Beavogui AH, Wele M, Tekete M, Fofana B, Dama S, Maiga H, Kone A, Niangaly A, Diarra I, Daou M, Guindo A, Traore K, Coulibaly D, Kone AK, Dicko A, Clark TG, Doumbo OK, Djimde A. IFNγ, TNFα polymorphisms and IFNγ serum levels are associated with the clearance of drug-resistant P. falciparum in Malian children. Cytokine 2023; 164:156137. [PMID: 36773528 DOI: 10.1016/j.cyto.2023.156137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 01/23/2023] [Accepted: 01/25/2023] [Indexed: 02/11/2023]
Abstract
Host immunity has been suggested to clear drug-resistant parasites in malaria-endemic settings. However, the immunogenetic mechanisms involved in parasite clearance are poorly understood. Characterizing the host's immunity and genes involved in controlling the parasitic infection can inform the development of blood-stage malaria vaccines. This study investigates host regulatory cytokines and immunogenomic factors associated with the clearance of Plasmodium falciparum carrying a chloroquine resistance genotype. Biological samples from participants of previous drug efficacy trials conducted in two Malian localities were retrieved. The P. falciparum chloroquine resistance transporter (Pfcrt) gene was genotyped using parasite DNA. Children carrying parasites with the mutant allele (Pfcrt-76T) were classified based on their ability to clear their parasites. The levels of the different cytokines were measured in serum. The polymorphisms of specific human genes involved in malaria susceptibility were genotyped using human DNA. The prevalence of the Pfcrt-76T was significantly higher in Kolle than in Bandiagara (81.6 % vs 38.6 %, p < 10-6). The prevalence of children who cleared their mutant parasites was significantly higher in Bandiagara than in Kolle (82.2 % vs 67.4 %, p < 0.05). The genotyping of host genes revealed that IFN-γ -874 T and TNF-α -308A alleles were positively associated with parasite clearance. Cytokine profiling revealed that IFN-γ level was positively associated with parasite clearance (p = 0.04). This study highlights the role of host's immunity and immunogenetic factors to clear resistant parasites, suggesting further characterization of these polymorphisms may help to develop novel approaches to antiparasitic treatment strategies.
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Affiliation(s)
- Bourema Kouriba
- Malaria Research and Training Center, University of Sciences, Techniques and Technologies, Bamako, Mali; Centre d'Infectiologie Charles Mérieux-Mali, Mali.
| | - Charles Arama
- Malaria Research and Training Center, University of Sciences, Techniques and Technologies, Bamako, Mali
| | - Dinkorma T Ouologuem
- Malaria Research and Training Center, University of Sciences, Techniques and Technologies, Bamako, Mali
| | - Yacouba Cissoko
- Department of Infectious and Tropical Diseases, Point G Teaching Hospital, Bamako, Mali
| | - Mahamadou Diakite
- Malaria Research and Training Center, University of Sciences, Techniques and Technologies, Bamako, Mali
| | - Abdoul Habib Beavogui
- Maferinyah National Training and Research Center in Rural Health, Forecariah, Guinea
| | - Mamadou Wele
- Institute of Applied Sciences, University of Sciences, Techniques and Technologies, Bamako, Mali
| | - Mamadou Tekete
- Malaria Research and Training Center, University of Sciences, Techniques and Technologies, Bamako, Mali
| | - Bakary Fofana
- Malaria Research and Training Center, University of Sciences, Techniques and Technologies, Bamako, Mali
| | - Souleymane Dama
- Malaria Research and Training Center, University of Sciences, Techniques and Technologies, Bamako, Mali
| | - Hamma Maiga
- Institut National de Santé Publique, Bamako, Mali
| | - Aminatou Kone
- Malaria Research and Training Center, University of Sciences, Techniques and Technologies, Bamako, Mali
| | - Amadou Niangaly
- Malaria Research and Training Center, University of Sciences, Techniques and Technologies, Bamako, Mali
| | - Issa Diarra
- Malaria Research and Training Center, University of Sciences, Techniques and Technologies, Bamako, Mali
| | - Modibo Daou
- Malaria Research and Training Center, University of Sciences, Techniques and Technologies, Bamako, Mali
| | - Ando Guindo
- Malaria Research and Training Center, University of Sciences, Techniques and Technologies, Bamako, Mali
| | - Karim Traore
- Malaria Research and Training Center, University of Sciences, Techniques and Technologies, Bamako, Mali
| | - Drissa Coulibaly
- Malaria Research and Training Center, University of Sciences, Techniques and Technologies, Bamako, Mali
| | - Abdoulaye K Kone
- Malaria Research and Training Center, University of Sciences, Techniques and Technologies, Bamako, Mali
| | - Alassane Dicko
- Malaria Research and Training Center, University of Sciences, Techniques and Technologies, Bamako, Mali
| | - Taane G Clark
- Department of Infection Biology, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, Keppel St., London WC1E 7HT, UK; Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, Keppel St, London WC1E 7HT, UK
| | - Ogobara K Doumbo
- Malaria Research and Training Center, University of Sciences, Techniques and Technologies, Bamako, Mali
| | - Abdoulaye Djimde
- Malaria Research and Training Center, University of Sciences, Techniques and Technologies, Bamako, Mali.
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Doumbo SN, Cissoko Y, Dama S, Niangaly A, Garango A, Konaté A, Koné A, Traoré B, Thera M, Djimde A, Denning DW. The estimated burden of fungal diseases in Mali. J Mycol Med 2023; 33:101333. [PMID: 36270216 DOI: 10.1016/j.mycmed.2022.101333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 09/09/2022] [Accepted: 09/20/2022] [Indexed: 11/17/2022]
Abstract
Mali is a developing country facing several health challenges with a high rate of tuberculosis (TB) and a moderate HIV infection burden. Little is known or done about fungal diseases, yet they represent a significant public health problem in certain populations. The aim of this study was to estimate the national burden of fungal disease, and summarize data, diagnostic and treatment gaps. We used national demographics and PubMed searches to retrieve articles on published data on these infections and at-risk populations (pulmonary TB, HIV/AIDS patients, patients receiving critical care etc.) in Mali. The estimated Malian population was 21,251,000 in 2020 (UN), of which 45% were children <14 years. Among HIV patients, we estimate an annual incidence of 611 cryptococcosis, 1393 Pneumocystis pneumonia, 180 histoplasmosis and >5,700 esophageal candidiasis and some microsporidiosis cases. Our prevalence estimates for tinea capitis are 2.3 million, for recurrent vulvovaginal candidiasis 272,460, ∼60,000 fungal asthma and 7,290 cases of chronic pulmonary aspergillosis (often mistaken for TB). Less common acute fungal infections are probably invasive aspergillosis (n=1230), fungal keratitis (n=2820), candidaemia (>1,060) and mucormycosis (n=43). Histoplasmin was found in 6% in general population. A few cases of mycetoma are described in Mali. Many WHO Essential medicines and Diagnostics are not available in Mali. This shows a marked disparity in documented and estimated cases of fungal diseases in Mali. These infections are underestimated due to the lack of accurate diagnosis tools and lack of support for fungal diseases diagnosis and management.
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Affiliation(s)
- Safiatou Niaré Doumbo
- Department of epidemiology in parasitic diseases, University of Science, Techniques and Technologies of Bamako, Mali.
| | - Yacouba Cissoko
- Infectious disease and tropical medicine Unit, CHU Point G Bamako, Mali
| | - Souleymane Dama
- Department of epidemiology in parasitic diseases, University of Science, Techniques and Technologies of Bamako, Mali
| | - Amadou Niangaly
- Department of epidemiology in parasitic diseases, University of Science, Techniques and Technologies of Bamako, Mali
| | - Adam Garango
- Department of epidemiology in parasitic diseases, University of Science, Techniques and Technologies of Bamako, Mali
| | - Ahmed Konaté
- Department of epidemiology in parasitic diseases, University of Science, Techniques and Technologies of Bamako, Mali
| | - Abdoulaye Koné
- Department of epidemiology in parasitic diseases, University of Science, Techniques and Technologies of Bamako, Mali
| | - Boubacar Traoré
- Department of epidemiology in parasitic diseases, University of Science, Techniques and Technologies of Bamako, Mali
| | - Mahamadou Thera
- Department of epidemiology in parasitic diseases, University of Science, Techniques and Technologies of Bamako, Mali
| | - Abdoulaye Djimde
- Department of epidemiology in parasitic diseases, University of Science, Techniques and Technologies of Bamako, Mali
| | - David W Denning
- Manchester Fungal Infection Group, Core Technology Facility Grafton Street, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK; Global Action for Fungal Infections, Geneva, Switzerland
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Abdel Hamid MM, Abdelraheem MH, Acheampong DO, Ahouidi A, Ali M, Almagro-Garcia J, Amambua-Ngwa A, Amaratunga C, Amenga-Etego L, Andagalu B, Anderson T, Andrianaranjaka V, Aniebo I, Aninagyei E, Ansah F, Ansah PO, Apinjoh T, Arnaldo P, Ashley E, Auburn S, Awandare GA, Ba H, Baraka V, Barry A, Bejon P, Bertin GI, Boni MF, Borrmann S, Bousema T, Bouyou-Akotet M, Branch O, Bull PC, Cheah H, Chindavongsa K, Chookajorn T, Chotivanich K, Claessens A, Conway DJ, Corredor V, Courtier E, Craig A, D'Alessandro U, Dama S, Day N, Denis B, Dhorda M, Diakite M, Djimde A, Dolecek C, Dondorp A, Doumbia S, Drakeley C, Drury E, Duffy P, Echeverry DF, Egwang TG, Enosse SMM, Erko B, Fairhurst RM, Faiz A, Fanello CA, Fleharty M, Forbes M, Fukuda M, Gamboa D, Ghansah A, Golassa L, Goncalves S, Harrison GLA, Healy SA, Hendry JA, Hernandez-Koutoucheva A, Hien TT, Hill CA, Hombhanje F, Hott A, Htut Y, Hussein M, Imwong M, Ishengoma D, Jackson SA, Jacob CG, Jeans J, Johnson KJ, Kamaliddin C, Kamau E, Keatley J, Kochakarn T, Konate DS, Konaté A, Kone A, Kwiatkowski DP, Kyaw MP, Kyle D, Lawniczak M, Lee SK, Lemnge M, Lim P, Lon C, Loua KM, Mandara CI, Marfurt J, Marsh K, Maude RJ, Mayxay M, Maïga-Ascofaré O, Miotto O, Mita T, Mobegi V, Mohamed AO, Mokuolu OA, Montgomery J, Morang’a CM, Mueller I, Murie K, Newton PN, Ngo Duc T, Nguyen T, Nguyen TN, Nguyen Thi Kim T, Nguyen Van H, Noedl H, Nosten F, Noviyanti R, Ntui VNN, Nzila A, Ochola-Oyier LI, Ocholla H, Oduro A, Omedo I, Onyamboko MA, Ouedraogo JB, Oyebola K, Oyibo WA, Pearson R, Peshu N, Phyo AP, Plowe CV, Price RN, Pukrittayakamee S, Quang HH, Randrianarivelojosia M, Rayner JC, Ringwald P, Rosanas-Urgell A, Rovira-Vallbona E, Ruano-Rubio V, Ruiz L, Saunders D, Shayo A, Siba P, Simpson VJ, Sissoko MS, Smith C, Su XZ, Sutherland C, Takala-Harrison S, Talman A, Tavul L, Thanh NV, Thathy V, Thu AM, Toure M, Tshefu A, Verra F, Vinetz J, Wellems TE, Wendler J, White NJ, Whitton G, Yavo W, van der Pluijm RW. Pf7: an open dataset of Plasmodium falciparum genome variation in 20,000 worldwide samples. Wellcome Open Res 2023; 8:22. [PMID: 36864926 PMCID: PMC9971654 DOI: 10.12688/wellcomeopenres.18681.1] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2022] [Indexed: 01/18/2023] Open
Abstract
We describe the MalariaGEN Pf7 data resource, the seventh release of Plasmodium falciparum genome variation data from the MalariaGEN network. It comprises over 20,000 samples from 82 partner studies in 33 countries, including several malaria endemic regions that were previously underrepresented. For the first time we include dried blood spot samples that were sequenced after selective whole genome amplification, necessitating new methods to genotype copy number variations. We identify a large number of newly emerging crt mutations in parts of Southeast Asia, and show examples of heterogeneities in patterns of drug resistance within Africa and within the Indian subcontinent. We describe the profile of variations in the C-terminal of the csp gene and relate this to the sequence used in the RTS,S and R21 malaria vaccines. Pf7 provides high-quality data on genotype calls for 6 million SNPs and short indels, analysis of large deletions that cause failure of rapid diagnostic tests, and systematic characterisation of six major drug resistance loci, all of which can be freely downloaded from the MalariaGEN website.
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Affiliation(s)
| | | | - Mohamed Hassan Abdelraheem
- Institute of Endemic Diseases, University of Khartoum, Khartoum, Sudan
- Nuclear Applications In Biological Sciences, Sudan Atomic Energy Commission, Khartoum, Sudan
| | - Desmond Omane Acheampong
- Department of Biomedical Sciences, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Ambroise Ahouidi
- Health Research Epidemiological Surveillance and Training Institute (IRESSEF), Université Cheikh Anta Diop, Dakar, Senegal
| | - Mozam Ali
- Wellcome Sanger Institute, Hinxton, UK
| | | | - Alfred Amambua-Ngwa
- Wellcome Sanger Institute, Hinxton, UK
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Banjul, The Gambia
| | - Chanaki Amaratunga
- National Institute of Allergy and Infectious Diseases (NIAID), NIH, Maryland, USA
| | - Lucas Amenga-Etego
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), University of Ghana, Legon, Ghana
- Navrongo Health Research Centre, Ghana Health Service, Navrongo, Ghana
| | - Ben Andagalu
- United States Army Medical Research Directorate-Africa, Kenya Medical Research Institute/Walter Reed Project, Kisumu, Kenya
| | - Tim Anderson
- Texas Biomedical Research Institute, San Antonio, USA
| | | | | | - Enoch Aninagyei
- Department of Biomedical Sciences, School of Basic and Biomedical Sciences, University of Health & Allied Sciences, Ho, Ghana
| | - Felix Ansah
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), University of Ghana, Legon, Ghana
| | - Patrick O Ansah
- Navrongo Health Research Centre, Ghana Health Service, Navrongo, Ghana
| | | | - Paulo Arnaldo
- Instituto Nacional de Saúde (INS), Maputo, Mozambique
| | - Elizabeth Ashley
- Mahidol-Oxford Tropical Medicine Research Unit (MORU), Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
| | - Sarah Auburn
- Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
- Nuffield Department of Medicine, University of Oxford, UK
| | - Gordon A Awandare
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), University of Ghana, Legon, Ghana
| | - Hampate Ba
- Institut National de Recherche en Santé Publique, Nouakchott, Mauritania
| | - Vito Baraka
- National Institute for Medical Research (NIMR), Dar es Salaam, Tanzania
- Department of Epidemiology, International Health Unit, Universiteit Antwerpen, Antwerp, Belgium
| | - Alyssa Barry
- Walter and Eliza Hall Institute, Melbourne, Australia
- Deakin University, Geelong, Australia
- Burnet Institute, Melbourne, Australia
| | - Philip Bejon
- KEMRI Wellcome Trust Research Programme, Kilifi, Kenya
| | | | - Maciej F Boni
- Nuffield Department of Medicine, University of Oxford, UK
- Oxford University Clinical Research Unit (OUCRU), Ho Chi Minh City, Vietnam
| | - Steffen Borrmann
- Institute for Tropical Medicine, University of Tübingen, Tübingen, Germany
| | - Teun Bousema
- London School of Hygiene and Tropical Medicine, London, UK
- Radboud University Medical Center, Nijmegen, The Netherlands
| | - Marielle Bouyou-Akotet
- Department of Parasitology-Mycology, Université des Sciences de la Santé, Libreville, Gabon
| | - Oralee Branch
- NYU School of Medicine Langone Medical Center, New York, USA
| | - Peter C Bull
- KEMRI Wellcome Trust Research Programme, Kilifi, Kenya
- Department of Pathology, University of Cambridge, Cambridge, UK
| | - Huch Cheah
- National Center for Parasitology, Entomology and Malaria Control, Phnom Penh, Cambodia
| | | | | | | | - Antoine Claessens
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Banjul, The Gambia
- LPHI, MIVEGEC, INSERM, CNRS, IRD, University of Montpellier, Montpellier, France
| | - David J Conway
- London School of Hygiene and Tropical Medicine, London, UK
| | | | | | - Alister Craig
- Liverpool School of Tropical Medicine, Liverpool, UK
- Malawi-Liverpool-Wellcome Trust Clinical Research Program, Blantyre, Malawi
| | - Umberto D'Alessandro
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Banjul, The Gambia
| | - Souleymane Dama
- Malaria Research and Training Centre, University of Science, Techniques and Technologies of Bamako, Bamako, Mali
| | - Nicholas Day
- Mahidol-Oxford Tropical Medicine Research Unit (MORU), Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
| | - Brigitte Denis
- Malawi-Liverpool-Wellcome Trust Clinical Research Program, Blantyre, Malawi
| | - Mehul Dhorda
- Mahidol-Oxford Tropical Medicine Research Unit (MORU), Bangkok, Thailand
- WorldWide Antimalarial Resistance Network – Asia Regional Centre, Bangkok, Thailand
| | - Mahamadou Diakite
- Malaria Research and Training Centre, University of Science, Techniques and Technologies of Bamako, Bamako, Mali
- University Clinical Research Center (UCRC), Bamako, Mali
| | - Abdoulaye Djimde
- Malaria Research and Training Centre, University of Science, Techniques and Technologies of Bamako, Bamako, Mali
| | | | - Arjen Dondorp
- Mahidol-Oxford Tropical Medicine Research Unit (MORU), Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
| | - Seydou Doumbia
- Malaria Research and Training Centre, University of Science, Techniques and Technologies of Bamako, Bamako, Mali
- University Clinical Research Center (UCRC), Bamako, Mali
| | - Chris Drakeley
- London School of Hygiene and Tropical Medicine, London, UK
| | | | - Patrick Duffy
- National Institute of Allergy and Infectious Diseases (NIAID), NIH, Maryland, USA
| | - Diego F Echeverry
- Departamento de Microbiología, Universidad del Valle, Cali, Colombia
- Centro Internacional de Entrenamiento e Investigaciones Médicas - CIDEIM, Cali, Colombia
| | | | | | - Berhanu Erko
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | | | | | - Caterina A Fanello
- Mahidol-Oxford Tropical Medicine Research Unit (MORU), Bangkok, Thailand
| | - Mark Fleharty
- Broad Institute of Harvard and MIT and Harvard, Cambridge, MA, USA
| | | | - Mark Fukuda
- Department of Immunology and Medicine, US Army Medical Component, Armed Forces Research Institute of Medical Sciences (USAMC-AFRIMS), Bangkok, Thailand
| | - Dionicia Gamboa
- Laboratorio ICEMR-Amazonia, Laboratorios de Investigacion y Desarrollo, Facultad de Ciencias y Filosofia, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Anita Ghansah
- Nogouchi Memorial Institute for Medical Research, Legon-Accra, Ghana
| | - Lemu Golassa
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | | | | | - Sara Anne Healy
- National Institute of Allergy and Infectious Diseases (NIAID), NIH, Maryland, USA
| | - Jason A Hendry
- Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK
| | | | - Tran Tinh Hien
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
- Oxford University Clinical Research Unit (OUCRU), Ho Chi Minh City, Vietnam
| | - Catherine A Hill
- Department of Entomology, Purdue University, West Lafayette, USA
| | - Francis Hombhanje
- Centre for Health Research & Diagnostics, Divine Word University, Madang, Papua New Guinea
| | | | - Ye Htut
- Department of Medical Research, Yangon, Myanmar
| | - Mazza Hussein
- Institute of Endemic Diseases, University of Khartoum, Khartoum, Sudan
| | | | - Deus Ishengoma
- National Institute for Medical Research (NIMR), Dar es Salaam, Tanzania
- East African Consortium for Clinical Research (EACCR), Dar es Salaam, Tanzania
| | - Scott A Jackson
- Center for Applied Genetic Technologies, University of Georgia, Athens, GA, USA
| | | | | | | | - Claire Kamaliddin
- Institute of Research for Development (IRD), Paris, France
- The University of Calgary, Calgary, Canada
| | - Edwin Kamau
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | | | | | - Drissa S Konate
- Malaria Research and Training Centre, University of Science, Techniques and Technologies of Bamako, Bamako, Mali
| | | | - Aminatou Kone
- Malaria Research and Training Centre, University of Science, Techniques and Technologies of Bamako, Bamako, Mali
| | | | - Myat P Kyaw
- Myanmar Oxford Clinical Research Unit, University of Oxford, Yangon, Myanmar
- University of Public Health, Yangon, Myanmar
| | - Dennis Kyle
- University of South Florida, Tampa, USA
- University of Georgia, Athens, USA
| | | | - Samuel K Lee
- Broad Institute of Harvard and MIT and Harvard, Cambridge, MA, USA
| | - Martha Lemnge
- National Institute for Medical Research (NIMR), Dar es Salaam, Tanzania
| | - Pharath Lim
- National Institute of Allergy and Infectious Diseases (NIAID), NIH, Maryland, USA
- Medical Care Development International, Maryland, USA
| | - Chanthap Lon
- National Institute of Allergy and Infectious Diseases, Phnom Penh, Cambodia
| | - Kovana M Loua
- University Gamal Abdel Nasser of Conakry, Conakry, Guinea
- Institut National de Santé Publique, Conakry, Guinea
| | - Celine I Mandara
- National Institute for Medical Research (NIMR), Dar es Salaam, Tanzania
| | - Jutta Marfurt
- Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Kevin Marsh
- Nuffield Department of Medicine, University of Oxford, UK
- KEMRI Wellcome Trust Research Programme, Kilifi, Kenya
| | - Richard James Maude
- Mahidol-Oxford Tropical Medicine Research Unit (MORU), Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
- Harvard TH Chan School of Public Health, Harvard University, Boston, USA
| | - Mayfong Mayxay
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao People's Democratic Republic
- Institute of Research and Education Development (IRED), University of Health Sciences, Ministry of Health, Vientiane, Lao People's Democratic Republic
| | - Oumou Maïga-Ascofaré
- Malaria Research and Training Centre, University of Science, Techniques and Technologies of Bamako, Bamako, Mali
- Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
- Research in Tropical Medicine, Kwame Nkrumah University of Sciences and Technology, Kumasi, Ghana
| | - Olivo Miotto
- Wellcome Sanger Institute, Hinxton, UK
- Mahidol-Oxford Tropical Medicine Research Unit (MORU), Bangkok, Thailand
- MRC Centre for Genomics and Global Health, Big Data Institute, Oxford University, Oxford, UK
| | | | - Victor Mobegi
- Department of Biochemistry and Centre for Biotechnology and Bioinformatics, University of Nairobi, Nairobi, Kenya
| | | | - Olugbenga A Mokuolu
- Department of Paediatrics and Child Health, University of Ilorin, Ilorin, Nigeria
| | - Jaqui Montgomery
- Malawi-Liverpool-Wellcome Trust Clinical Research Program, Blantyre, Malawi
- World Mosquito Program, Monash University, Melbourne, Australia
| | - Collins Misita Morang’a
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), University of Ghana, Legon, Ghana
| | - Ivo Mueller
- Walter and Eliza Hall Institute, Melbourne, Australia
- University of Melbourne, Melbourne, Australia
| | | | - Paul N Newton
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao People's Democratic Republic
| | - Thang Ngo Duc
- National Institute of Malariology, Parasitology and Entomology (NIMPE), Hanoi, Vietnam
| | | | - Thuy-Nhien Nguyen
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
- Oxford University Clinical Research Unit (OUCRU), Ho Chi Minh City, Vietnam
| | | | - Hong Nguyen Van
- National Institute of Malariology, Parasitology and Entomology (NIMPE), Hanoi, Vietnam
| | - Harald Noedl
- MARIB - Malaria Research Initiative Bandarban, Bandarban, Bangladesh
- Medical University of Vienna, Vienna, Austria
| | - Francois Nosten
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
| | | | | | - Alexis Nzila
- King Fahid University of Petroleum and Minerals (KFUMP), Dhahran, Saudi Arabia
| | | | - Harold Ocholla
- KEMRI Centres for Disease Control and Prevention (CDC) Research Program, Kisumu, Kenya
- Centre for Bioinformatics and Biotechnology, University of Nairobi, Nairobi, Kenya
| | - Abraham Oduro
- Navrongo Health Research Centre, Ghana Health Service, Navrongo, Ghana
| | - Irene Omedo
- Wellcome Sanger Institute, Hinxton, UK
- KEMRI Wellcome Trust Research Programme, Kilifi, Kenya
| | - Marie A Onyamboko
- Kinshasa School of Public Health, University of Kinshasa, Kinshasa, Congo, Democratic Republic
| | | | - Kolapo Oyebola
- Nigerian Institute of Medical Research, Lagos, Nigeria
- Parasitology and Bioinformatics Unit, Faculty of Science, University of Lagos, Lagos, Nigeria
| | | | | | - Norbert Peshu
- KEMRI Wellcome Trust Research Programme, Kilifi, Kenya
| | - Aung P Phyo
- Mahidol-Oxford Tropical Medicine Research Unit (MORU), Bangkok, Thailand
- Shoklo Malaria Research Unit, Bangkok, Thailand
| | | | - Ric N Price
- Mahidol-Oxford Tropical Medicine Research Unit (MORU), Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
- Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | | | - Huynh Hong Quang
- Institute of Malariology, Parasitology, and Entomology (IMPE) Quy Nhon, Ministry of Health, Quy Nhon, Vietnam
| | - Milijaona Randrianarivelojosia
- Institut Pasteur de Madagascar, Antananarivo, Madagascar
- Universités d'Antananarivo et de Mahajanga, Antananarivo, Madagascar
| | - Julian C Rayner
- Cambridge Institute for Medical Research, University of Cambridge, Cambridge, UK
| | | | | | | | | | - Lastenia Ruiz
- Universidad Nacional de la Amazonia Peruana, Iquitos, Peru
| | - David Saunders
- Department of Medicine, Uniformed Services University, Bethesda, MD, USA
| | - Alex Shayo
- Nelson Mandela Institute of Science and Technology, Arusha, Tanzania
| | - Peter Siba
- Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea
| | | | - Mahamadou S. Sissoko
- Malaria Research and Training Centre, University of Science, Techniques and Technologies of Bamako, Bamako, Mali
| | | | - Xin-zhuan Su
- National Institute of Allergy and Infectious Diseases (NIAID), NIH, Maryland, USA
| | | | - Shannon Takala-Harrison
- Center for Vaccine Development and Global Health, University of Maryland, School of Medicine, Baltimore, MD, USA
| | - Arthur Talman
- MIVEGEC, Université de Montpellier, IRD, CNRS, Montpellier, France
| | - Livingstone Tavul
- Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea
| | - Ngo Viet Thanh
- Oxford University Clinical Research Unit (OUCRU), Ho Chi Minh City, Vietnam
| | - Vandana Thathy
- KEMRI Wellcome Trust Research Programme, Kilifi, Kenya
- Department of Microbiology and Immunology, Columbia University Irving Medical Center, New York, NY, USA
| | - Aung Myint Thu
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
| | - Mahamoudou Toure
- Malaria Research and Training Centre, University of Science, Techniques and Technologies of Bamako, Bamako, Mali
| | | | | | - Joseph Vinetz
- Laboratorio ICEMR-Amazonia, Laboratorios de Investigacion y Desarrollo, Facultad de Ciencias y Filosofia, Universidad Peruana Cayetano Heredia, Lima, Peru
- Yale School of Medicine, New Haven, CT, USA
| | - Thomas E Wellems
- National Institute of Allergy and Infectious Diseases (NIAID), NIH, Maryland, USA
| | - Jason Wendler
- National Institute of Allergy and Infectious Diseases (NIAID), NIH, Maryland, USA
- Seattle Children’s Hospital, Seattle, USA
| | - Nicholas J White
- Mahidol-Oxford Tropical Medicine Research Unit (MORU), Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
| | | | - William Yavo
- University Félix Houphouët-Boigny, Abidjan, Cote d'Ivoire
- Malaria Research and Control Center of the National Institute of Public Health, Abidjan, Cote d'Ivoire
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Coulibaly A, Diop MF, Kone A, Dara A, Ouattara A, Mulder N, Miotto O, Diakite M, Djimde A, Amambua-Ngwa A. Genome-wide SNP analysis of Plasmodium falciparum shows differentiation at drug-resistance-associated loci among malaria transmission settings in southern Mali. Front Genet 2022; 13:943445. [PMID: 36267403 PMCID: PMC9576839 DOI: 10.3389/fgene.2022.943445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 08/26/2022] [Indexed: 11/15/2022] Open
Abstract
Plasmodium falciparum malaria cases in Africa represent over 90% of the global burden with Mali being amongst the 11 highest burden countries that account for 70% of this annual incidence. The persistence of P. falciparum despite massive global interventions is because of its genetic diversity that drives its ability to adapt to environmental changes, develop resistance to drugs, and evade the host immune system. Knowledge on P. falciparum genetic diversity across populations and intervention landscape is thus critical for the implementation of new strategies to eliminate malaria. This study assessed genetic variation with 12,177 high-quality SNPs from 830 Malian P. falciparum isolates collected between 2007 and 2017 from seven locations. The complexity of infections remained high, varied between sites, and showed a trend toward overall decreasing complexity over the decade. Though there was no significant substructure, allele frequencies varied geographically, partly driven by temporal variance in sampling, particularly for drug resistance and antigen loci. Thirty-two mutations in known drug resistance markers (pfcrt, pfdhps, pfdhfr, pfmdr1, pfmdr2, and pfk13) attained a frequency of at least 2% in the populations. SNPs within and around the major markers of resistance to quinolines (pfmdr1 and pfcrt) and antifolates (pfdhfr and pfdhps) varied temporally and geographically, with strong linkage disequilibrium and signatures of directional selection in the genome. These geo-temporal populations also differentiated at alleles in immune-related loci, including, protein E140, pfsurfin8, pfclag8, and pfceltos, as well as pftrap, which showed signatures of haplotype differentiation between populations. Several regions across the genomes, including five known drug resistance loci, showed signatures of differential positive selection. These results suggest that drugs and immune pressure are dominant selective forces against P. falciparum in Mali, but their effect on the parasite genome varies temporally and spatially. Interventions interacting with these genomic variants need to be routinely evaluated as malaria elimination strategies are implemented.
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Affiliation(s)
- Aoua Coulibaly
- Malaria Research and Training Center, University of Science, Techniques, and Technologies of Bamako, Bamako, Mali
- Computational Biology Division, University of Cape Town, Cape Town, South Africa
| | - Mouhamadou Fadel Diop
- Disease Control and Elimination, Medical Research Council Unit The Gambia at LSHTM, Banjul, Gambia
| | - Aminatou Kone
- Malaria Research and Training Center, University of Science, Techniques, and Technologies of Bamako, Bamako, Mali
| | - Antoine Dara
- Malaria Research and Training Center, University of Science, Techniques, and Technologies of Bamako, Bamako, Mali
| | - Amed Ouattara
- Malaria Research and Training Center, University of Science, Techniques, and Technologies of Bamako, Bamako, Mali
- University of Maryland Baltimore, Baltimore, MD, United States
| | - Nicola Mulder
- Computational Biology Division, University of Cape Town, Cape Town, South Africa
| | - Olivo Miotto
- Mahidol Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand
| | - Mahamadou Diakite
- Malaria Research and Training Center, University of Science, Techniques, and Technologies of Bamako, Bamako, Mali
| | - Abdoulaye Djimde
- Malaria Research and Training Center, University of Science, Techniques, and Technologies of Bamako, Bamako, Mali
| | - Alfred Amambua-Ngwa
- Disease Control and Elimination, Medical Research Council Unit The Gambia at LSHTM, Banjul, Gambia
- *Correspondence: Alfred Amambua-Ngwa,
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8
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Sagara I, Zongo I, Cairns M, Yerbanga RS, Mahamar A, Nikièma F, Tapily A, Sompougdou F, Diarra M, Zoungrana C, Issiaka D, Haro A, Sanogo K, Aziz Sienou A, Kaya M, Traore S, Thera I, Diarra K, Dolo A, Kuepfer I, Snell P, Milligan P, Ockenhouse C, Ofori-Anyinam O, Tinto H, Djimde A, Ouedraogo JB, Dicko A, Chandramohan D, Greenwood B. The Anti-Circumsporozoite Antibody Response of Children to Seasonal Vaccination With the RTS,S/AS01E Malaria Vaccine. Clin Infect Dis 2022; 75:613-622. [PMID: 34894221 PMCID: PMC9464075 DOI: 10.1093/cid/ciab1017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND A trial in African children showed that combining seasonal vaccination with the RTS,S/AS01E vaccine with seasonal malaria chemoprevention reduced the incidence of uncomplicated and severe malaria compared with either intervention given alone. Here, we report on the anti-circumsporozoite antibody response to seasonal RTS,S/AS01E vaccination in children in this trial. METHODS Sera from a randomly selected subset of children collected before and 1 month after 3 priming doses of RTS,S/AS01E and before and 1 month after 2 seasonal booster doses were tested for anti-circumsporozoite antibodies using enzyme-linked immunosorbent assay. The association between post-vaccination antibody titer and incidence of malaria was explored. RESULTS A strong anti-circumsporozoite antibody response to 3 priming doses of RTS,S/AS01E was seen (geometric mean titer, 368.9 enzyme-linked immunosorbent assay units/mL), but titers fell prior to the first booster dose. A strong antibody response to an annual, pre-malaria transmission season booster dose was observed, but this was lower than after the primary vaccination series and lower after the second than after the first booster dose (ratio of geometric mean rise, 0.66; 95% confidence interval [CI], .57-.77). Children whose antibody response was in the upper tercile post-vaccination had a lower incidence of malaria during the following year than children in the lowest tercile (hazard ratio, 0.43; 95% CI, .28-.66). CONCLUSIONS Seasonal vaccination with RTS,S/AS01E induced a strong booster antibody response that was lower after the second than after the first booster dose. The diminished antibody response to the second booster dose was not associated with diminished efficacy. CLINICAL TRIALS REGISTRATION NCT03143218.
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Affiliation(s)
| | | | - Matthew Cairns
- London School of Hygiene & Tropical Medicine, London, United Kingdom
| | | | - Almahamoudou Mahamar
- The Malaria Research and Training Center, University of Sciences, Techniques and Technologies, Bamako, Mali
| | - Frédéric Nikièma
- Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso
| | - Amadou Tapily
- The Malaria Research and Training Center, University of Sciences, Techniques and Technologies, Bamako, Mali
| | | | - Modibo Diarra
- The Malaria Research and Training Center, University of Sciences, Techniques and Technologies, Bamako, Mali
| | - Charles Zoungrana
- Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso
| | - Djibrilla Issiaka
- The Malaria Research and Training Center, University of Sciences, Techniques and Technologies, Bamako, Mali
| | - Alassane Haro
- Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso
| | - Koualy Sanogo
- The Malaria Research and Training Center, University of Sciences, Techniques and Technologies, Bamako, Mali
| | - Abdoul Aziz Sienou
- Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso
| | - Mahamadou Kaya
- The Malaria Research and Training Center, University of Sciences, Techniques and Technologies, Bamako, Mali
| | - Seydou Traore
- The Malaria Research and Training Center, University of Sciences, Techniques and Technologies, Bamako, Mali
| | - Ismaila Thera
- The Malaria Research and Training Center, University of Sciences, Techniques and Technologies, Bamako, Mali
| | - Kalifa Diarra
- The Malaria Research and Training Center, University of Sciences, Techniques and Technologies, Bamako, Mali
| | - Amagana Dolo
- The Malaria Research and Training Center, University of Sciences, Techniques and Technologies, Bamako, Mali
| | - Irene Kuepfer
- London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Paul Snell
- London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Paul Milligan
- London School of Hygiene & Tropical Medicine, London, United Kingdom
| | | | | | - Halidou Tinto
- Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso
| | - Abdoulaye Djimde
- The Malaria Research and Training Center, University of Sciences, Techniques and Technologies, Bamako, Mali
| | | | - Alassane Dicko
- The Malaria Research and Training Center, University of Sciences, Techniques and Technologies, Bamako, Mali
| | | | - Brian Greenwood
- Correspondence: B. Greenwood, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, Keppel St., London WC1E 7HT, UK ()
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9
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Sokhna C, Brah S, Djimde A, Mouffok N, Zahraoui M, Ould Mohamed Salem Boukhary A, Bitam I, Cisse B, Thera M, Lekana-Douki JB, Adehossi E, Seydi M, Akiana J, Heikel J, Lagier JC, Mboup S, Mouyembe-Tamfum JJ, Parola P. COVID-19 in africa: what else? New Microbes New Infect 2022; 47:100982. [PMID: 35573042 PMCID: PMC9081042 DOI: 10.1016/j.nmni.2022.100982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 04/29/2022] [Accepted: 05/02/2022] [Indexed: 11/15/2022] Open
Affiliation(s)
- C. Sokhna
- VITROME, Campus International IRD-UCAD, Dakar, Senegal
| | - S. Brah
- Service de Médecine Interne, Hôpital Général de Référence, Niamey, Niger
| | - A. Djimde
- Malaria Research and Training Center, University of Science, Techniques and Technologies of Bamako, Bamako, Mali
| | - N. Mouffok
- Service des Maladies Infectieuses, Centre Hospitalier Universitaire, Oran, Algeria
| | - M. Zahraoui
- Service de Médecine Interne, Clinique De Vinci, Casablanca, Morocco
| | | | - I. Bitam
- Ecole Supérieure en Sciences de L'Aliment et des Industries Agroalimentaire, Direction Générale de La Recherche Scientifique et Développement Technologique, Ministère de L'enseignement Supérieur et de La Recherche Scientifique, Alger, Algeria
| | - B. Cisse
- Institut de Recherche en Santé, de Surveillance Epidemiologique et de Formation (IRESSEF), Dakar, Senegal
| | - M.A. Thera
- Malaria Research and Training Center, University of Science, Techniques and Technologies of Bamako, Bamako, Mali
| | - J.-B. Lekana-Douki
- Département de Parasitologie-Mycologie, Université des Sciences de La Santé (USS) Libreville, UNEEREP-CIRMF, Franceville, Gabon
| | | | - M. Seydi
- Service de Maladies Infectieuses et Tropicale, Centre Hospitalier Universitaire de Fann, Université Cheikh Anta Diop, Dakar, Senegal
| | - J. Akiana
- Faculté des Sciences et Techniques/Université Marien NGOUABI de Brazzaville, Democratic Republic of the Congo
| | - J. Heikel
- Service de Médecine Interne, Clinique De Vinci, Casablanca, Morocco
| | - J.-C. Lagier
- University Hospital Institute IHU-Méditerranée Infection, Marseille, France
- Aix Marseille Univ, IRD, AP-HM, MEPHI, Marseille, France
| | - S. Mboup
- Institut de Recherche en Santé, de Surveillance Epidemiologique et de Formation (IRESSEF), Dakar, Senegal
| | - J.-J. Mouyembe-Tamfum
- Département de Microbiologie, Faculté de Médecine, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - P. Parola
- University Hospital Institute IHU-Méditerranée Infection, Marseille, France
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France
- Corresponding author: Philippe Parola, University Hospital Institute IHU-Méditerranée Infection, Marseille, France.
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10
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Rosenthal PJ, Björkman A, Dhorda M, Djimde A, Dondorp AM, Gaye O, Guerin PJ, Juma E, Kwiatkowski DP, Merson L, Ntoumi F, Price RN, Raman J, Roos DS, ter Kuile F, Tinto H, Tomko SS, White NJ, Barnes KI. Cooperation in Countering Artemisinin Resistance in Africa: Learning from COVID-19. Am J Trop Med Hyg 2022; 106:tpmd220148. [PMID: 35413688 PMCID: PMC9209939 DOI: 10.4269/ajtmh.22-0148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 03/05/2022] [Indexed: 01/13/2023] Open
Affiliation(s)
| | - Anders Björkman
- Malaria Group, University of Karolinska Institutet, Stockholm, Sweden
| | - Mehul Dhorda
- Mahidol Oxford Tropical Medicine Research Unit, Bangkok, Thailand
| | - Abdoulaye Djimde
- Malaria Research and Training Centre, University of Science, Techniques and Technologies, Bamako, Mali
| | - Arjen M. Dondorp
- Mahidol Oxford Tropical Medicine Research Unit, Bangkok, Thailand
| | - Oumar Gaye
- Department of Medical Parasitology, Faculty of Medicine, Pharmacy and Dentistry, L’Université Cheikh Anta Diop, Dakar, Senegal
| | - Philippe J. Guerin
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
- WorldWide Antimalarial Resistance Network and Infectious Diseases Data Observatory, Oxford University, Oxford, United Kingdom
| | - Elizabeth Juma
- World Health Organization African Regional Office, Accra, Ghana
| | | | - Laura Merson
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
- WorldWide Antimalarial Resistance Network and Infectious Diseases Data Observatory, Oxford University, Oxford, United Kingdom
| | - Francine Ntoumi
- Fondation Congolaise pour la Recherche Médicale, Brazzaville, Republic of the Congo
- Institute for Tropical Medicine, University of Tübingen, Tübingen, Germany
| | - Ric N. Price
- Mahidol Oxford Tropical Medicine Research Unit, Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
- WorldWide Antimalarial Resistance Network and Infectious Diseases Data Observatory, Oxford University, Oxford, United Kingdom
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Jaishree Raman
- South African National Institute for Communicable Diseases, Johannesburg, South Africa
- Wits Research Institute for Malaria, School of Pathology, University of Witwatersrand, Johannesburg, South Africa
| | - David S. Roos
- University of Pennsylvania, Philadelphia, Pennsylvania
| | - Feiko ter Kuile
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
- Kenya Medical Research Institute, Centre for Global Health Research, Kisumu, Kenya
| | - Halidou Tinto
- Institut de Recherche en Sciences de la Santé, Nanoro, Burkina Faso
| | | | | | - Karen I. Barnes
- Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa
- WorldWide Antimalarial Resistance Network, Pharmacology Scientific Module, Department of Medicine, University of Cape Town, Cape Town, South Africa
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11
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Bassat Q, Maïga-Ascofaré O, May J, Clain J, Mombo-Ngoma G, Groger M, Adegnika AA, Agobé JCD, Djimde A, Mischlinger J, Ramharter M. Challenges in the clinical development pathway for triple and multiple drug combinations in the treatment of uncomplicated falciparum malaria. Malar J 2022; 21:61. [PMID: 35193586 PMCID: PMC8864855 DOI: 10.1186/s12936-022-04079-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 02/06/2022] [Indexed: 11/23/2022] Open
Abstract
The addition of a third anti-malarial drug matching the pharmacokinetic characteristics of the slowly eliminated partner drug in artemisinin-based combination therapy (ACT) has been proposed as new therapeutic paradigm for the treatment of uncomplicated falciparum malaria. These triple artemisinin-based combination therapy (TACT) should in theory more effectively prevent the development and spread of multidrug resistance than current ACT. Several clinical trials evaluating TACT—or other multidrug anti-malarial combination therapy (MDACT)—have been reported and more are underway. From a regulatory perspective, these clinical development programmes face a strategic dilemma: pivotal clinical trials evaluating TACT are designed to test for non-inferiority of efficacy compared to standard ACT as primary endpoint. While meeting the endpoint of non-inferior efficacy, TACT are consistently associated with a slightly higher frequency of adverse drug reactions than currently used ACT. Moreover, the prevention of the selection of specific drug resistance—one of the main reasons for TACT development—is beyond the scope of even large-scale clinical trials. This raises important questions: if equal efficacy is combined with poorer tolerability, how can then the actual benefit of these drug combinations be demonstrated? How should clinical development plans be conceived to provide objective evidence for or against an improved management of patients and effective prevention of anti-malarial drug resistance by TACT? What are the objective criteria to ultimately convince regulators to approve these new products? In this Opinion paper, the authors discuss the challenges for the clinical development of triple and multidrug anti-malarial combination therapies and the hard choices that need to be taken in the further clinical evaluation and future implementation of this new treatment paradigm.
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Affiliation(s)
- Quique Bassat
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain.,Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique.,ICREA, Passeig de Lluís Companys 23, 08010, Barcelona, Spain.,Pediatrics Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Esplugues, Barcelona, Spain.,Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Oumou Maïga-Ascofaré
- Kumasi Center for Collaborative Research, Kumasi, Ghana.,Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany.,German Center for Infection Research, Partner Site Hamburg- Lübeck-Borstel-Riems, Hamburg- Lübeck-Borstel-Riems, Germany
| | - Jürgen May
- Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany.,German Center for Infection Research, Partner Site Hamburg- Lübeck-Borstel-Riems, Hamburg- Lübeck-Borstel-Riems, Germany
| | - Jerôme Clain
- Université de Paris, Centre National de Référence du Paludisme, Hôpital Bichat- Claude Bernard, Assistance Publique des Hôpitaux de Paris, Paris, France
| | - Ghyslain Mombo-Ngoma
- Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany.,German Center for Infection Research, Partner Site Hamburg- Lübeck-Borstel-Riems, Hamburg- Lübeck-Borstel-Riems, Germany.,Centre de Recherches de Lambaréné, Lambaréné, Gabon
| | - Mirjam Groger
- Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany.,German Center for Infection Research, Partner Site Hamburg- Lübeck-Borstel-Riems, Hamburg- Lübeck-Borstel-Riems, Germany
| | - Ayôla A Adegnika
- Centre de Recherches de Lambaréné, Lambaréné, Gabon.,Institute for Tropical Medicine, University of Tübingen, Tübingen, Germany
| | | | - Abdoulaye Djimde
- Malaria Research and Training Centre (MRTC), Faculty of Pharmacy, Université des Sciences, des Techniques et des Technologies de Bamako (USTTB), Bamako, Mali
| | - Johannes Mischlinger
- Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany.,German Center for Infection Research, Partner Site Hamburg- Lübeck-Borstel-Riems, Hamburg- Lübeck-Borstel-Riems, Germany
| | - Michael Ramharter
- Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany. .,German Center for Infection Research, Partner Site Hamburg- Lübeck-Borstel-Riems, Hamburg- Lübeck-Borstel-Riems, Germany. .,Centre de Recherches de Lambaréné, Lambaréné, Gabon.
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12
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Grant J, Sagara I, Zongo I, Cairns M, Yerbanga RS, Diarra M, Zoungrana C, Issiaka D, Nikièma F, Sompougdou F, Tapily A, Kaya M, Haro A, Sanogo K, Sienou AA, Traore S, Thera I, Yalcouye H, Kuepfer I, Snell P, Milligan P, Ockenhouse C, Ofori-Anyinam O, Tinto H, Djimde A, Chandramohan D, Greenwood B, Dicko A, Ouédraogo JB. Impact of seasonal RTS,S/AS01 E vaccination plus seasonal malaria chemoprevention on the nutritional status of children in Burkina Faso and Mali. Malar J 2022; 21:59. [PMID: 35193608 PMCID: PMC8864823 DOI: 10.1186/s12936-022-04077-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 02/06/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A recent trial in Burkina Faso and Mali showed that combining seasonal RTS,S/AS01E malaria vaccination with seasonal malaria chemoprevention (SMC) substantially reduced the incidence of uncomplicated and severe malaria in young children compared to either intervention alone. Given the possible negative effect of malaria on nutrition, the study investigated whether these children also experienced lower prevalence of acute and chronic malnutrition. METHODS In Burkina Faso and Mali 5920 children were randomized to receive either SMC alone, RTS,S/AS01E alone, or SMC combined with RTS,S/AS01E for three malaria transmission seasons (2017-2019). After each transmission season, anthropometric measurements were collected from all study children at a cross-sectional survey and used to derive nutritional status indicators, including the binary variables wasted and stunted (weight-for-height and height-for-age z-scores below - 2, respectively). Binary and continuous outcomes between treatment groups were compared by Poisson and linear regression. RESULTS In 2017, compared to SMC alone, the combined intervention reduced the prevalence of wasting by approximately 12% [prevalence ratio (PR) = 0.88 (95% CI 0.75, 1.03)], and approximately 21% in 2018 [PR = 0.79 (95% CI 0.62, 1.01)]. Point estimates were similar for comparisons with RTS,S/AS01E, but there was stronger evidence of a difference. There was at least a 30% reduction in the point estimates for the prevalence of severe wasting in the combined group compared to the other two groups in 2017 and 2018. There was no difference in the prevalence of moderate or severe wasting between the groups in 2019. The prevalence of stunting, low-MUAC-for-age or being underweight did not differ between groups for any of the three years. The prevalence of severe stunting was higher in the combined group compared to both other groups in 2018, and compared to RTS,S/AS01E alone in 2017; this observation does not have an obvious explanation and may be a chance finding. Overall, malnutrition was very common in this cohort, but declined over the study as the children became older. CONCLUSIONS Despite a high burden of malnutrition and malaria in the study populations, and a major reduction in the incidence of malaria in children receiving both interventions, this had only a modest impact on nutritional status. Therefore, other interventions are needed to reduce the high burden of malnutrition in these areas. TRIAL REGISTRATION https://www.clinicaltrials.gov/ct2/show/NCT03143218 , registered 8th May 2017.
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Affiliation(s)
- Jane Grant
- London School of Hygiene and Tropical Medicine, Keppel St., London, WC1E 7HT, UK.
| | - Issaka Sagara
- Malaria Research and Training Center, University of Science, Techniques, and Technologies of Bamako, Bamako, Mali
| | - Issaka Zongo
- Institut de Recherche en Sciences de La Santé, Bobo-Dioulasso, Burkina Faso
| | - Matthew Cairns
- London School of Hygiene and Tropical Medicine, Keppel St., London, WC1E 7HT, UK
| | | | - Modibo Diarra
- Malaria Research and Training Center, University of Science, Techniques, and Technologies of Bamako, Bamako, Mali
| | - Charles Zoungrana
- Institut de Recherche en Sciences de La Santé, Bobo-Dioulasso, Burkina Faso
| | - Djibrilla Issiaka
- Malaria Research and Training Center, University of Science, Techniques, and Technologies of Bamako, Bamako, Mali
| | - Frédéric Nikièma
- Institut de Recherche en Sciences de La Santé, Bobo-Dioulasso, Burkina Faso
| | | | - Amadou Tapily
- Malaria Research and Training Center, University of Science, Techniques, and Technologies of Bamako, Bamako, Mali
| | - Mahamadou Kaya
- Malaria Research and Training Center, University of Science, Techniques, and Technologies of Bamako, Bamako, Mali
| | - Alassane Haro
- Institut de Recherche en Sciences de La Santé, Bobo-Dioulasso, Burkina Faso
| | - Koualy Sanogo
- Malaria Research and Training Center, University of Science, Techniques, and Technologies of Bamako, Bamako, Mali
| | - Abdoul Aziz Sienou
- Institut de Recherche en Sciences de La Santé, Bobo-Dioulasso, Burkina Faso
| | - Seydou Traore
- Malaria Research and Training Center, University of Science, Techniques, and Technologies of Bamako, Bamako, Mali
| | - Ismaila Thera
- Malaria Research and Training Center, University of Science, Techniques, and Technologies of Bamako, Bamako, Mali
| | - Hama Yalcouye
- Malaria Research and Training Center, University of Science, Techniques, and Technologies of Bamako, Bamako, Mali
| | - Irene Kuepfer
- London School of Hygiene and Tropical Medicine, Keppel St., London, WC1E 7HT, UK
| | - Paul Snell
- London School of Hygiene and Tropical Medicine, Keppel St., London, WC1E 7HT, UK
| | - Paul Milligan
- London School of Hygiene and Tropical Medicine, Keppel St., London, WC1E 7HT, UK
| | | | | | - Halidou Tinto
- Institut de Recherche en Sciences de La Santé, Bobo-Dioulasso, Burkina Faso
| | - Abdoulaye Djimde
- Malaria Research and Training Center, University of Science, Techniques, and Technologies of Bamako, Bamako, Mali
| | - Daniel Chandramohan
- London School of Hygiene and Tropical Medicine, Keppel St., London, WC1E 7HT, UK
| | - Brian Greenwood
- London School of Hygiene and Tropical Medicine, Keppel St., London, WC1E 7HT, UK
| | - Alassane Dicko
- Malaria Research and Training Center, University of Science, Techniques, and Technologies of Bamako, Bamako, Mali
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13
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Mahamar A, Sumner KM, Levitt B, Freedman B, Traore A, Barry A, Issiaka D, Dembele AB, Kanoute MB, Attaher O, Diarra BN, Sagara I, Djimde A, Duffy PE, Fried M, Taylor SM, Dicko A. Effect of three years' seasonal malaria chemoprevention on molecular markers of resistance of Plasmodium falciparum to sulfadoxine-pyrimethamine and amodiaquine in Ouelessebougou, Mali. Malar J 2022; 21:39. [PMID: 35135546 PMCID: PMC8822718 DOI: 10.1186/s12936-022-04059-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 01/21/2022] [Indexed: 11/11/2022] Open
Abstract
Background In 2012, seasonal malaria chemoprevention (SMC) was recommended as policy for malaria control by the World Health Organization (WHO) in areas of highly seasonal malaria transmission across the Sahel sub-region in Africa along with monitoring of drug resistance. We assessed the long-term impact of SMC on Plasmodium falciparum resistance to sulfadoxine-pyrimethamine (SP) and amodiaquine (AQ) over a 3-year period of SMC implementation in the health district of Ouelessebougou, Mali. Methods In 8 randomly selected sub-districts of Ouelessebougou, Mali, children aged 0–5 years were randomly selected during cross-sectional surveys at baseline (August 2014) and 1, 2 and 3 years post-SMC, at the beginning and end of the malaria transmission season. Blood smears and blood spots on filter paper were obtained and frequencies of mutation in P. falciparum genes related to resistance to SP and AQ (Pfdhfr, Pfdhps, Pfmdr1, and Pfcrt) were assessed by PCR amplification on individual samples and PCR amplification followed by deep sequencing on pooled (by site and year) samples. Results At each survey, approximately 50–100 individual samples were analysed by PCR amplification and a total of 1,164 samples were analysed by deep sequencing with an average read depth of 18,018–36,918 after pooling by site and year. Most molecular markers of resistance did not increase in frequency over the period of study (2014–2016). After 3 years of SMC, the frequencies of Pfdhps 540E, Pfdhps 437G and Pfcrt K76T remained similar compared to baseline (4.0 vs 1.4%, p = 0.41; 74.5 vs 64.6%, p = 0.22; 71.3 vs 67.4%, p = 0.69). Nearly all samples tested carried Pfdhfr 59R, and this proportion remained similar 3 years after SMC implementation (98.8 vs 100%, p = 1). The frequency of Pfmdr1 N86Y increased significantly over time from 5.6% at baseline to 18.6% after 3 years of SMC (p = 0.016). Results of pooled analysis using deep sequencing were consistent with those by individual analysis with standard PCR, but also indicated for the first time the presence of mutations at the Pfdhps A581G allele at a frequency of 11.7% after 2 years of SMC, as well as the Pfdhps I431V allele at frequencies of 1.6–9.3% following 1 and 2 years of SMC, respectively. Conclusion Two and 3 years of SMC implementation were associated with increased frequency of the Pfmdr1 N86Y mutation but not Pfdhps 540E, Pfdhps 437G and Pfcrt K76T. The first-time detection of the Pfdhps haplotype bearing the I431V and A581G mutations in Mali, even at low frequency, warrants further long-term surveillance.
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Affiliation(s)
- Almahamoudou Mahamar
- Malaria Research & Training Center, Faculty of Medicine, Pharmacy and Dentistry, University of Science, Techniques and Technologies (USTT), Bamako, Mali.
| | - Kelsey M Sumner
- Division of Infectious Diseases, Duke University Medical Center, Durham, NC, USA.,Department of Epidemiology, UNC Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Brandt Levitt
- Division of Infectious Diseases, Duke University Medical Center, Durham, NC, USA
| | - Betsy Freedman
- Division of Infectious Diseases, Duke University Medical Center, Durham, NC, USA
| | - Aliou Traore
- Malaria Research & Training Center, Faculty of Medicine, Pharmacy and Dentistry, University of Science, Techniques and Technologies (USTT), Bamako, Mali
| | - Amadou Barry
- Malaria Research & Training Center, Faculty of Medicine, Pharmacy and Dentistry, University of Science, Techniques and Technologies (USTT), Bamako, Mali
| | - Djibrilla Issiaka
- Malaria Research & Training Center, Faculty of Medicine, Pharmacy and Dentistry, University of Science, Techniques and Technologies (USTT), Bamako, Mali
| | - Adama B Dembele
- Malaria Research & Training Center, Faculty of Medicine, Pharmacy and Dentistry, University of Science, Techniques and Technologies (USTT), Bamako, Mali
| | - Moussa B Kanoute
- Malaria Research & Training Center, Faculty of Medicine, Pharmacy and Dentistry, University of Science, Techniques and Technologies (USTT), Bamako, Mali
| | - Oumar Attaher
- Malaria Research & Training Center, Faculty of Medicine, Pharmacy and Dentistry, University of Science, Techniques and Technologies (USTT), Bamako, Mali
| | | | - Issaka Sagara
- Malaria Research & Training Center, Faculty of Medicine, Pharmacy and Dentistry, University of Science, Techniques and Technologies (USTT), Bamako, Mali
| | - Abdoulaye Djimde
- Malaria Research & Training Center, Faculty of Medicine, Pharmacy and Dentistry, University of Science, Techniques and Technologies (USTT), Bamako, Mali
| | - Patrick E Duffy
- Laboratory of Malaria Immunology and Vaccinology (LMIV), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Bethesda, MD, USA
| | - Michal Fried
- Laboratory of Malaria Immunology and Vaccinology (LMIV), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Bethesda, MD, USA
| | - Steve M Taylor
- Division of Infectious Diseases, Duke University Medical Center, Durham, NC, USA.,Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Alassane Dicko
- Malaria Research & Training Center, Faculty of Medicine, Pharmacy and Dentistry, University of Science, Techniques and Technologies (USTT), Bamako, Mali
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14
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Doumbo SN, Dara NJ, Bamadio A, Zeguime A, Diarra N, Garango A, Diarra B, Konaté A, Koné A, Tegueté I, Traoré B, Djimde A, Thera MA. [Epidemiological and etiological profile of vulvovaginal candidiasis in women in consultation in the gynecology-obstetrics department, CHU Gabriel Toure, Bamako - Mali]. Mali Med 2022; 37:35-39. [PMID: 38514949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
Vulvovaginal candidiasis (VVC) is a fungal infection caused by yeasts of the genus Candida that leads to vulvar pruritus and vaginal discharge. METHOD In order to evaluate the epidemiological and etiological Profile of vvc, we carried out a cross-sectional study among women in consultation in the gynecological department of the CHU-Gabriel Toure in Bamako. Two swabs were taken from each woman for mycological diagnosis. The presence of yeasts and pseudo-filaments was observed on direct examination. The culture was performed on Sabouraud-Chloramphenicol medium and at 37°C for 24 to 48 hours. Identification was based on the macroscopic and microscopic characteristics of the colonies, the germinative tube test and the Vitek•2 instrument. of the colonies, the germinative tube test and the VITEK® 2 instrument. RESULT A total of 240 women were included with a mean age of 31.5 ± 3.15 [15-64 years]. Married women represented 91.67% (n=220) and 51.25% were housewises. Pruritus 49.17% (118/240) and dyspareunia 42.08% (101/240) were the most frequent clinical signs. Previous use of antifungals was demonstrated in 85.83% of women. Candida species were confirmed in 60.42% (145/240) of cases. C. albicans was the most frequent species followed by C. famata, C. dubliniensis, C. krusei.. This study allowed us to identify the most frequent cases of C. albicans, followed by C. famata, C. dubliniensis, and C. krusei.. Further studies are still needed to characterize the antifungal susceptibility profile of the Candida species involved.
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Affiliation(s)
- Safiatou Niare Doumbo
- Département d'Epidémiologie des Affections Parasitaires / Malaria Research and Training Center: DEAP/MRTC
| | - Niawalou Jacob Dara
- Département d'Epidémiologie des Affections Parasitaires / Malaria Research and Training Center: DEAP/MRTC
| | - Amadou Bamadio
- Département d'Epidémiologie des Affections Parasitaires / Malaria Research and Training Center: DEAP/MRTC
| | - Amatigue Zeguime
- Département d'Epidémiologie des Affections Parasitaires / Malaria Research and Training Center: DEAP/MRTC
| | - Nana Diarra
- Service de of Gynécologie et d'Obstétrique/ CHU Gabriel Touré
| | - Adam Garango
- Département d'Epidémiologie des Affections Parasitaires / Malaria Research and Training Center: DEAP/MRTC
| | - Bintou Diarra
- Département d'Epidémiologie des Affections Parasitaires / Malaria Research and Training Center: DEAP/MRTC
| | - Ahmed Konaté
- Département d'Epidémiologie des Affections Parasitaires / Malaria Research and Training Center: DEAP/MRTC
| | - Abdoulaye Koné
- Département d'Epidémiologie des Affections Parasitaires / Malaria Research and Training Center: DEAP/MRTC
| | - Ibrahim Tegueté
- Service de of Gynécologie et d'Obstétrique/ CHU Gabriel Touré
| | - Boubacar Traoré
- Département d'Epidémiologie des Affections Parasitaires / Malaria Research and Training Center: DEAP/MRTC
| | - Abdoulaye Djimde
- Département d'Epidémiologie des Affections Parasitaires / Malaria Research and Training Center: DEAP/MRTC
| | - Mahamadou A Thera
- Département d'Epidémiologie des Affections Parasitaires / Malaria Research and Training Center: DEAP/MRTC
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Chandramohan D, Zongo I, Sagara I, Cairns M, Yerbanga RS, Diarra M, Nikièma F, Tapily A, Sompougdou F, Issiaka D, Zoungrana C, Sanogo K, Haro A, Kaya M, Sienou AA, Traore S, Mahamar A, Thera I, Diarra K, Dolo A, Kuepfer I, Snell P, Milligan P, Ockenhouse C, Ofori-Anyinam O, Tinto H, Djimde A, Ouédraogo JB, Dicko A, Greenwood B. Seasonal Malaria Vaccination with or without Seasonal Malaria Chemoprevention. N Engl J Med 2021; 385:1005-1017. [PMID: 34432975 DOI: 10.1056/nejmoa2026330] [Citation(s) in RCA: 89] [Impact Index Per Article: 29.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Malaria control remains a challenge in many parts of the Sahel and sub-Sahel regions of Africa. METHODS We conducted an individually randomized, controlled trial to assess whether seasonal vaccination with RTS,S/AS01E was noninferior to chemoprevention in preventing uncomplicated malaria and whether the two interventions combined were superior to either one alone in preventing uncomplicated malaria and severe malaria-related outcomes. RESULTS We randomly assigned 6861 children 5 to 17 months of age to receive sulfadoxine-pyrimethamine and amodiaquine (2287 children [chemoprevention-alone group]), RTS,S/AS01E (2288 children [vaccine-alone group]), or chemoprevention and RTS,S/AS01E (2286 children [combination group]). Of these, 1965, 1988, and 1967 children in the three groups, respectively, received the first dose of the assigned intervention and were followed for 3 years. Febrile seizure developed in 5 children the day after receipt of the vaccine, but the children recovered and had no sequelae. There were 305 events of uncomplicated clinical malaria per 1000 person-years at risk in the chemoprevention-alone group, 278 events per 1000 person-years in the vaccine-alone group, and 113 events per 1000 person-years in the combination group. The hazard ratio for the protective efficacy of RTS,S/AS01E as compared with chemoprevention was 0.92 (95% confidence interval [CI], 0.84 to 1.01), which excluded the prespecified noninferiority margin of 1.20. The protective efficacy of the combination as compared with chemoprevention alone was 62.8% (95% CI, 58.4 to 66.8) against clinical malaria, 70.5% (95% CI, 41.9 to 85.0) against hospital admission with severe malaria according to the World Health Organization definition, and 72.9% (95% CI, 2.9 to 92.4) against death from malaria. The protective efficacy of the combination as compared with the vaccine alone against these outcomes was 59.6% (95% CI, 54.7 to 64.0), 70.6% (95% CI, 42.3 to 85.0), and 75.3% (95% CI, 12.5 to 93.0), respectively. CONCLUSIONS Administration of RTS,S/AS01E was noninferior to chemoprevention in preventing uncomplicated malaria. The combination of these interventions resulted in a substantially lower incidence of uncomplicated malaria, severe malaria, and death from malaria than either intervention alone. (Funded by the Joint Global Health Trials and PATH; ClinicalTrials.gov number, NCT03143218.).
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Affiliation(s)
- Daniel Chandramohan
- From the London School of Hygiene and Tropical Medicine, London (D.C., M.C., I.K., P.S., P.M., B.G.); Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso (I.Z., R.-S.Y., F.N., F.S., C.Z., A.H., A.-A.S., H.T., J.-B.O.); the Malaria Research and Training Center, University of Sciences, Technologies, and Techniques of Bamako, Bamako, Mali (I.S., M.D., A.T., D.I., K.S., M.K., S.T., A.M., I.T., K.D., A. Dolo, A. Djimde, A. Dicko); PATH, Seattle (C.O.); and GlaxoSmithKline Vaccines, Rixensart, Belgium (O.O.-A.)
| | - Issaka Zongo
- From the London School of Hygiene and Tropical Medicine, London (D.C., M.C., I.K., P.S., P.M., B.G.); Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso (I.Z., R.-S.Y., F.N., F.S., C.Z., A.H., A.-A.S., H.T., J.-B.O.); the Malaria Research and Training Center, University of Sciences, Technologies, and Techniques of Bamako, Bamako, Mali (I.S., M.D., A.T., D.I., K.S., M.K., S.T., A.M., I.T., K.D., A. Dolo, A. Djimde, A. Dicko); PATH, Seattle (C.O.); and GlaxoSmithKline Vaccines, Rixensart, Belgium (O.O.-A.)
| | - Issaka Sagara
- From the London School of Hygiene and Tropical Medicine, London (D.C., M.C., I.K., P.S., P.M., B.G.); Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso (I.Z., R.-S.Y., F.N., F.S., C.Z., A.H., A.-A.S., H.T., J.-B.O.); the Malaria Research and Training Center, University of Sciences, Technologies, and Techniques of Bamako, Bamako, Mali (I.S., M.D., A.T., D.I., K.S., M.K., S.T., A.M., I.T., K.D., A. Dolo, A. Djimde, A. Dicko); PATH, Seattle (C.O.); and GlaxoSmithKline Vaccines, Rixensart, Belgium (O.O.-A.)
| | - Matthew Cairns
- From the London School of Hygiene and Tropical Medicine, London (D.C., M.C., I.K., P.S., P.M., B.G.); Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso (I.Z., R.-S.Y., F.N., F.S., C.Z., A.H., A.-A.S., H.T., J.-B.O.); the Malaria Research and Training Center, University of Sciences, Technologies, and Techniques of Bamako, Bamako, Mali (I.S., M.D., A.T., D.I., K.S., M.K., S.T., A.M., I.T., K.D., A. Dolo, A. Djimde, A. Dicko); PATH, Seattle (C.O.); and GlaxoSmithKline Vaccines, Rixensart, Belgium (O.O.-A.)
| | - Rakiswendé-Serge Yerbanga
- From the London School of Hygiene and Tropical Medicine, London (D.C., M.C., I.K., P.S., P.M., B.G.); Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso (I.Z., R.-S.Y., F.N., F.S., C.Z., A.H., A.-A.S., H.T., J.-B.O.); the Malaria Research and Training Center, University of Sciences, Technologies, and Techniques of Bamako, Bamako, Mali (I.S., M.D., A.T., D.I., K.S., M.K., S.T., A.M., I.T., K.D., A. Dolo, A. Djimde, A. Dicko); PATH, Seattle (C.O.); and GlaxoSmithKline Vaccines, Rixensart, Belgium (O.O.-A.)
| | - Modibo Diarra
- From the London School of Hygiene and Tropical Medicine, London (D.C., M.C., I.K., P.S., P.M., B.G.); Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso (I.Z., R.-S.Y., F.N., F.S., C.Z., A.H., A.-A.S., H.T., J.-B.O.); the Malaria Research and Training Center, University of Sciences, Technologies, and Techniques of Bamako, Bamako, Mali (I.S., M.D., A.T., D.I., K.S., M.K., S.T., A.M., I.T., K.D., A. Dolo, A. Djimde, A. Dicko); PATH, Seattle (C.O.); and GlaxoSmithKline Vaccines, Rixensart, Belgium (O.O.-A.)
| | - Frédéric Nikièma
- From the London School of Hygiene and Tropical Medicine, London (D.C., M.C., I.K., P.S., P.M., B.G.); Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso (I.Z., R.-S.Y., F.N., F.S., C.Z., A.H., A.-A.S., H.T., J.-B.O.); the Malaria Research and Training Center, University of Sciences, Technologies, and Techniques of Bamako, Bamako, Mali (I.S., M.D., A.T., D.I., K.S., M.K., S.T., A.M., I.T., K.D., A. Dolo, A. Djimde, A. Dicko); PATH, Seattle (C.O.); and GlaxoSmithKline Vaccines, Rixensart, Belgium (O.O.-A.)
| | - Amadou Tapily
- From the London School of Hygiene and Tropical Medicine, London (D.C., M.C., I.K., P.S., P.M., B.G.); Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso (I.Z., R.-S.Y., F.N., F.S., C.Z., A.H., A.-A.S., H.T., J.-B.O.); the Malaria Research and Training Center, University of Sciences, Technologies, and Techniques of Bamako, Bamako, Mali (I.S., M.D., A.T., D.I., K.S., M.K., S.T., A.M., I.T., K.D., A. Dolo, A. Djimde, A. Dicko); PATH, Seattle (C.O.); and GlaxoSmithKline Vaccines, Rixensart, Belgium (O.O.-A.)
| | - Frédéric Sompougdou
- From the London School of Hygiene and Tropical Medicine, London (D.C., M.C., I.K., P.S., P.M., B.G.); Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso (I.Z., R.-S.Y., F.N., F.S., C.Z., A.H., A.-A.S., H.T., J.-B.O.); the Malaria Research and Training Center, University of Sciences, Technologies, and Techniques of Bamako, Bamako, Mali (I.S., M.D., A.T., D.I., K.S., M.K., S.T., A.M., I.T., K.D., A. Dolo, A. Djimde, A. Dicko); PATH, Seattle (C.O.); and GlaxoSmithKline Vaccines, Rixensart, Belgium (O.O.-A.)
| | - Djibrilla Issiaka
- From the London School of Hygiene and Tropical Medicine, London (D.C., M.C., I.K., P.S., P.M., B.G.); Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso (I.Z., R.-S.Y., F.N., F.S., C.Z., A.H., A.-A.S., H.T., J.-B.O.); the Malaria Research and Training Center, University of Sciences, Technologies, and Techniques of Bamako, Bamako, Mali (I.S., M.D., A.T., D.I., K.S., M.K., S.T., A.M., I.T., K.D., A. Dolo, A. Djimde, A. Dicko); PATH, Seattle (C.O.); and GlaxoSmithKline Vaccines, Rixensart, Belgium (O.O.-A.)
| | - Charles Zoungrana
- From the London School of Hygiene and Tropical Medicine, London (D.C., M.C., I.K., P.S., P.M., B.G.); Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso (I.Z., R.-S.Y., F.N., F.S., C.Z., A.H., A.-A.S., H.T., J.-B.O.); the Malaria Research and Training Center, University of Sciences, Technologies, and Techniques of Bamako, Bamako, Mali (I.S., M.D., A.T., D.I., K.S., M.K., S.T., A.M., I.T., K.D., A. Dolo, A. Djimde, A. Dicko); PATH, Seattle (C.O.); and GlaxoSmithKline Vaccines, Rixensart, Belgium (O.O.-A.)
| | - Koualy Sanogo
- From the London School of Hygiene and Tropical Medicine, London (D.C., M.C., I.K., P.S., P.M., B.G.); Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso (I.Z., R.-S.Y., F.N., F.S., C.Z., A.H., A.-A.S., H.T., J.-B.O.); the Malaria Research and Training Center, University of Sciences, Technologies, and Techniques of Bamako, Bamako, Mali (I.S., M.D., A.T., D.I., K.S., M.K., S.T., A.M., I.T., K.D., A. Dolo, A. Djimde, A. Dicko); PATH, Seattle (C.O.); and GlaxoSmithKline Vaccines, Rixensart, Belgium (O.O.-A.)
| | - Alassane Haro
- From the London School of Hygiene and Tropical Medicine, London (D.C., M.C., I.K., P.S., P.M., B.G.); Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso (I.Z., R.-S.Y., F.N., F.S., C.Z., A.H., A.-A.S., H.T., J.-B.O.); the Malaria Research and Training Center, University of Sciences, Technologies, and Techniques of Bamako, Bamako, Mali (I.S., M.D., A.T., D.I., K.S., M.K., S.T., A.M., I.T., K.D., A. Dolo, A. Djimde, A. Dicko); PATH, Seattle (C.O.); and GlaxoSmithKline Vaccines, Rixensart, Belgium (O.O.-A.)
| | - Mahamadou Kaya
- From the London School of Hygiene and Tropical Medicine, London (D.C., M.C., I.K., P.S., P.M., B.G.); Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso (I.Z., R.-S.Y., F.N., F.S., C.Z., A.H., A.-A.S., H.T., J.-B.O.); the Malaria Research and Training Center, University of Sciences, Technologies, and Techniques of Bamako, Bamako, Mali (I.S., M.D., A.T., D.I., K.S., M.K., S.T., A.M., I.T., K.D., A. Dolo, A. Djimde, A. Dicko); PATH, Seattle (C.O.); and GlaxoSmithKline Vaccines, Rixensart, Belgium (O.O.-A.)
| | - Abdoul-Aziz Sienou
- From the London School of Hygiene and Tropical Medicine, London (D.C., M.C., I.K., P.S., P.M., B.G.); Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso (I.Z., R.-S.Y., F.N., F.S., C.Z., A.H., A.-A.S., H.T., J.-B.O.); the Malaria Research and Training Center, University of Sciences, Technologies, and Techniques of Bamako, Bamako, Mali (I.S., M.D., A.T., D.I., K.S., M.K., S.T., A.M., I.T., K.D., A. Dolo, A. Djimde, A. Dicko); PATH, Seattle (C.O.); and GlaxoSmithKline Vaccines, Rixensart, Belgium (O.O.-A.)
| | - Seydou Traore
- From the London School of Hygiene and Tropical Medicine, London (D.C., M.C., I.K., P.S., P.M., B.G.); Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso (I.Z., R.-S.Y., F.N., F.S., C.Z., A.H., A.-A.S., H.T., J.-B.O.); the Malaria Research and Training Center, University of Sciences, Technologies, and Techniques of Bamako, Bamako, Mali (I.S., M.D., A.T., D.I., K.S., M.K., S.T., A.M., I.T., K.D., A. Dolo, A. Djimde, A. Dicko); PATH, Seattle (C.O.); and GlaxoSmithKline Vaccines, Rixensart, Belgium (O.O.-A.)
| | - Almahamoudou Mahamar
- From the London School of Hygiene and Tropical Medicine, London (D.C., M.C., I.K., P.S., P.M., B.G.); Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso (I.Z., R.-S.Y., F.N., F.S., C.Z., A.H., A.-A.S., H.T., J.-B.O.); the Malaria Research and Training Center, University of Sciences, Technologies, and Techniques of Bamako, Bamako, Mali (I.S., M.D., A.T., D.I., K.S., M.K., S.T., A.M., I.T., K.D., A. Dolo, A. Djimde, A. Dicko); PATH, Seattle (C.O.); and GlaxoSmithKline Vaccines, Rixensart, Belgium (O.O.-A.)
| | - Ismaila Thera
- From the London School of Hygiene and Tropical Medicine, London (D.C., M.C., I.K., P.S., P.M., B.G.); Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso (I.Z., R.-S.Y., F.N., F.S., C.Z., A.H., A.-A.S., H.T., J.-B.O.); the Malaria Research and Training Center, University of Sciences, Technologies, and Techniques of Bamako, Bamako, Mali (I.S., M.D., A.T., D.I., K.S., M.K., S.T., A.M., I.T., K.D., A. Dolo, A. Djimde, A. Dicko); PATH, Seattle (C.O.); and GlaxoSmithKline Vaccines, Rixensart, Belgium (O.O.-A.)
| | - Kalifa Diarra
- From the London School of Hygiene and Tropical Medicine, London (D.C., M.C., I.K., P.S., P.M., B.G.); Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso (I.Z., R.-S.Y., F.N., F.S., C.Z., A.H., A.-A.S., H.T., J.-B.O.); the Malaria Research and Training Center, University of Sciences, Technologies, and Techniques of Bamako, Bamako, Mali (I.S., M.D., A.T., D.I., K.S., M.K., S.T., A.M., I.T., K.D., A. Dolo, A. Djimde, A. Dicko); PATH, Seattle (C.O.); and GlaxoSmithKline Vaccines, Rixensart, Belgium (O.O.-A.)
| | - Amagana Dolo
- From the London School of Hygiene and Tropical Medicine, London (D.C., M.C., I.K., P.S., P.M., B.G.); Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso (I.Z., R.-S.Y., F.N., F.S., C.Z., A.H., A.-A.S., H.T., J.-B.O.); the Malaria Research and Training Center, University of Sciences, Technologies, and Techniques of Bamako, Bamako, Mali (I.S., M.D., A.T., D.I., K.S., M.K., S.T., A.M., I.T., K.D., A. Dolo, A. Djimde, A. Dicko); PATH, Seattle (C.O.); and GlaxoSmithKline Vaccines, Rixensart, Belgium (O.O.-A.)
| | - Irene Kuepfer
- From the London School of Hygiene and Tropical Medicine, London (D.C., M.C., I.K., P.S., P.M., B.G.); Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso (I.Z., R.-S.Y., F.N., F.S., C.Z., A.H., A.-A.S., H.T., J.-B.O.); the Malaria Research and Training Center, University of Sciences, Technologies, and Techniques of Bamako, Bamako, Mali (I.S., M.D., A.T., D.I., K.S., M.K., S.T., A.M., I.T., K.D., A. Dolo, A. Djimde, A. Dicko); PATH, Seattle (C.O.); and GlaxoSmithKline Vaccines, Rixensart, Belgium (O.O.-A.)
| | - Paul Snell
- From the London School of Hygiene and Tropical Medicine, London (D.C., M.C., I.K., P.S., P.M., B.G.); Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso (I.Z., R.-S.Y., F.N., F.S., C.Z., A.H., A.-A.S., H.T., J.-B.O.); the Malaria Research and Training Center, University of Sciences, Technologies, and Techniques of Bamako, Bamako, Mali (I.S., M.D., A.T., D.I., K.S., M.K., S.T., A.M., I.T., K.D., A. Dolo, A. Djimde, A. Dicko); PATH, Seattle (C.O.); and GlaxoSmithKline Vaccines, Rixensart, Belgium (O.O.-A.)
| | - Paul Milligan
- From the London School of Hygiene and Tropical Medicine, London (D.C., M.C., I.K., P.S., P.M., B.G.); Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso (I.Z., R.-S.Y., F.N., F.S., C.Z., A.H., A.-A.S., H.T., J.-B.O.); the Malaria Research and Training Center, University of Sciences, Technologies, and Techniques of Bamako, Bamako, Mali (I.S., M.D., A.T., D.I., K.S., M.K., S.T., A.M., I.T., K.D., A. Dolo, A. Djimde, A. Dicko); PATH, Seattle (C.O.); and GlaxoSmithKline Vaccines, Rixensart, Belgium (O.O.-A.)
| | - Christian Ockenhouse
- From the London School of Hygiene and Tropical Medicine, London (D.C., M.C., I.K., P.S., P.M., B.G.); Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso (I.Z., R.-S.Y., F.N., F.S., C.Z., A.H., A.-A.S., H.T., J.-B.O.); the Malaria Research and Training Center, University of Sciences, Technologies, and Techniques of Bamako, Bamako, Mali (I.S., M.D., A.T., D.I., K.S., M.K., S.T., A.M., I.T., K.D., A. Dolo, A. Djimde, A. Dicko); PATH, Seattle (C.O.); and GlaxoSmithKline Vaccines, Rixensart, Belgium (O.O.-A.)
| | - Opokua Ofori-Anyinam
- From the London School of Hygiene and Tropical Medicine, London (D.C., M.C., I.K., P.S., P.M., B.G.); Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso (I.Z., R.-S.Y., F.N., F.S., C.Z., A.H., A.-A.S., H.T., J.-B.O.); the Malaria Research and Training Center, University of Sciences, Technologies, and Techniques of Bamako, Bamako, Mali (I.S., M.D., A.T., D.I., K.S., M.K., S.T., A.M., I.T., K.D., A. Dolo, A. Djimde, A. Dicko); PATH, Seattle (C.O.); and GlaxoSmithKline Vaccines, Rixensart, Belgium (O.O.-A.)
| | - Halidou Tinto
- From the London School of Hygiene and Tropical Medicine, London (D.C., M.C., I.K., P.S., P.M., B.G.); Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso (I.Z., R.-S.Y., F.N., F.S., C.Z., A.H., A.-A.S., H.T., J.-B.O.); the Malaria Research and Training Center, University of Sciences, Technologies, and Techniques of Bamako, Bamako, Mali (I.S., M.D., A.T., D.I., K.S., M.K., S.T., A.M., I.T., K.D., A. Dolo, A. Djimde, A. Dicko); PATH, Seattle (C.O.); and GlaxoSmithKline Vaccines, Rixensart, Belgium (O.O.-A.)
| | - Abdoulaye Djimde
- From the London School of Hygiene and Tropical Medicine, London (D.C., M.C., I.K., P.S., P.M., B.G.); Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso (I.Z., R.-S.Y., F.N., F.S., C.Z., A.H., A.-A.S., H.T., J.-B.O.); the Malaria Research and Training Center, University of Sciences, Technologies, and Techniques of Bamako, Bamako, Mali (I.S., M.D., A.T., D.I., K.S., M.K., S.T., A.M., I.T., K.D., A. Dolo, A. Djimde, A. Dicko); PATH, Seattle (C.O.); and GlaxoSmithKline Vaccines, Rixensart, Belgium (O.O.-A.)
| | - Jean-Bosco Ouédraogo
- From the London School of Hygiene and Tropical Medicine, London (D.C., M.C., I.K., P.S., P.M., B.G.); Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso (I.Z., R.-S.Y., F.N., F.S., C.Z., A.H., A.-A.S., H.T., J.-B.O.); the Malaria Research and Training Center, University of Sciences, Technologies, and Techniques of Bamako, Bamako, Mali (I.S., M.D., A.T., D.I., K.S., M.K., S.T., A.M., I.T., K.D., A. Dolo, A. Djimde, A. Dicko); PATH, Seattle (C.O.); and GlaxoSmithKline Vaccines, Rixensart, Belgium (O.O.-A.)
| | - Alassane Dicko
- From the London School of Hygiene and Tropical Medicine, London (D.C., M.C., I.K., P.S., P.M., B.G.); Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso (I.Z., R.-S.Y., F.N., F.S., C.Z., A.H., A.-A.S., H.T., J.-B.O.); the Malaria Research and Training Center, University of Sciences, Technologies, and Techniques of Bamako, Bamako, Mali (I.S., M.D., A.T., D.I., K.S., M.K., S.T., A.M., I.T., K.D., A. Dolo, A. Djimde, A. Dicko); PATH, Seattle (C.O.); and GlaxoSmithKline Vaccines, Rixensart, Belgium (O.O.-A.)
| | - Brian Greenwood
- From the London School of Hygiene and Tropical Medicine, London (D.C., M.C., I.K., P.S., P.M., B.G.); Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso (I.Z., R.-S.Y., F.N., F.S., C.Z., A.H., A.-A.S., H.T., J.-B.O.); the Malaria Research and Training Center, University of Sciences, Technologies, and Techniques of Bamako, Bamako, Mali (I.S., M.D., A.T., D.I., K.S., M.K., S.T., A.M., I.T., K.D., A. Dolo, A. Djimde, A. Dicko); PATH, Seattle (C.O.); and GlaxoSmithKline Vaccines, Rixensart, Belgium (O.O.-A.)
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Beavogui AH, Cherif MS, Camara BS, Delamou A, Kolie D, Cissé A, Camara D, Sow A, Camara G, Yattara M, Goumou N, Doumbouya A, Kourouma K, Diarra B, Djimde A. PREVALENCE OF PARASITIC INFECTIONS IN CHILDREN OF BOKE, GUINEA. J Parasitol 2021; 107:783-789. [PMID: 34581794 DOI: 10.1645/19-198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Helminthic and intestinal protozoan infections and malaria infections are common in children less than 15 yr old in sub-Saharan Africa, but little is known about these infections in Guinea. The aim of this study was to determine the prevalence of parasitic infections in children aged less than 15 yr and the relationship of these infections with anemia. The cross-sectional study was done in Dabbis sub-prefecture in the Boke region of Guinea from 18 to 26 March 2017. A simple random sampling at the household level was performed, and 1 child under the age of 15 was included per eligible household. A total of 392 children were included in the analysis. Clinical and parasitological information were assessed, including anthropometric measures (weight and height), disease symptoms, hemoglobin level, and malaria parasitemia. Helminthic and protozoan intestinal infections were present in 59.7% of the children surveyed. Malaria infection prevalence was 45.5% when assessed by microscopy and 43.6% when assessed by a rapid diagnostic test. Plasmodium falciparum, accounting for 84.2% of malaria infections, was the main malaria species infection. Gastrointestinal parasites were present in 19.1% of children. The main gastrointestinal parasites present included Entamoeba coli (5.4%) and Giardia intestinalis (5.1%). There was no association between the presence of anemia and the parasitic status of the children. Parasitic screening and mass treatment in this age group, as well as household awareness raising, would reduce cases of parasitic infections in rural Guinea.
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Affiliation(s)
- Abdoul H Beavogui
- Centre National de formation et de recherche en Santé Rurale (CNFRSR) "Jean Senecal" de Mafèrinyah, Forécariah, Guinea.,Bioclinical and Fundamental Sciences Chair, Department of Medical Sciences, Faculty of Health Science and Techniques, Gamal Abdel Nasser University of Conakry, Conakry, Guinea
| | - Mahamoud S Cherif
- Centre National de formation et de recherche en Santé Rurale (CNFRSR) "Jean Senecal" de Mafèrinyah, Forécariah, Guinea.,Pediatric Chair, Department of Medicine, Faculty of Health Science and Techniques, Gamal Abdel Nasser University of Conakry, Conakry, Guinea
| | - Bienvenu S Camara
- Centre National de formation et de recherche en Santé Rurale (CNFRSR) "Jean Senecal" de Mafèrinyah, Forécariah, Guinea
| | - Alexandre Delamou
- Centre National de formation et de recherche en Santé Rurale (CNFRSR) "Jean Senecal" de Mafèrinyah, Forécariah, Guinea.,Department of Public Health, Faculty of Health Science and Techniques, Gamal Abdel Nasser University of Conakry, Conakry, Guinea
| | - Delphin Kolie
- Centre National de formation et de recherche en Santé Rurale (CNFRSR) "Jean Senecal" de Mafèrinyah, Forécariah, Guinea
| | - Ansoumane Cissé
- Centre National de formation et de recherche en Santé Rurale (CNFRSR) "Jean Senecal" de Mafèrinyah, Forécariah, Guinea
| | - Daouda Camara
- Centre National de formation et de recherche en Santé Rurale (CNFRSR) "Jean Senecal" de Mafèrinyah, Forécariah, Guinea
| | - Amadou Sow
- Centre National de formation et de recherche en Santé Rurale (CNFRSR) "Jean Senecal" de Mafèrinyah, Forécariah, Guinea
| | - Gnepou Camara
- Centre National de formation et de recherche en Santé Rurale (CNFRSR) "Jean Senecal" de Mafèrinyah, Forécariah, Guinea
| | - Mohamed Yattara
- Centre National de formation et de recherche en Santé Rurale (CNFRSR) "Jean Senecal" de Mafèrinyah, Forécariah, Guinea
| | - Nèma Goumou
- Centre National de formation et de recherche en Santé Rurale (CNFRSR) "Jean Senecal" de Mafèrinyah, Forécariah, Guinea
| | - Abdoulaye Doumbouya
- Centre National de formation et de recherche en Santé Rurale (CNFRSR) "Jean Senecal" de Mafèrinyah, Forécariah, Guinea
| | - Karifa Kourouma
- Centre National de formation et de recherche en Santé Rurale (CNFRSR) "Jean Senecal" de Mafèrinyah, Forécariah, Guinea
| | - Bassirou Diarra
- University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - Abdoulaye Djimde
- University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
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17
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Beavogui AH, Diawara EY, Cherif MS, Delamou A, Diallo N, Traore A, Millimouno P, Camara D, Sylla MM, Toure AA, Diallo MS, Toure S, Togo A, Camara G, Kourouma K, Sagara I, Dicko A, Djimde A. SELECTION OF PFCRT 76T AND PFMDR1 86Y MUTANT PLASMODIUM FALCIPARUM AFTER TREATMENT OF UNCOMPLICATED MALARIA WITH ARTESUNATE-AMODIAQUINE IN REPUBLIC OF GUINEA. J Parasitol 2021; 107:778-782. [PMID: 34581793 DOI: 10.1645/19-199] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
The use of Amodiaquine monotherapy is associated with the selection of molecular markers of Plasmodium falciparum resistance to chloroquine (pfcrt and pfmdr1). The decrease in sensitivity and the emergence of P. falciparum resistant to artemisinin-based combination therapy have been reported. Therefore, it is important to assess the impact of treatment of uncomplicated malaria with Artesunate-Amodiaquine (AS+AQ) on molecular markers of antimalarial resistance. We used standard World Health Organization (WHO) protocols to determine the in vivo efficacy of the combination (AS+AQ). In total, 170 subjects were included in the study. The molecular analysis focused on 168 dried blood spots. The aims were to determine the frequency of pfcrt 76T and pfmdr1 86Y mutations and the rates of reinfection using polymorphism markers msp1, msp2, and microsatellite markers (CA1, Ta87, TA99). Nested-PCR was used, followed in some cases by a restriction digestion. The level of P. falciparum clinical response was 92.9% (156/168) of Adequate Clinical and Parasitological Response (ACPR) before molecular correction and 97.0% (163/168) after molecular correction (P = 0.089). The frequency of mutation point pfcrt 76T was 76.2% (128/168) before treatment and 100% (7/7) after treatment (P = 0.1423). For the pfmdr1 mutation, the frequency was 28% (47/168) before treatment and 60% (6/10) after treatment (P = 0.1124). The rate of pfcrt 76T + pfmdr1 86Y was 22% (37/168) before and 50% (6/12) after treatment (P = 0.1465). Despite the presence of AS in the combination, AS+AQ selects for pfcrt 76T and pfmdr1 86Y mutant P. falciparum in Guinea.
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Affiliation(s)
- Abdoul H Beavogui
- Centre National de formation et de recherche en santé rurale (CNFRSR), Jean Senecal de Maferinyah, Forécariah, Guinea.,Bioclinical and Fundamental Sciences Chair, Department of Medical Sciences, Faculty of Health Science and Techniques, Gamal Abdel Nasser University of Conakry, Conakry, Guinea
| | - Elisabeth Y Diawara
- Centre National de formation et de recherche en santé rurale (CNFRSR), Jean Senecal de Maferinyah, Forécariah, Guinea
| | - Mahamoud S Cherif
- Centre National de formation et de recherche en santé rurale (CNFRSR), Jean Senecal de Maferinyah, Forécariah, Guinea.,Pediatric Chair, Department of Medicine, Faculty of Health Science and Techniques, Gamal Abdel Nasser University of Conakry, Conakry, Guinea
| | - Alexandre Delamou
- Centre National de formation et de recherche en santé rurale (CNFRSR), Jean Senecal de Maferinyah, Forécariah, Guinea.,Department of Public Health, Faculty of Health Science and Techniques, Gamal Abdel Nasser University of Conakry, Conakry, Guinea
| | - Nouhoum Diallo
- Malaria Research and Training Center, University of Sciences, Techniques and Technologies of Bamako, PO Box: 1805 Point G, Bamako, Mali
| | - Aliou Traore
- Malaria Research and Training Center, University of Sciences, Techniques and Technologies of Bamako, PO Box: 1805 Point G, Bamako, Mali
| | - Pascal Millimouno
- Centre National de formation et de recherche en santé rurale (CNFRSR), Jean Senecal de Maferinyah, Forécariah, Guinea
| | - Daouda Camara
- Centre National de formation et de recherche en santé rurale (CNFRSR), Jean Senecal de Maferinyah, Forécariah, Guinea
| | - Malick M Sylla
- Centre National de formation et de recherche en santé rurale (CNFRSR), Jean Senecal de Maferinyah, Forécariah, Guinea
| | - Almamy A Toure
- Centre National de formation et de recherche en santé rurale (CNFRSR), Jean Senecal de Maferinyah, Forécariah, Guinea
| | - Mamadou S Diallo
- Centre National de formation et de recherche en santé rurale (CNFRSR), Jean Senecal de Maferinyah, Forécariah, Guinea
| | - Sekou Toure
- Malaria Research and Training Center, University of Sciences, Techniques and Technologies of Bamako, PO Box: 1805 Point G, Bamako, Mali
| | - Amadou Togo
- Malaria Research and Training Center, University of Sciences, Techniques and Technologies of Bamako, PO Box: 1805 Point G, Bamako, Mali
| | - Gnepou Camara
- Centre National de formation et de recherche en santé rurale (CNFRSR), Jean Senecal de Maferinyah, Forécariah, Guinea
| | - Karifa Kourouma
- Centre National de formation et de recherche en santé rurale (CNFRSR), Jean Senecal de Maferinyah, Forécariah, Guinea
| | - Issaka Sagara
- Malaria Research and Training Center, University of Sciences, Techniques and Technologies of Bamako, PO Box: 1805 Point G, Bamako, Mali
| | - Alhassane Dicko
- Malaria Research and Training Center, University of Sciences, Techniques and Technologies of Bamako, PO Box: 1805 Point G, Bamako, Mali
| | - Abdoulaye Djimde
- Malaria Research and Training Center, University of Sciences, Techniques and Technologies of Bamako, PO Box: 1805 Point G, Bamako, Mali
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Cohee LM, Nankabirwa JI, Greenwood B, Djimde A, Mathanga DP. Time for malaria control in school-age children. Lancet Child Adolesc Health 2021; 5:537-538. [PMID: 34051141 DOI: 10.1016/s2352-4642(21)00158-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 05/11/2021] [Indexed: 10/21/2022]
Affiliation(s)
- Lauren M Cohee
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
| | - Joaniter I Nankabirwa
- Makerere University College of Health Sciences and Infectious Diseases Research Collaboration, Kampala, Uganda
| | - Brian Greenwood
- Faculty of Infectious and Tropical Diseases, Department of Disease Control, London School of Hygiene and Tropical Medicine, London, UK
| | - Abdoulaye Djimde
- Malaria Research and Training Center, Department of Epidemiology of Parasitic Diseases, Faculty of Pharmacy, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - Don P Mathanga
- Malaria Alert Center, University of Malawi College of Medicine, Blantyre, Malawi
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19
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Baba E, Hamade P, Kivumbi H, Marasciulo M, Maxwell K, Moroso D, Roca-Feltrer A, Sanogo A, Stenstrom Johansson J, Tibenderana J, Abdoulaye R, Coulibaly P, Hubbard E, Jah H, Lama EK, Razafindralambo L, Van Hulle S, Jagoe G, Tchouatieu AM, Collins D, Gilmartin C, Tetteh G, Djibo Y, Ndiaye F, Kalleh M, Kandeh B, Audu B, Ntadom G, Kiba A, Savodogo Y, Boulotigam K, Sougoudi DA, Guilavogui T, Keita M, Kone D, Jackou H, Ouba I, Ouedraogo E, Messan HA, Jah F, Kaira MJ, Sano MS, Traore MC, Ngarnaye N, Elagbaje AYC, Halleux C, Merle C, Iessa N, Pal S, Sefiani H, Souleymani R, Laminou I, Doumagoum D, Kesseley H, Coldiron M, Grais R, Kana M, Ouedraogo JB, Zongo I, Eloike T, Ogboi SJ, Achan J, Bojang K, Ceesay S, Dicko A, Djimde A, Sagara I, Diallo A, NdDiaye JL, Loua KM, Beshir K, Cairns M, Fernandez Y, Lal S, Mansukhani R, Muwanguzi J, Scott S, Snell P, Sutherland C, Tuta R, Milligan P. Effectiveness of seasonal malaria chemoprevention at scale in west and central Africa: an observational study. Lancet 2020; 396:1829-1840. [PMID: 33278936 PMCID: PMC7718580 DOI: 10.1016/s0140-6736(20)32227-3] [Citation(s) in RCA: 104] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 08/20/2020] [Accepted: 09/17/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Seasonal malaria chemoprevention (SMC) aims to prevent malaria in children during the high malaria transmission season. The Achieving Catalytic Expansion of SMC in the Sahel (ACCESS-SMC) project sought to remove barriers to the scale-up of SMC in seven countries in 2015 and 2016. We evaluated the project, including coverage, effectiveness of the intervention, safety, feasibility, drug resistance, and cost-effectiveness. METHODS For this observational study, we collected data on the delivery, effectiveness, safety, influence on drug resistance, costs of delivery, impact on malaria incidence and mortality, and cost-effectiveness of SMC, during its administration for 4 months each year (2015 and 2016) to children younger than 5 years, in Burkina Faso, Chad, The Gambia, Guinea, Mali, Niger, and Nigeria. SMC was administered monthly by community health workers who visited door-to-door. Drug administration was monitored via tally sheets and via household cluster-sample coverage surveys. Pharmacovigilance was based on targeted spontaneous reporting and monitoring systems were strengthened. Molecular markers of resistance to sulfadoxine-pyrimethamine and amodiaquine in the general population before and 2 years after SMC introduction was assessed from community surveys. Effectiveness of monthly SMC treatments was measured in case-control studies that compared receipt of SMC between patients with confirmed malaria and neighbourhood-matched community controls eligible to receive SMC. Impact on incidence and mortality was assessed from confirmed outpatient cases, hospital admissions, and deaths associated with malaria, as reported in national health management information systems in Burkina Faso and The Gambia, and from data from selected outpatient facilities (all countries). Provider costs of SMC were estimated from financial costs, costs of health-care staff time, and volunteer opportunity costs, and cost-effectiveness ratios were calculated as the total cost of SMC in each country divided by the predicted number of cases averted. FINDINGS 12 467 933 monthly SMC treatments were administered in 2015 to a target population of 3 650 455 children, and 25 117 480 were administered in 2016 to a target population of 7 551 491. In 2015, among eligible children, mean coverage per month was 76·4% (95% CI 74·0-78·8), and 54·5% children (95% CI 50·4-58·7) received all four treatments. Similar coverage was achieved in 2016 (74·8% [72·2-77·3] treated per month and 53·0% [48·5-57·4] treated four times). In 779 individual case safety reports over 2015-16, 36 serious adverse drug reactions were reported (one child with rash, two with fever, 31 with gastrointestinal disorders, one with extrapyramidal syndrome, and one with Quincke's oedema). No cases of severe skin reactions (Stevens-Johnson or Lyell syndrome) were reported. SMC treatment was associated with a protective effectiveness of 88·2% (95% CI 78·7-93·4) over 28 days in case-control studies (2185 cases of confirmed malaria and 4370 controls). In Burkina Faso and The Gambia, implementation of SMC was associated with reductions in the number of malaria deaths in hospital during the high transmission period, of 42·4% (95% CI 5·9 to 64·7) in Burkina Faso and 56·6% (28·9 to 73·5) in The Gambia. Over 2015-16, the estimated reduction in confirmed malaria cases at outpatient clinics during the high transmission period in the seven countries ranged from 25·5% (95% CI 6·1 to 40·9) in Nigeria to 55·2% (42·0 to 65·3) in The Gambia. Molecular markers of resistance occurred at low frequencies. In individuals aged 10-30 years without SMC, the combined mutations associated with resistance to amodiaquine (pfcrt CVIET haplotype and pfmdr1 mutations [86Tyr and 184Tyr]) had a prevalence of 0·7% (95% CI 0·4-1·2) in 2016 and 0·4% (0·1-0·8) in 2018 (prevalence ratio 0·5 [95% CI 0·2-1·2]), and the quintuple mutation associated with resistance to sulfadoxine-pyrimethamine (triple mutation in pfdhfr and pfdhps mutations [437Gly and 540Glu]) had a prevalence of 0·2% (0·1-0·5) in 2016 and 1·0% (0·6-1·6) in 2018 (prevalence ratio 4·8 [1·7-13·7]). The weighted average economic cost of administering four monthly SMC treatments was US$3·63 per child. INTERPRETATION SMC at scale was effective in preventing morbidity and mortality from malaria. Serious adverse reactions were rarely reported. Coverage varied, with some areas consistently achieving high levels via door-to-door campaigns. Markers of resistance to sulfadoxine-pyrimethamine and amodiaquine remained uncommon, but with some selection for resistance to sulfadoxine-pyrimethamine, and the situation needs to be carefully monitored. These findings should support efforts to ensure high levels of SMC coverage in west and central Africa. FUNDING Unitaid.
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20
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Cohee LM, Opondo C, Clarke SE, Halliday KE, Cano J, Shipper AG, Barger-Kamate B, Djimde A, Diarra S, Dokras A, Kamya MR, Lutumba P, Ly AB, Nankabirwa JI, Njagi JK, Maiga H, Maiteki-Sebuguzi C, Matangila J, Okello G, Rohner F, Roschnik N, Rouhani S, Sissoko MS, Staedke SG, Thera MA, Turner EL, Van Geertruyden JP, Zimmerman MB, Jukes MCH, Brooker SJ, Allen E, Laufer MK, Chico RM. Preventive malaria treatment among school-aged children in sub-Saharan Africa: a systematic review and meta-analyses. Lancet Glob Health 2020; 8:e1499-e1511. [PMID: 33222799 PMCID: PMC7721819 DOI: 10.1016/s2214-109x(20)30325-9] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 05/09/2020] [Accepted: 07/02/2020] [Indexed: 01/19/2023]
Abstract
BACKGROUND The burden of malaria infection in sub-Saharan Africa among school-aged children aged 5-15 years is underappreciated and represents an important source of human-to-mosquito transmission of Plasmodium falciparum. Additional interventions are needed to control and eliminate malaria. We aimed to assess whether preventive treatment of malaria might be an effective means of reducing P falciparum infection and anaemia in school-aged children and lowering parasite transmission. METHODS In this systematic review and two meta-analyses, we searched the online databases PubMed, Embase, Cochrane CENTRAL, and Clinicaltrials.gov for intervention studies published between Jan 1, 1990, and Dec 14, 2018. We included randomised studies that assessed the effect of antimalarial treatment among asymptomatic school-aged children aged 5-15 years in sub-Saharan Africa on prevalence of P falciparum infection and anaemia, clinical malaria, and cognitive function. We first extracted data for a study-level meta-analysis, then contacted research groups to request data for an individual participant data meta-analysis. Outcomes of interest included prevalence of P falciparum infection detected by microscopy, anaemia (study defined values or haemoglobin less than age-adjusted and sex-adjusted values), clinical malaria (infection and symptoms on the basis of study-specific definitions) during follow-up, and code transmission test scores. We assessed effects by treatment type and duration of time protected, and explored effect modification by transmission setting. For study-level meta-analysis, we calculated risk ratios for binary outcomes and standardised mean differences for continuous outcomes and pooled outcomes using fixed-effect and random-effects models. We used a hierarchical generalised linear model for meta-analysis of individual participant data. This study is registered with PROSPERO, CRD42016030197. FINDINGS Of 628 studies identified, 13 were eligible for the study-level meta-analysis (n=16 309). Researchers from 11 studies contributed data on at least one outcome (n=15 658) for an individual participant data meta-analysis. Interventions and study designs were highly heterogeneous; overall risk of bias was low. In the study-level meta-analysis, treatment was associated with reductions in P falciparum prevalence (risk ratio [RR] 0·27, 95% CI 0·17-0·44), anaemia (0·77, 0·65-0·91), and clinical malaria (0·40, 0·28-0·56); results for cognitive outcomes are not presented because data were only available for three trials. In our individual participant data meta-analysis, we found treatment significantly decreased P falciparum prevalence (adjusted RR [ARR] 0·46, 95% CI 0·40-0·53; p<0·0001; 15 648 individuals; 11 studies), anaemia (ARR 0·85, 0·77-0·92; p<0·0001; 15 026 individuals; 11 studies), and subsequent clinical malaria (ARR 0·50, 0·39-0·60; p<0·0001; 1815 individuals; four studies) across transmission settings. We detected a marginal effect on cognitive function in children older than 10 years (adjusted mean difference in standardised test scores 0·36, 0·01-0·71; p=0·044; 3962 individuals; five studies) although we found no significant effect when combined across all ages. INTERPRETATION Preventive treatment of malaria among school-aged children significantly decreases P falciparum prevalence, anaemia, and risk of subsequent clinical malaria across transmission settings. Policy makers and programme managers should consider preventive treatment of malaria to protect this age group and advance the goal of malaria elimination, while weighing these benefits against potential risks of chemoprevention. FUNDING US National Institutes of Health and Burroughs Wellcome Fund/ASTMH Fellowship.
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Affiliation(s)
- Lauren M Cohee
- Center for Vaccine Development and Global Health, University of Maryland, Baltimore, MA, USA
| | - Charles Opondo
- Department of Medical Statistics, Faculty of Epidemiology and Population Health, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Siân E Clarke
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Katherine E Halliday
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Jorge Cano
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Andrea G Shipper
- University of Maryland School of Medicine, and Health Sciences and Human Services Library, University of Maryland, Baltimore, MA, USA
| | | | - Abdoulaye Djimde
- Faculty of Medicine, Pharmacy, and Odnonto-Stomatology, Malaria Research and Training Center, University of Sciences, Techniques and Technologies of Bamako, Mali
| | | | - Aditi Dokras
- Department of Pediatrics, University of Maryland, Baltimore, MA, USA
| | - Moses R Kamya
- Infectious Diseases Research Collaboration, Kampala, Uganda
| | - Pascal Lutumba
- Tropical Medicine Department, University of Kinshasa, Kinshasa, Democratic Republic of Congo
| | | | - Joaniter I Nankabirwa
- School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda; Infectious Diseases Research Collaboration, Kampala, Uganda
| | - J Kiambo Njagi
- National Malaria Control Programme, Ministry of Health, Nairobi, Kenya
| | - Hamma Maiga
- Faculty of Medicine, Pharmacy, and Odnonto-Stomatology, Malaria Research and Training Center, University of Sciences, Techniques and Technologies of Bamako, Mali
| | | | - Junior Matangila
- Tropical Medicine Department, University of Kinshasa, Kinshasa, Democratic Republic of Congo; Global Health Institute, University of Antwerp, Antwerp, Belgium
| | - George Okello
- Health Systems and Social Science Research Group, Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya
| | | | | | - Saba Rouhani
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK; Save the Children, Bamako, Mali
| | - Mahamadou S Sissoko
- Faculty of Medicine, Pharmacy, and Odnonto-Stomatology, Malaria Research and Training Center, University of Sciences, Techniques and Technologies of Bamako, Mali
| | - Sarah G Staedke
- Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Mahamadou A Thera
- Faculty of Medicine, Pharmacy, and Odnonto-Stomatology, Malaria Research and Training Center, University of Sciences, Techniques and Technologies of Bamako, Mali
| | - Elizabeth L Turner
- Department of Biostatistics & Bioinformatics and Duke Global Health Institute, Duke University, Durham, NC, USA
| | | | - Michael B Zimmerman
- Institute of Food, Nutrition, and Health, Swiss Federal Institute of Technology, Zurich, Switzerland
| | | | | | - Elizabeth Allen
- Department of Medical Statistics, Faculty of Epidemiology and Population Health, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Miriam K Laufer
- Center for Vaccine Development and Global Health, University of Maryland, Baltimore, MA, USA
| | - R Matthew Chico
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
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Oriero EC, Olukosi AY, Oduwole OA, Djimde A, D'Alessandro U, Meremikwu MM, Amambua-Ngwa A. Seroprevalence and Parasite Rates of Plasmodium malariae in a High Malaria Transmission Setting of Southern Nigeria. Am J Trop Med Hyg 2020; 103:2208-2216. [PMID: 33124531 PMCID: PMC7695047 DOI: 10.4269/ajtmh.20-0593] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Although Plasmodium falciparum continues to be the main target for malaria elimination, other Plasmodium species persist in Africa. Their clinical diagnosis is uncommon, whereas rapid diagnostic tests (RDTs), the most widely used malaria diagnostic tools, are only able to distinguish between P. falciparum and non-falciparum species, the latter as “pan-species.” Blood samples from health facilities were collected in southern Nigeria (Lagos and Calabar) in 2017 (October–December) and Calabar only in 2018 (October–November), and analyzed by several methods, namely, microscopy, quantitative real-time PCR (qPCR), and peptide serology targeting candidate antigens (Plasmodium malariae apical membrane antigen, P. malariae lactose dehydrogenase, and P. malariae circumsporozoite surface protein). Both microscopy and qPCR diagnostic approaches detected comparable proportions (∼80%) of all RDT-positive samples infected with the dominant P. falciparum malaria parasite. However, higher proportions of non-falciparum species were detected by qPCR than microscopy, 10% against 3% infections for P. malariae and 3% against 0% for Plasmodium ovale, respectively. No Plasmodium vivax infection was detected. Infection rates for P. malariae varied between age-groups, with the highest rates in individuals aged > 5 years. Plasmodium malariae–specific seroprevalence rates fluctuated in those aged < 10 years but generally reached the peak around 20 years of age for all peptides. The heterogeneity and rates of these non-falciparum species call for increased specific diagnosis and targeting by elimination strategies.
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Affiliation(s)
- Eniyou C Oriero
- Medical Research Council Unit The Gambia at LSHTM, Banjul, The Gambia
| | | | - Olabisi A Oduwole
- Calabar Institute of Tropical Disease Research and Prevention, University of Calabar Teaching Hospital, Calabar, Nigeria
| | - Abdoulaye Djimde
- Department of Epidemiology of Parasitic Diseases, Malaria Research and Training Center, University of Science, Techniques and Technology of Bamako, Bamako, Mali
| | | | - Martin M Meremikwu
- Calabar Institute of Tropical Disease Research and Prevention, University of Calabar Teaching Hospital, Calabar, Nigeria
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22
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Diarra AZ, Kone AK, Doumbo Niare S, Laroche M, Diatta G, Atteynine SA, Coulibaly M, Sangare AK, Kouriba B, Djimde A, Dabo A, Sagara I, Davoust B, Ranque S, Thera MA, Raoult D, Doumbo OK, Parola P. Molecular Detection of Microorganisms Associated with Small Mammals and Their Ectoparasites in Mali. Am J Trop Med Hyg 2020; 103:2542-2551. [PMID: 33146105 DOI: 10.4269/ajtmh.19-0727] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Small mammals are the natural reservoirs for many zoonotic pathogens. Using molecular tools, we assessed the prevalence of bacteria and protozoans in small mammals and their ectoparasites in Faladjè, Bougouni, and Bamoko, Mali. A total of 130 small mammals belonging to 10 different species were captured, of which 74 (56.9%) were infested by ectoparasites, including Laelaps echidnina, Xenopsylla cheopis, Amblyomma variegatum, Rhipicephalus sanguineus sensu lato, and Haemaphysalis spp. nymphs. DNA of Bartonella was found in 14/75 (18.7%), 6/48 (12.5%), and 3/7 (42.8%) small mammals from Faladjè, Bougouni, and Bamako, respectively. In Faladjè, Bartonella DNA was detected in 31/68 (45.6%) of L. echidnina and 14/22 (63.6%) of X. cheopis. In Bougouni, it was found in 2/26 (7.7%) of L. echidnina and 10/42 (23.8%) of X. cheopis. The sequences of Bartonella obtained from small mammals were close to those of Bartonella mastomydis, Bartonella elizabethae, and uncultured Bartonella spp. In Faladjè, Coxiella burnetii DNA was detected in 64.4% (29/45) of Haemaphysalis spp. ticks, 4.5% (2/44) of Mastomys erythroleucus, 12.5% (1/8) of Praomys daltoni, and 1.5% (1/68) of L. echidnina. We found DNA of Wolbachia in X. cheopis from Faladjè and DNA of Rickettsia africae and Ehrlichia ruminantium in Am. variegatum from Bougouni. The results of our study show that several small mammal species harbor and may serve as potential reservoirs of Bartonella spp., likely to play a major role in the maintenance, circulation, and potential transmission of bacteria in Mali. The pathogenicity of these bacteria for humans or animals remains to be demonstrated.
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Affiliation(s)
- Adama Zan Diarra
- Aix Marseille Univ., IRD, AP-HM, SSA, VITROME, Marseille, France.,Malaria Research and Training Center (MRTC), Department of Epidemiology of Parasitic Diseases (DEAP), Faculty of Medicine and Dentistry, UMI 3189 "Environnement, Santé, Sociétés", University of Science, Techniques and Technologies of Bamako (USTTB), Bamako, Mali.,IHU-Méditerranée Infection, Marseille, France
| | - Abdoulaye Kassoum Kone
- Malaria Research and Training Center (MRTC), Department of Epidemiology of Parasitic Diseases (DEAP), Faculty of Medicine and Dentistry, UMI 3189 "Environnement, Santé, Sociétés", University of Science, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - Safiatou Doumbo Niare
- Malaria Research and Training Center (MRTC), Department of Epidemiology of Parasitic Diseases (DEAP), Faculty of Medicine and Dentistry, UMI 3189 "Environnement, Santé, Sociétés", University of Science, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - Maureen Laroche
- IHU-Méditerranée Infection, Marseille, France.,Aix Marseille Univ., IRD, AP-HM, SSA, VITROME, Marseille, France
| | - Georges Diatta
- VITROME Dakar, Campus International IRD-UCAD Hann, Dakar, Senegal
| | | | - Maïmouna Coulibaly
- Malaria Research and Training Center (MRTC), Department of Epidemiology of Parasitic Diseases (DEAP), Faculty of Medicine and Dentistry, UMI 3189 "Environnement, Santé, Sociétés", University of Science, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - Abdoul Karim Sangare
- Malaria Research and Training Center (MRTC), Department of Epidemiology of Parasitic Diseases (DEAP), Faculty of Medicine and Dentistry, UMI 3189 "Environnement, Santé, Sociétés", University of Science, Techniques and Technologies of Bamako (USTTB), Bamako, Mali.,Centre d'Infectiologie Charles Mérieux, Bamako, Mali
| | - Bouréma Kouriba
- Malaria Research and Training Center (MRTC), Department of Epidemiology of Parasitic Diseases (DEAP), Faculty of Medicine and Dentistry, UMI 3189 "Environnement, Santé, Sociétés", University of Science, Techniques and Technologies of Bamako (USTTB), Bamako, Mali.,Centre d'Infectiologie Charles Mérieux, Bamako, Mali
| | - Abdoulaye Djimde
- Malaria Research and Training Center (MRTC), Department of Epidemiology of Parasitic Diseases (DEAP), Faculty of Medicine and Dentistry, UMI 3189 "Environnement, Santé, Sociétés", University of Science, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - Abdoulaye Dabo
- Malaria Research and Training Center (MRTC), Department of Epidemiology of Parasitic Diseases (DEAP), Faculty of Medicine and Dentistry, UMI 3189 "Environnement, Santé, Sociétés", University of Science, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - Issaka Sagara
- Malaria Research and Training Center (MRTC), Department of Epidemiology of Parasitic Diseases (DEAP), Faculty of Medicine and Dentistry, UMI 3189 "Environnement, Santé, Sociétés", University of Science, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - Bernard Davoust
- IHU-Méditerranée Infection, Marseille, France.,Aix Marseille Univ., IRD, AP-HM, MEPHI, Marseille, France
| | - Stéphane Ranque
- IHU-Méditerranée Infection, Marseille, France.,Aix Marseille Univ., IRD, AP-HM, SSA, VITROME, Marseille, France
| | - Mahamadou A Thera
- Malaria Research and Training Center (MRTC), Department of Epidemiology of Parasitic Diseases (DEAP), Faculty of Medicine and Dentistry, UMI 3189 "Environnement, Santé, Sociétés", University of Science, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - Didier Raoult
- IHU-Méditerranée Infection, Marseille, France.,Aix Marseille Univ., IRD, AP-HM, MEPHI, Marseille, France
| | - Ogobara K Doumbo
- Malaria Research and Training Center (MRTC), Department of Epidemiology of Parasitic Diseases (DEAP), Faculty of Medicine and Dentistry, UMI 3189 "Environnement, Santé, Sociétés", University of Science, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - Philippe Parola
- IHU-Méditerranée Infection, Marseille, France.,Aix Marseille Univ., IRD, AP-HM, SSA, VITROME, Marseille, France
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23
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Cairns ME, Sagara I, Zongo I, Kuepfer I, Thera I, Nikiema F, Diarra M, Yerbanga SR, Barry A, Tapily A, Coumare S, Milligan P, Tinto H, Ouédraogo JB, Chandramohan D, Greenwood B, Djimde A, Dicko A. Evaluation of seasonal malaria chemoprevention in two areas of intense seasonal malaria transmission: Secondary analysis of a household-randomised, placebo-controlled trial in Houndé District, Burkina Faso and Bougouni District, Mali. PLoS Med 2020; 17:e1003214. [PMID: 32822362 PMCID: PMC7442230 DOI: 10.1371/journal.pmed.1003214] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 07/31/2020] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Seasonal malaria chemoprevention (SMC) is now widely deployed in the Sahel, including several countries that are major contributors to the global burden of malaria. Consequently, it is important to understand whether SMC continues to provide a high level of protection and how SMC might be improved. SMC was evaluated using data from a large, household-randomised trial in Houndé, Burkina Faso and Bougouni, Mali. METHODS AND FINDINGS The parent trial evaluated monthly SMC plus either azithromycin (AZ) or placebo, administered as directly observed therapy 4 times per year between August and November (2014-2016). In July 2014, 19,578 children aged 3-59 months were randomised by household to study group. Children who remained within the age range 3-59 months in August each year, plus children born into study households or who moved into the study area, received study drugs in 2015 and 2016. These analyses focus on the approximately 10,000 children (5,000 per country) under observation each year in the SMC plus placebo group. Despite high coverage and high adherence to SMC, the incidence of hospitalisations or deaths due to malaria and uncomplicated clinical malaria remained high in the study areas (overall incidence rates 12.5 [95% confidence interval (CI): 11.2, 14.1] and 871.1 [95% CI: 852.3, 890.6] cases per 1,000 person-years, respectively) and peaked in July each year, before SMC delivery began in August. The incidence rate ratio comparing SMC within the past 28 days with SMC more than 35 days ago-adjusted for age, country, and household clustering-was 0.13 (95% CI: 0.08, 0.20), P < 0.001 for malaria hospitalisations and deaths from malaria and 0.21 (95% CI 0.20, 0.23), P < 0.001 for uncomplicated malaria, indicating protective efficacy of 87.4% (95% CI: 79.6%, 92.2%) and 78.3% (95% CI: 76.8%, 79.6%), respectively. The prevalence of malaria parasitaemia at weekly surveys during the rainy season and at the end of the transmission season was several times higher in children who missed the SMC course preceding the survey contact, and the smallest prevalence ratio observed was 2.98 (95% CI: 1.95, 4.54), P < 0.001. The frequency of molecular markers of sulfadoxine-pyrimethamine (SP) and amodiaquine (AQ) resistance did not increase markedly over the study period either amongst study children or amongst school-age children resident in the study areas. After 3 years of SMC deployment, the day 28 PCR-unadjusted adequate clinical and parasitological response rate of the SP + AQ regimen in children with asymptomatic malaria was 98.3% (95% CI: 88.6%, 99.8%) in Burkina Faso and 96.1% (95% CI: 91.5%, 98.2%) in Mali. Key limitations of this study are the potential overdiagnosis of uncomplicated malaria by rapid diagnostic tests and the potential for residual confounding from factors related to adherence to the monthly SMC schedule. CONCLUSION Despite strong evidence that SMC is providing a high level of protection, the burden of malaria remains substantial in the 2 study areas. These results emphasise the need for continuing support of SMC programmes. A fifth monthly SMC course is needed to adequately cover the whole transmission season in the study areas and in settings with similar epidemiology. TRIAL REGISTRATION The AZ-SMC trial in which these data were collected was registered at clinicaltrials.gov: NCT02211729.
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Affiliation(s)
- Matthew E. Cairns
- Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, London, United Kingdom
- * E-mail:
| | | | - Issaka Zongo
- Institut de Recherche en Sciences de la Santé, Bobo Dioulasso, Burkina Faso
| | - Irene Kuepfer
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | - Frederic Nikiema
- Institut de Recherche en Sciences de la Santé, Bobo Dioulasso, Burkina Faso
| | | | - Serge R. Yerbanga
- Institut de Recherche en Sciences de la Santé, Bobo Dioulasso, Burkina Faso
| | - Amadou Barry
- Malaria Research and Training Centre, Bamako, Mali
| | | | | | - Paul Milligan
- Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Halidou Tinto
- Institut de Recherche en Sciences de la Santé, Bobo Dioulasso, Burkina Faso
| | | | - Daniel Chandramohan
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Brian Greenwood
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
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24
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Beavogui AH, Delamou A, Camara BS, Camara D, Kourouma K, Camara R, Sagara I, Lama EK, Djimde A. Prevalence of malaria and factors associated with infection in children aged 6 months to 9 years in Guinea: Results from a national cross-sectional study. Parasite Epidemiol Control 2020; 11:e00162. [PMID: 32715113 PMCID: PMC7378695 DOI: 10.1016/j.parepi.2020.e00162] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 04/23/2020] [Accepted: 06/18/2020] [Indexed: 01/03/2023] Open
Abstract
Worldwide, a child dies every two minutes due to malaria with Africa bearing about 90% of all malaria deaths particularly among children. This study aimed to describe malaria prevalence and its associated factors among children aged 6 months to 9 years in Guinea. We conducted a cross-sectional household survey between 02 and 29 August 2014 in children aged 6 months to 9 years in the four natural regions of the country. A five-level cluster sampling using the national database from the national institute of statistics was used to select study participants. A total of 1984 children aged 6 months to 9 years were enrolled. The mean age was 50 months (SD, 27). The rapid diagnostic test showed a high malaria prevalence (44%) countrywide along with regional variation ranging from 38% to 61%. A multivariate analysis showed that living in Forest Guinea (AOR: 2.48; 95% CI: 1.78–3.46), in rural areas (AOR: 1.91; 95% IC: 1.45–2.5) and having a splenomegaly (AOR: 2.66; 95% CI: 1.75–4.04) were highly associated with malaria. This study shows that malaria is still prevalent in Guinea among children aged 6 months to 9 years of age.
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Affiliation(s)
- Abdoul Habib Beavogui
- Centre National de formation et de recherche en santé rurale (CNFRSR) de Maferinyah, Forécariah, Guinea
- Department of Bioclinical and Fundamental Sciences, Gamal Abdel Nasser University, Conakry, Guinea
- Centre d'Excellence Africain pour la Prevention des Maladies Transmissibles (CEA-PCMT), Gamal Abdel Nasser University, Conakry, Guinea
- Corresponding author at: Centre National de formation et de recherche en santé rurale (CNFRSR) de Maferinyah, Forécariah, PoBox: 2649, Conakry, Guinea.
| | - Alexandre Delamou
- Centre National de formation et de recherche en santé rurale (CNFRSR) de Maferinyah, Forécariah, Guinea
- Centre d'Excellence Africain pour la Prevention des Maladies Transmissibles (CEA-PCMT), Gamal Abdel Nasser University, Conakry, Guinea
- Department of Public Health, Gamal Abdel Nasser University, Conakry, Guinea
| | - Bienvenu Salim Camara
- Centre National de formation et de recherche en santé rurale (CNFRSR) de Maferinyah, Forécariah, Guinea
| | - Daouda Camara
- Centre National de formation et de recherche en santé rurale (CNFRSR) de Maferinyah, Forécariah, Guinea
| | - Karifa Kourouma
- Centre National de formation et de recherche en santé rurale (CNFRSR) de Maferinyah, Forécariah, Guinea
| | - Robert Camara
- National Institute of Public Health, Conakry, Guinea
| | - Issaka Sagara
- Malaria Research and Training Center, Faculty of Pharmacy, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | | | - Abdoulaye Djimde
- Malaria Research and Training Center, Faculty of Pharmacy, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
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25
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Talman AM, Ouologuem DTD, Love K, Howick VM, Mulamba C, Haidara A, Dara N, Sylla D, Sacko A, Coulibaly MM, Dao F, Sangare CPO, Djimde A, Lawniczak MKN. Uptake of Plasmodium falciparum Gametocytes During Mosquito Bloodmeal by Direct and Membrane Feeding. Front Microbiol 2020; 11:246. [PMID: 32194521 PMCID: PMC7062676 DOI: 10.3389/fmicb.2020.00246] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 02/03/2020] [Indexed: 11/25/2022] Open
Abstract
Plasmodium falciparum remains one of the leading causes of child mortality, and nearly half of the world's population is at risk of contracting malaria. While pathogenesis results from replication of asexual forms in human red blood cells, it is the sexually differentiated forms, gametocytes, which are responsible for the spread of the disease. For transmission to succeed, both mature male and female gametocytes must be taken up by a female Anopheles mosquito during its blood meal for subsequent differentiation into gametes and mating inside the mosquito gut. Observed circulating numbers of gametocytes in the human host are often surprisingly low. A pre-fertilization behavior, such as skin sequestration, has been hypothesized to explain the efficiency of human-to-mosquito transmission but has not been sufficiently tested due to a lack of appropriate tools. In this study, we describe the optimization of a qPCR tool that enables the relative quantification of gametocytes within very small input samples. Such a tool allows for the quantification of gametocytes in different compartments of the host and the vector that could potentially unravel mechanisms that enable highly efficient malaria transmission. We demonstrate the use of our gametocyte quantification method in mosquito blood meals from both direct skin feeding on Plasmodium gametocyte carriers and standard membrane feeding assay. Relative gametocyte abundance was not different between mosquitoes fed through a membrane or directly on the skin suggesting that there is no systematic enrichment of gametocytes picked up in the skin.
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Affiliation(s)
- Arthur M. Talman
- Wellcome Sanger Institute, Hinxton, United Kingdom
- MIVEGEC, IRD, CNRS, University of Montpellier, Montpellier, France
| | - Dinkorma T. D. Ouologuem
- Malaria Research and Training Centre, University of Science, Techniques and Technologies of Bamako, Bamako, Mali
| | - Katie Love
- Wellcome Sanger Institute, Hinxton, United Kingdom
| | | | | | - Aboubecrin Haidara
- Malaria Research and Training Centre, University of Science, Techniques and Technologies of Bamako, Bamako, Mali
| | - Niawanlou Dara
- Malaria Research and Training Centre, University of Science, Techniques and Technologies of Bamako, Bamako, Mali
| | - Daman Sylla
- Malaria Research and Training Centre, University of Science, Techniques and Technologies of Bamako, Bamako, Mali
| | - Adama Sacko
- Malaria Research and Training Centre, University of Science, Techniques and Technologies of Bamako, Bamako, Mali
| | - Mamadou M. Coulibaly
- Malaria Research and Training Centre, University of Science, Techniques and Technologies of Bamako, Bamako, Mali
| | - Francois Dao
- Malaria Research and Training Centre, University of Science, Techniques and Technologies of Bamako, Bamako, Mali
| | - Cheick P. O. Sangare
- Malaria Research and Training Centre, University of Science, Techniques and Technologies of Bamako, Bamako, Mali
| | - Abdoulaye Djimde
- Malaria Research and Training Centre, University of Science, Techniques and Technologies of Bamako, Bamako, Mali
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26
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Chan XHS, Win YN, Haeusler IL, Tan JY, Loganathan S, Saralamba S, Chan SKS, Ashley EA, Barnes KI, Baiden R, Bassi PU, Djimde A, Dorsey G, Duparc S, Hanboonkunupakarn B, ter Kuile FO, Lacerda MVG, Nasa A, Nosten FH, Onyeji CO, Pukrittayakamee S, Siqueira AM, Tarning J, Taylor WRJ, Valentini G, van Vugt M, Wesche D, Day NPJ, Huang CLH, Brugada J, Price RN, White NJ. Factors affecting the electrocardiographic QT interval in malaria: A systematic review and meta-analysis of individual patient data. PLoS Med 2020; 17:e1003040. [PMID: 32134952 PMCID: PMC7058280 DOI: 10.1371/journal.pmed.1003040] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 02/05/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Electrocardiographic QT interval prolongation is the most widely used risk marker for ventricular arrhythmia potential and thus an important component of drug cardiotoxicity assessments. Several antimalarial medicines are associated with QT interval prolongation. However, interpretation of electrocardiographic changes is confounded by the coincidence of peak antimalarial drug concentrations with recovery from malaria. We therefore reviewed all available data to characterise the effects of malaria disease and demographic factors on the QT interval in order to improve assessment of electrocardiographic changes in the treatment and prevention of malaria. METHODS AND FINDINGS We conducted a systematic review and meta-analysis of individual patient data. We searched clinical bibliographic databases (last on August 21, 2017) for studies of the quinoline and structurally related antimalarials for malaria-related indications in human participants in which electrocardiograms were systematically recorded. Unpublished studies were identified by the World Health Organization (WHO) Evidence Review Group (ERG) on the Cardiotoxicity of Antimalarials. Risk of bias was assessed using the Pharmacoepidemiological Research on Outcomes of Therapeutics by a European Consortium (PROTECT) checklist for adverse drug events. Bayesian hierarchical multivariable regression with generalised additive models was used to investigate the effects of malaria and demographic factors on the pretreatment QT interval. The meta-analysis included 10,452 individuals (9,778 malaria patients, including 343 with severe disease, and 674 healthy participants) from 43 studies. 7,170 (68.6%) had fever (body temperature ≥ 37.5°C), and none developed ventricular arrhythmia after antimalarial treatment. Compared to healthy participants, patients with uncomplicated falciparum malaria had shorter QT intervals (-61.77 milliseconds; 95% credible interval [CI]: -80.71 to -42.83) and increased sensitivity of the QT interval to heart rate changes. These effects were greater in severe malaria (-110.89 milliseconds; 95% CI: -140.38 to -81.25). Body temperature was associated independently with clinically significant QT shortening of 2.80 milliseconds (95% CI: -3.17 to -2.42) per 1°C increase. Study limitations include that it was not possible to assess the effect of other factors that may affect the QT interval but are not consistently collected in malaria clinical trials. CONCLUSIONS Adjustment for malaria and fever-recovery-related QT lengthening is necessary to avoid misattributing malaria-disease-related QT changes to antimalarial drug effects. This would improve risk assessments of antimalarial-related cardiotoxicity in clinical research and practice. Similar adjustments may be indicated for other febrile illnesses for which QT-interval-prolonging medications are important therapeutic options.
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Affiliation(s)
- Xin Hui S. Chan
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Yan Naung Win
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Health and Diseases Control Unit, Naypyidaw, Myanmar
| | - Ilsa L. Haeusler
- WorldWide Antimalarial Research Network, Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
- University College London Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Jireh Y. Tan
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Shanghavie Loganathan
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Christ Church College, University of Oxford, Oxford, United Kingdom
| | - Sompob Saralamba
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Shu Kiat S. Chan
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Singapore Armed Forces Medical Corps, Singapore
| | - Elizabeth A. Ashley
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Vientiane, Lao PDR
| | - Karen I. Barnes
- Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa
- WorldWide Antimalarial Resistance Network, Cape Town, South Africa
| | | | - Peter U. Bassi
- Department of Internal Medicine, Faculty of Clinical Sciences, College of Health Sciences, University of Abuja, Abuja, Nigeria
| | - Abdoulaye Djimde
- Malaria Research and Training Center, Department of Epidemiology of Parasitic Diseases, Faculty of Pharmacy, University of Science Techniques and Technologies of Bamako, Bamako, Mali
| | - Grant Dorsey
- Department of Medicine, University of California San Francisco, San Francisco, California, United States of America
| | | | - Borimas Hanboonkunupakarn
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Feiko O. ter Kuile
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Marcus V. G. Lacerda
- Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Manaus, Brazil
- Instituto Leônidas e Maria Deane (FIOCRUZ-Amazonas), Fundação Oswaldo Cruz, Manaus, Brazil
| | - Amit Nasa
- Sun Pharmaceutical Industries Ltd, Gurgaon, Haryana, India
| | - François H. Nosten
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
| | | | - Sasithon Pukrittayakamee
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- The Royal Society of Thailand, Dusit, Bangkok, Thailand
| | - André M. Siqueira
- Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Manaus, Brazil
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Joel Tarning
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
- WorldWide Antimalarial Research Network, Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Walter R. J. Taylor
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | | | - Michèle van Vugt
- Amsterdam University Medical Centers, Location Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - David Wesche
- Certara, Princeton, New Jersey, United States of America
| | - Nicholas P. J. Day
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | | | - Josep Brugada
- Cardiovascular Institute, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Ric N. Price
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Nicholas J. White
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
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Togo AH, Dubourg G, Camara A, Konate S, Delerce J, Andrieu C, Djimde A, Thera MA, Million M, Raoult D. Listeria monocytogenes in human milk in Mali: A potential health emergency. J Infect 2019; 80:121-142. [PMID: 31560881 DOI: 10.1016/j.jinf.2019.09.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Accepted: 09/19/2019] [Indexed: 12/26/2022]
Affiliation(s)
- Amadou Hamidou Togo
- Aix Marseille Univ, IRD, AP-HM, MEPHI, Marseille, France; IHU-Méditerranée Infection, Marseille, France; Malaria Research and Training Center, Department of Epidemiology of Parasitic Diseases, University of Science, Techniques and Technologies of Bamako, Bamako, Mali
| | - Gregory Dubourg
- Aix Marseille Univ, IRD, AP-HM, MEPHI, Marseille, France; IHU-Méditerranée Infection, Marseille, France
| | - Aminata Camara
- Aix Marseille Univ, IRD, AP-HM, MEPHI, Marseille, France; IHU-Méditerranée Infection, Marseille, France; Malaria Research and Training Center, Department of Epidemiology of Parasitic Diseases, University of Science, Techniques and Technologies of Bamako, Bamako, Mali
| | - Salimata Konate
- Aix Marseille Univ, IRD, AP-HM, MEPHI, Marseille, France; IHU-Méditerranée Infection, Marseille, France; Malaria Research and Training Center, Department of Epidemiology of Parasitic Diseases, University of Science, Techniques and Technologies of Bamako, Bamako, Mali
| | - Jeremy Delerce
- Aix Marseille Univ, IRD, AP-HM, MEPHI, Marseille, France; IHU-Méditerranée Infection, Marseille, France
| | - Claudia Andrieu
- Aix Marseille Univ, IRD, AP-HM, MEPHI, Marseille, France; IHU-Méditerranée Infection, Marseille, France
| | - Abdoulaye Djimde
- Malaria Research and Training Center, Department of Epidemiology of Parasitic Diseases, University of Science, Techniques and Technologies of Bamako, Bamako, Mali
| | - Mahamadou Ali Thera
- Malaria Research and Training Center, Department of Epidemiology of Parasitic Diseases, University of Science, Techniques and Technologies of Bamako, Bamako, Mali
| | - Matthieu Million
- Aix Marseille Univ, IRD, AP-HM, MEPHI, Marseille, France; IHU-Méditerranée Infection, Marseille, France
| | - Didier Raoult
- Aix Marseille Univ, IRD, AP-HM, MEPHI, Marseille, France; IHU-Méditerranée Infection, Marseille, France.
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Ghansah A, Kamau E, Amambua-Ngwa A, Ishengoma DS, Maiga-Ascofare O, Amenga-Etego L, Deme A, Yavo W, Randrianarivelojosia M, Ochola-Oyier LI, Helegbe GK, Bailey J, Alifrangis M, Djimde A. Targeted Next Generation Sequencing for malaria research in Africa: current status and outlook. Malar J 2019; 18:324. [PMID: 31547818 PMCID: PMC6757370 DOI: 10.1186/s12936-019-2944-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 08/29/2019] [Indexed: 11/10/2022] Open
Abstract
Targeted Next Generation Sequencing (TNGS) is an efficient and economical Next Generation Sequencing (NGS) platform and the preferred choice when specific genomic regions are of interest. So far, only institutions located in middle and high-income countries have developed and implemented the technology, however, the efficiency and cost savings, as opposed to more traditional sequencing methodologies (e.g. Sanger sequencing) make the approach potentially well suited for resource-constrained regions as well. In April 2018, scientists from the Plasmodium Diversity Network Africa (PDNA) and collaborators met during the 7th Pan African Multilateral Initiative of Malaria (MIM) conference held in Dakar, Senegal to explore the feasibility of applying TNGS to genetic studies and malaria surveillance in Africa. The group of scientists reviewed the current experience with TNGS platforms in sub-Saharan Africa (SSA) and identified potential roles the technology might play to accelerate malaria research, scientific discoveries and improved public health in SSA. Research funding, infrastructure and human resources were highlighted as challenges that will have to be mitigated to enable African scientists to drive the implementation of TNGS in SSA. Current roles of important stakeholders and strategies to strengthen existing networks to effectively harness this powerful technology for malaria research of public health importance were discussed.
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Affiliation(s)
- Anita Ghansah
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, P. O. Box LG 581, Legon, Ghana
| | - Edwin Kamau
- Department of Emerging and Infectious Diseases (DEID), United States Army Medical Research Directorate -Africa (USAMR D-A), Kenya Medical Research Institute (KEMRI), Kisumu, Kenya.,U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Alfred Amambua-Ngwa
- Parasite Molecular Biology, Disease Control and Elimination, Medical Research Council Unit The Gambia at LSHTM, Atlantic Road Fajara, Banjul, The Gambia
| | | | | | - Lucas Amenga-Etego
- West Africa Centre for Cell Biology of Infectious Pathogens, College of Basic and Applied Sciences, University of Ghana, Legon, Ghana
| | - Awa Deme
- Department of Parasitology, Faculty of Medicine and Pharmacy, Cheikh Anta Diop University, Dakar, Senegal
| | - William Yavo
- Faculty of Pharmacy, Department of Parasitology and Mycology, Fe ́lix Houphoue ̈t-Boigny University, BPV 34, Abidjan, Côte d'Ivoire.,Malaria Research and Control Centre, National Institute of Public Health, BPV 47, Abidjan, Côte d'Ivoire
| | | | | | | | - Gideon Kofi Helegbe
- Department of Biochemistry and Molecular Medicine, School of Medicine and Health Sciences, University for Development Studies, P. O. Box TL1883, Tamale, Northern Region, Ghana
| | - Jeffery Bailey
- Warren Alpert Medical School, Brown University, 55 Claverick St, Rm 314B, Providence, RI, 02903, USA
| | - Michael Alifrangis
- Centre for Medical Parasitology, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Abdoulaye Djimde
- Malaria Research and Training Centre, University of Science, Techniques and Technologies of Bamako, Bamako, Mali. .,Wellcome Trust Sanger Institute, Hinxton, UK.
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Apinjoh TO, Ouattara A, Titanji VPK, Djimde A, Amambua-Ngwa A. Genetic diversity and drug resistance surveillance of Plasmodium falciparum for malaria elimination: is there an ideal tool for resource-limited sub-Saharan Africa? Malar J 2019; 18:217. [PMID: 31242921 PMCID: PMC6595576 DOI: 10.1186/s12936-019-2844-5] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Accepted: 06/18/2019] [Indexed: 12/20/2022] Open
Abstract
The intensification of malaria control interventions has resulted in its global decline, but it remains a significant public health burden especially in sub-Saharan Africa (sSA). Knowledge on the parasite diversity, its transmission dynamics, mechanisms of adaptation to environmental and interventional pressures could help refine or develop new control and elimination strategies. Critical to this is the accurate assessment of the parasite’s genetic diversity and monitoring of genetic markers of anti-malarial resistance across all susceptible populations. Such wide molecular surveillance will require selected tools and approaches from a variety of ever evolving advancements in technology and the changing epidemiology of malaria. The choice of an effective approach for specific endemic settings remains challenging, particularly for countries in sSA with limited access to advanced technologies. This article examines the current strategies and tools for Plasmodium falciparum genetic diversity typing and resistance monitoring and proposes how the different tools could be employed in resource-poor settings. Advanced approaches enabling targeted deep sequencing is valued as a sensitive method for assessing drug resistance and parasite diversity but remains out of the reach of most laboratories in sSA due to the high cost of development and maintenance. It is, however, feasible to equip a limited number of laboratories as Centres of Excellence in Africa (CEA), which will receive and process samples from a network of peripheral laboratories in the continent. Cheaper, sensitive and portable real-time PCR methods can be used in peripheral laboratories to pre-screen and select samples for targeted deep sequence or genome wide analyses at these CEAs.
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Affiliation(s)
- Tobias O Apinjoh
- Department of Biochemistry and Molecular Biology, University of Buea, Buea, Cameroon
| | - Amed Ouattara
- School of Medicine, University of Maryland, College Park, Baltimore, USA
| | - Vincent P K Titanji
- Faculty of Science, Engineering and Technology, Cameroon Christian University, Bali, Cameroon
| | - Abdoulaye Djimde
- Malaria Research and Training Centre, University of Science, Techniques and Technologies of Bamako, Bamako, Mali
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Maiga H, Bamadio A, Traore A, Diallo N, Diarra M, Sagara I, Niangaly H, Coumare S, Sangare B, Traore D, Vaillant M, Dicko A, Doumbo OK, Djimde A. PO 8269 SELECTION OF SEVEN-MUTATION PFCRT-PFMDR1 GENOTYPE AFTER SCALING-UP SEASONAL MALARIA CHEMOPREVENTION WITH SULPHADOXINE-PYRIMETHAMINE AND AMODIAQUINE IN MALI. BMJ Glob Health 2019. [DOI: 10.1136/bmjgh-2019-edc.63] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BackgroundWHO recommended seasonal malaria chemoprevention (SMC) in 2012 for Sahel countries in Africa with the aim to reduce malaria among children under 5 years old by using sulphadoxine-pyrimethamine and amodiaquine (SP+AQ). This strategy was scaled up in Mali from 2012. The use of millions of doses of SP+AQ could generate potential Plasmodium falciparum resistance in mutant parasites. The aim of this study was to monitor the prevalence of Pfdhfr +Pfdhps+pfcrt +pfmdr1 mutations in parasites infecting the target population.MethodsTwo cross-sectional surveys were conducted before (August 2012, n=662) and after (June 2014, n=670) a pilot implementation of SMC in the health district of Koutiala. Children aged 3–59 months received 3 and 4 rounds of curative doses of SP+AQ over two malaria seasons in 2012 and 2013, respectively. Genotypes of P. falciparum Pfdhfr codons 51, 59, 108 and 164; Pfdhps codons 437 and 540, Pfcrt codon 76 and Pfmdr1 codon 86 were analysed by PCR on DNA of parasites from SMC population blood samples (after and before) and non-SMC patients aged 7 years or above (November 2014, n=500).ResultsIn the SMC population 191 and 85 children before and after SMC implementation, respectively, were included inthe molecular analysis. In the non-SMC patients, 220 weresuccessfully PCR analysed. In the SMC population, theprevalence of the six-mutation Pfcrt [Pfdhfr-dhps quintuple +Pfcrt-76T] genotype increased significantly after SMC implementation, from 0.0% to 7.1% (p=0.0008). The post-intervention prevalence of the six-mutation Pfmdr1 [Pfdhfr-dhps quintuple +Pfmdr1–86Y] and the seven-mutation Pfcrt +Pfmdr1 [Pfdhfr-dhps quintuple +Pfmdr1–86Y+Pfcrt-76T] genotypes were both 1.2% among the SMC population. No six-mutation and seven-mutation genotypes were observed among SMC population at baseline nor in the non-SMC patient population (p=0.30).ConclusionSMC increased the prevalence of the six-mutation Pfcrt genotype of P. falciparum that can lead to resistance in a population exposed to SMC with SP+AQ.
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Djimde A, Grobusch MP, Zoleko Manego R, Mombo-Ngoma G, Picot S, Sagara I, Sutherland C, Kone A, Doumbo OK, Pedro Gil J, Björkman A, Borrmann S, Soulama I, Fofana B, Duparc S, Dicko A, Hughes D, Winnips C, Sirima SB, Adehossi E, Ouedraogo JB, Dembele L, Zongo I, Biguenet S, Ilboudo-Sanogo E, Fofana A. OC 8721 WANECAM II – A CLINICAL TRIAL PROGRAMME TO ASSESS SAFETY, EFFICACY AND TRANSMISSION-BLOCKING PROPERTIES OF A NEW ANTIMALARIAL KAF156 (GANAPLACIDE) IN UNCOMPLICATED MALARIA IN WEST AND CENTRAL AFRICA. BMJ Glob Health 2019. [DOI: 10.1136/bmjgh-2019-edc.43] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
BackgroundDespite major progress in the past decade, malaria remains a major public health problem in sub-Saharan Africa. West and Central Africa account for nearly 2/3 of the burden currently attributable to falciparum malaria. Artemisinin-based combination therapies (ACT) are a cornerstone of our strategy for controlling and eventually eliminating malaria. However, reduced responsiveness/resistance to artemisinin derivatives and to ACTs, an increasing problem in South-East Asia is a major concern. It is of utmost importance to develop new antimalarial drugs from novel chemical classes that can replace ACTs. KAF156, an imidazolepiperazine, is a leading candidate in the antimalarial drug development pipeline. Combination of KAF156 with a Solid Dispersion Formulation of lumefantrine (LUM-SDF) is expected to be fast acting, fully curative, improve patient adherence and can potentially reduce malaria transmission.MethodsWANECAM II proposes to advance the clinical development of KAF156 through clinical trials in adults and children, with integrated capacity building and infrastructure development activities. The trial programme will be undertaken in the context of networking, team-building, leadership development and community engagement schemes that will involve intra-European, European-African and intra-African collaborative activities. WANECAM II will accelerate the clinical study of children less than 2 years of age which are the key target for new antimalarial treatments.ResultsBy the end of the project, the results are expected to contribute to the registration of KAF156/LUM-SDF through stringent regulatory health authorities, increase biomedical research capacity in the consortium and effectively promote networking among the respective teams. A new clinical research team in Niger, a grossly underrepresented country in the African research landscape, will be developed and further increase capacity and infrastructure in the consortium.ConclusionProviding a new antimalarial drug combination that does not contain an artemisinin derivative and is effective against resistant P. falciparum strains as well as gametocytes and that is likely to be taken in 3 or fewer single doses will be a major advance in the field. The new combination of KAF156 with LUM-SDF is expected to provide such major advance upon successful conclusion of the WANECAM II project.
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Inoue J, Silva M, Fofana B, Sanogo K, Mårtensson A, Sagara I, Björkman A, Veiga MI, Ferreira PE, Djimde A, Gil JP. Plasmodium falciparum Plasmepsin 2 Duplications, West Africa. Emerg Infect Dis 2018; 24. [PMID: 29798744 PMCID: PMC6056108 DOI: 10.3201/eid2408.180370] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Dihydroartemisinin/piperaquine (DHA/PPQ) is increasingly deployed as antimalaria drug in Africa. We report the detection in Mali of Plasmodium falciparum infections carrying plasmepsin 2 duplications (associated with piperaquine resistance) in 7/65 recurrent infections within 2 months after DHA/PPQ treatment. These findings raise concerns about the long-term efficacy of DHA/PPQ treatment in Africa.
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Apinjoh TO, Mugri RN, Miotto O, Chi HF, Tata RB, Anchang-Kimbi JK, Fon EM, Tangoh DA, Nyingchu RV, Jacob C, Amato R, Djimde A, Kwiatkowski D, Achidi EA, Amambua-Ngwa A. Molecular markers for artemisinin and partner drug resistance in natural Plasmodium falciparum populations following increased insecticide treated net coverage along the slope of mount Cameroon: cross-sectional study. Infect Dis Poverty 2017; 6:136. [PMID: 29110722 PMCID: PMC5674235 DOI: 10.1186/s40249-017-0350-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 08/09/2017] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Drug resistance is one of the greatest challenges of malaria control programmes, with the monitoring of parasite resistance to artemisinins or to Artemisinin Combination Therapy (ACT) partner drugs critical to elimination efforts. Markers of resistance to a wide panel of antimalarials were assessed in natural parasite populations from southwestern Cameroon. METHODS Individuals with asymptomatic parasitaemia or uncomplicated malaria were enrolled through cross-sectional surveys from May 2013 to March 2014 along the slope of mount Cameroon. Plasmodium falciparum malaria parasitaemic blood, screened by light microscopy, was depleted of leucocytes using CF11 cellulose columns and the parasite genotype ascertained by sequencing on the Illumina HiSeq platform. RESULTS A total of 259 participants were enrolled in this study from three different altitudes. While some alleles associated with drug resistance in pfdhfr, pfmdr1 and pfcrt were highly prevalent, less than 3% of all samples carried mutations in the pfkelch13 gene, none of which were amongst those associated with slow artemisinin parasite clearance rates in Southeast Asia. The most prevalent haplotypes were triple mutants Pfdhfr I 51 R 59 N 108 I 164(99%), pfcrt- C72V73 I 74 E 75 T 76 (47.3%), and single mutants PfdhpsS436 G 437K540A581A613(69%) and Pfmdr1 N86 F 184D1246 (53.2%). CONCLUSIONS The predominance of the Pf pfcrt CVIET and Pf dhfr IRN triple mutant parasites and absence of pfkelch13 resistance alleles suggest that the amodiaquine and pyrimethamine components of AS-AQ and SP may no longer be effective in their role while chloroquine resistance still persists in southwestern Cameroon.
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Affiliation(s)
- Tobias O. Apinjoh
- Department of Biochemistry and Molecular Biology, University of Buea, Buea, Cameroon
| | - Regina N. Mugri
- Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
| | - Olivo Miotto
- Mahidol-Oxford Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Hanesh F. Chi
- Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
| | - Rolland B. Tata
- Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
| | | | - Eleanor M. Fon
- Department of Biochemistry and Molecular Biology, University of Buea, Buea, Cameroon
| | - Delphine A. Tangoh
- Department of Biochemistry and Molecular Biology, University of Buea, Buea, Cameroon
- Department of Medical Laboratory Science, University of Buea, Buea, Cameroon
| | - Robert V. Nyingchu
- Department of Biochemistry and Molecular Biology, University of Buea, Buea, Cameroon
- Department of Medical Laboratory Science, University of Buea, Buea, Cameroon
| | | | - Roberto Amato
- Wellcome Trust Sanger Institute, Hinxton, Cambridge, CB10 1SA UK
| | | | | | - Eric A. Achidi
- Department of Biochemistry and Molecular Biology, University of Buea, Buea, Cameroon
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Kone A, Dara A, Niangaly A, Sinha I, Brodin D, Fofana B, Dama S, Dembele D, Sidibe B, Diallo N, Thera M, Sagara I, Wright K, Björkman A, Gil J, Doumbo O, Djimde A. EFFECT OF ARTESUNATE MONOTHERAPY ON PLASMODIUM FALCIPARUMIN VIVO GENOMIC EXPRESSION. BMJ Glob Health 2017. [DOI: 10.1136/bmjgh-2016-000260.43] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Kabore N, Barry N, Kabre Z, Werme K, Fofana A, Compaore D, Nikiema F, Some F, Djimde A, Zongo I, Ouedraogo B. RANDOMIZED TRIAL TO ASSESS EFFECT OF REPEATED TREATMENT OF DHA-PQ AND AL ON QTC INTERVAL IN PATIENTS PRESENTING WITH UNCOMPLICATED MALARIA IN BOBO-DIOULASSO, BURKINA FASO. BMJ Glob Health 2017. [DOI: 10.1136/bmjgh-2016-000260.34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Kone A, Sagara I, Björkman A, Djimde A, Gil JP. PATTERNS OF MOLECULAR MARKERS OF RESISTANCE IN ‘REAL LIFE’ REPETITIVE DIHYDROARTEMISININ-PIPERAQUINE MALARIA TREATMENT: A MOLECULAR ANALYSIS OF THE WANECAM CLINICAL TRIAL PLATFORM OUTPUT. BMJ Glob Health 2017. [DOI: 10.1136/bmjgh-2016-000260.35] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Sissoko S, Kone A, Fofana B, Sangaré C, Dembele D, Toure S, Sanogo K, Diakite H, Toure S, Doumbia D, Haidara K, Doumbo O, Djimde A. PF3D7_1343700 KELCH PROPELLER (K13-PROPELLER) POLYMORPHISMS AND ARTESUNATE MONOTHERAPY EFFICACY IN UNCOMPLICATED MALARIA TREATMENT IN MALI. BMJ Glob Health 2017. [DOI: 10.1136/bmjgh-2016-000260.45] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Djimde M, Vaillant M, Samouda H, Sagara I, Djimde A, Doumbo O. WEIGHT STATUS ROLE ON ANTIMALARIAL DRUG EFFICACY AND SAFETY IN SUBURBAN CHILD POPULATION IN MALI. BMJ Glob Health 2017. [DOI: 10.1136/bmjgh-2016-000260.78] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Diawara E, Beavogui A, Camara D, Sylla M, Yattara M, Sow A, Camara GC, Diallo S, Doumbo O, Djimde A. IMPACT OF TREATMENT OF UNCOMPLICATED MALARIA BY AMODIAQUINE−ARTESUNATE (AS-AQ) ON PFCRT 76T AND PFMDR1 86Y MUTATIONS SELECTION IN PLASMODIUM FALCIPARUMISOLATES, REPUBLIC OF GUINEA. BMJ Glob Health 2017. [DOI: 10.1136/bmjgh-2016-000260.56] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Fofana B, Djimde A, Diakité H, Sagara I, Doumbo O, Toure S, Sanogo K. TIME TO SECOND AND THIRD EPISODES OF MALARIA OF DIHYDROARTEMISININ−PIPERAQUINE VSARTESUNATE−AMODIAQUINE AND ARTESUNATE−PYRONARIDINE VSARTEMETER−LUMEFANTRINE IN BOUGOULA HAMEAU, MALI. BMJ Glob Health 2017. [DOI: 10.1136/bmjgh-2016-000260.64] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Dao F, Dara N, Sidibe B, Coulibaly M, Tolo A, Maiga H, Ouologuem N, Niangaly H, Sagara I, Djimde A. COMPARISON OF AUTOMATIC AND MANUAL MEASUREMENT OF QT AND QTC INTERVALS DURING A CLINICAL PHASE III-B/ IV IN KOLLE, MALI. BMJ Glob Health 2017. [DOI: 10.1136/bmjgh-2016-000260.51] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Tekete M, Burhenne J, Fofana B, Toure S, Dama S, Dara N, Traore O, Sidibe B, Djimde A, Haefeli W, Borrmann S. LUMEFANTRINE DISPOSITION AFTER REPETITIVE TREATMENT OF UNCOMPLICATED MALARIA PATIENTS WITH ARTEMETHER-LUMEFANTRINE IN MALI. BMJ Glob Health 2017. [DOI: 10.1136/bmjgh-2016-000260.61] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Maiga H, Lasry E, Diarra M, Sagara I, Bamadio A, Traore A, Coumare S, Soma B, Dicko Y, Diallo N, Sangare B, Tembely A, Traore D, Niangaly H, Dao F, Haidara A, Dicko A, Doumbo O, Djimde A. SEASONAL MALARIA CHEMOPREVENTION WITH SULPHADOXINE-PYRIMETHAMINE AND AMODIAQUINE SELECTS DHFR-DHPS QUINTUPLE MUTANT GENOTYPE IN MALI. BMJ Glob Health 2017. [DOI: 10.1136/bmjgh-2016-000260.55] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Okeke IN, Babalola CP, Byarugaba DK, Djimde A, Osoniyi OR. Broadening Participation in the Sciences within and from Africa: Purpose, Challenges, and Prospects. CBE Life Sci Educ 2017; 16:16/2/es2. [PMID: 28408409 PMCID: PMC5459259 DOI: 10.1187/cbe.15-12-0265] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Revised: 12/29/2016] [Accepted: 01/06/2017] [Indexed: 06/02/2023]
Abstract
Many of Africa's challenges have scientific solutions, but there are fewer individuals engaged in scientific activity per capita on this continent than on any other. Only a handful of African scientists use their skills to capacity or are leaders in their disciplines. Underrepresentation of Africans in scientific practice, discourse, and decision making reduces the richness of intellectual contributions toward hard problems worldwide. This essay outlines challenges faced by teacher-scholars from sub-Saharan Africa as we build scientific expertise. Access to tertiary-level science is difficult and uneven across Africa, and the quality of training available varies from top-range to inadequate. Access to science higher education needs to increase, particularly for female students, first-generation literates, and rural populations. We make suggestions for collaborative initiatives involving stakeholders outside Africa and/or outside academia that could extend educational opportunities available to African students and increase the chance that Africa-based expertise is globally available.
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Affiliation(s)
- Iruka N Okeke
- Faculty of Pharmacy, University of Ibadan, Ibadan, Nigeria
| | | | - Denis K Byarugaba
- Department of Microbiology, Makerere University, Kampala 7062, Uganda
| | - Abdoulaye Djimde
- Malaria Research and Training Center, Department of Epidemiology of Parasitic Diseases, Faculty of Pharmacy, University of Science, Techniques and Technologies of Bamako, Bamako, Mali
| | - Omolaja R Osoniyi
- Department of Biochemistry, Obafemi Awolowo University, Ile-Ife, Nigeria
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Kone AK, Niare DS, Thera MA, Kayentao K, Djimde A, Delaunay P, Kouriba B, Giudice PD, Izri A, Marty P, Doumbo OK. Epidemiology of the outbreak, vectors and reservoirs of cutaneous leishmaniasis in Mali: A systematic review and meta-analysis. ASIAN PAC J TROP MED 2016; 9:985-990. [PMID: 27794393 DOI: 10.1016/j.apjtm.2016.07.025] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Revised: 07/03/2016] [Accepted: 07/10/2016] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To compile available data and to estimate the burden, characteristics and risks factors of cutaneous leishmaniasis (CL) in Mali. METHODS Articles in English and French were searched in Hinari, Google scholar and PubMed. Unpublished studies were identified by searching in Google.com. Terms used were cutaneous leishmaniasis Mali; Leishmaniasis Mali, Leishmania major Mali; or Phlebotomus Mali or Sergentomyia Mali. We select descriptive studies on CL and sandflies in Mali. Data were extracted and checked by the author, then analyzed by region, by study population and type of biological tests, meta-analysis approach with STATA software was used. RESULTS Nineteen published (n = 19) and three unpublished were included. CL epidemiology was characterized by occurrence of clinical cases in different areas of Mali, outbreaks restricted to known areas of transmission and isolated cases diagnosed in travelers. In endemic areas, population at risk are young age persons, farmers, ranchers, housewives, teachers and military personnel. The annual incidence ranged from 290 to 580 cases of CL. Leishmania major is the main species encountered throughout the country (North Savanna, Sahel and Sub-Saharan areas), and Phlebotomus duboscqi has been identified as the vector and Sergentomyia (Spelaeomyia) darlingi as possible vector. The overall estimated prevalence of positive LST (Leishmanin Skin Test) was 22.1%. The overall frequency of CL disease among suspected cases was 40.3%. CONCLUSIONS Although descriptive, hospital-based and cross-sectional studies are robust enough to determine the extent of CL in Mali; future well-designed eco-epidemiological studies at a nationwide scale are needed to fully characterize CL epidemiology and risk factors in Mali.
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Affiliation(s)
- Abdoulaye Kassoum Kone
- Malaria Research and Training Center, Department of Epidemiology of Parasitic Diseases, Faculty of Medicine, and Dentistry, UMI-3189, University of Science, Technique and Technology of Bamako, BP 1805, Bamako, Mali.
| | - Doumbo Safiatou Niare
- Malaria Research and Training Center, Department of Epidemiology of Parasitic Diseases, Faculty of Medicine, and Dentistry, UMI-3189, University of Science, Technique and Technology of Bamako, BP 1805, Bamako, Mali
| | - Mahamadou Ali Thera
- Malaria Research and Training Center, Department of Epidemiology of Parasitic Diseases, Faculty of Medicine, and Dentistry, UMI-3189, University of Science, Technique and Technology of Bamako, BP 1805, Bamako, Mali
| | - Kassoum Kayentao
- Malaria Research and Training Center, Department of Epidemiology of Parasitic Diseases, Faculty of Medicine, and Dentistry, UMI-3189, University of Science, Technique and Technology of Bamako, BP 1805, Bamako, Mali
| | - Abdoulaye Djimde
- Malaria Research and Training Center, Department of Epidemiology of Parasitic Diseases, Faculty of Medicine, and Dentistry, UMI-3189, University of Science, Technique and Technology of Bamako, BP 1805, Bamako, Mali
| | - Pascal Delaunay
- Inserm U1065, Centre Méditerranéen de Médecine Moléculaire, C3M, Université de Nice-Sophia Antipolis, 151, route St Antoine de Ginestière, BP 2 3194, 06204 Nice Cedex, France; Parasitologie-Mycologie, Hôpital de l'Archet, Centre Hospitalier Universitaire de Nice, France
| | - Bourema Kouriba
- Malaria Research and Training Center, Department of Epidemiology of Parasitic Diseases, Faculty of Medicine, and Dentistry, UMI-3189, University of Science, Technique and Technology of Bamako, BP 1805, Bamako, Mali
| | - Pascal Del Giudice
- Unit of Infectious et Tropical Diseases, Hospital Bonnet, 83700 Fréjus, France
| | - Arezki Izri
- Parasitology-Mycology, Hospital Avicenne, Paris 13 University, UMR 190, Aix-Marseille University, France
| | - Pierre Marty
- Inserm U1065, Centre Méditerranéen de Médecine Moléculaire, C3M, Université de Nice-Sophia Antipolis, 151, route St Antoine de Ginestière, BP 2 3194, 06204 Nice Cedex, France; Parasitologie-Mycologie, Hôpital de l'Archet, Centre Hospitalier Universitaire de Nice, France
| | - Ogobara K Doumbo
- Malaria Research and Training Center, Department of Epidemiology of Parasitic Diseases, Faculty of Medicine, and Dentistry, UMI-3189, University of Science, Technique and Technology of Bamako, BP 1805, Bamako, Mali; Inserm U1065, Centre Méditerranéen de Médecine Moléculaire, C3M, Université de Nice-Sophia Antipolis, 151, route St Antoine de Ginestière, BP 2 3194, 06204 Nice Cedex, France.
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Nabet C, Doumbo S, Jeddi F, Sagara I, Manciulli T, Tapily A, L'Ollivier C, Djimde A, Doumbo OK, Piarroux R. Analyzing Deoxyribose Nucleic Acid from Malaria Rapid Diagnostic Tests to Study Plasmodium falciparum Genetic Diversity in Mali. Am J Trop Med Hyg 2016; 94:1259-65. [PMID: 27001760 DOI: 10.4269/ajtmh.15-0832] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Accepted: 02/15/2016] [Indexed: 11/07/2022] Open
Abstract
We evaluated the use of positive malaria rapid diagnostic tests (mRDTs) to determine genetic diversity of Plasmodium falciparum in Mali. Genetic diversity was assessed via multiple loci variable number of tandem repeats analysis (MLVA). We performed DNA extraction from 104 positive and 30 negative used mRDTs that had been stored at ambient temperature for up to 14 months. Extracted DNA was analyzed via quantitative polymerase chain reaction (qPCR), and MLVA genotyping was then assessed on positive qPCR samples. Eighty-three of the positive mRDTs (83/104, 79.8%) and none of the negative mRDTs were confirmed P. falciparum positive via qPCR. We achieved complete genotyping of 90.4% (75/83) of the qPCR-positive samples. Genotyping revealed high genetic diversity among P. falciparum populations in Mali and an absence of population clustering. We show that mRDTs are useful to monitor P. falciparum genetic diversity and thereby can provide essential data to guide malaria control programs.
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Affiliation(s)
- Cécile Nabet
- UMR MD3 Infections Parasitaires Transmission Pharmacologie et Thérapeutique (IP-TPT), Aix-Marseille University, Marseilles, France; Parasitology Laboratory, Timone Hospital, Marseilles, France; Malaria Research and Training Center, Department of Epidemiology of Parasitic Diseases, UMI 3189, Faculty of Medicine and Dentistry, University of Sciences, Techniques and Technology, Bamako, Mali; University of Pavia, Pavia, Italy
| | - Safiatou Doumbo
- UMR MD3 Infections Parasitaires Transmission Pharmacologie et Thérapeutique (IP-TPT), Aix-Marseille University, Marseilles, France; Parasitology Laboratory, Timone Hospital, Marseilles, France; Malaria Research and Training Center, Department of Epidemiology of Parasitic Diseases, UMI 3189, Faculty of Medicine and Dentistry, University of Sciences, Techniques and Technology, Bamako, Mali; University of Pavia, Pavia, Italy
| | - Fakhri Jeddi
- UMR MD3 Infections Parasitaires Transmission Pharmacologie et Thérapeutique (IP-TPT), Aix-Marseille University, Marseilles, France; Parasitology Laboratory, Timone Hospital, Marseilles, France; Malaria Research and Training Center, Department of Epidemiology of Parasitic Diseases, UMI 3189, Faculty of Medicine and Dentistry, University of Sciences, Techniques and Technology, Bamako, Mali; University of Pavia, Pavia, Italy
| | - Issaka Sagara
- UMR MD3 Infections Parasitaires Transmission Pharmacologie et Thérapeutique (IP-TPT), Aix-Marseille University, Marseilles, France; Parasitology Laboratory, Timone Hospital, Marseilles, France; Malaria Research and Training Center, Department of Epidemiology of Parasitic Diseases, UMI 3189, Faculty of Medicine and Dentistry, University of Sciences, Techniques and Technology, Bamako, Mali; University of Pavia, Pavia, Italy
| | - Tommaso Manciulli
- UMR MD3 Infections Parasitaires Transmission Pharmacologie et Thérapeutique (IP-TPT), Aix-Marseille University, Marseilles, France; Parasitology Laboratory, Timone Hospital, Marseilles, France; Malaria Research and Training Center, Department of Epidemiology of Parasitic Diseases, UMI 3189, Faculty of Medicine and Dentistry, University of Sciences, Techniques and Technology, Bamako, Mali; University of Pavia, Pavia, Italy
| | - Amadou Tapily
- UMR MD3 Infections Parasitaires Transmission Pharmacologie et Thérapeutique (IP-TPT), Aix-Marseille University, Marseilles, France; Parasitology Laboratory, Timone Hospital, Marseilles, France; Malaria Research and Training Center, Department of Epidemiology of Parasitic Diseases, UMI 3189, Faculty of Medicine and Dentistry, University of Sciences, Techniques and Technology, Bamako, Mali; University of Pavia, Pavia, Italy
| | - Coralie L'Ollivier
- UMR MD3 Infections Parasitaires Transmission Pharmacologie et Thérapeutique (IP-TPT), Aix-Marseille University, Marseilles, France; Parasitology Laboratory, Timone Hospital, Marseilles, France; Malaria Research and Training Center, Department of Epidemiology of Parasitic Diseases, UMI 3189, Faculty of Medicine and Dentistry, University of Sciences, Techniques and Technology, Bamako, Mali; University of Pavia, Pavia, Italy
| | - Abdoulaye Djimde
- UMR MD3 Infections Parasitaires Transmission Pharmacologie et Thérapeutique (IP-TPT), Aix-Marseille University, Marseilles, France; Parasitology Laboratory, Timone Hospital, Marseilles, France; Malaria Research and Training Center, Department of Epidemiology of Parasitic Diseases, UMI 3189, Faculty of Medicine and Dentistry, University of Sciences, Techniques and Technology, Bamako, Mali; University of Pavia, Pavia, Italy
| | - Ogobara K Doumbo
- UMR MD3 Infections Parasitaires Transmission Pharmacologie et Thérapeutique (IP-TPT), Aix-Marseille University, Marseilles, France; Parasitology Laboratory, Timone Hospital, Marseilles, France; Malaria Research and Training Center, Department of Epidemiology of Parasitic Diseases, UMI 3189, Faculty of Medicine and Dentistry, University of Sciences, Techniques and Technology, Bamako, Mali; University of Pavia, Pavia, Italy
| | - Renaud Piarroux
- UMR MD3 Infections Parasitaires Transmission Pharmacologie et Thérapeutique (IP-TPT), Aix-Marseille University, Marseilles, France; Parasitology Laboratory, Timone Hospital, Marseilles, France; Malaria Research and Training Center, Department of Epidemiology of Parasitic Diseases, UMI 3189, Faculty of Medicine and Dentistry, University of Sciences, Techniques and Technology, Bamako, Mali; University of Pavia, Pavia, Italy
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Sagara I, Piarroux R, Djimde A, Giorgi R, Kayentao K, Doumbo OK, Gaudart J. Delayed anemia assessment in patients treated with oral artemisinin derivatives for uncomplicated malaria: a pooled analysis of clinical trials data from Mali. Malar J 2014; 13:358. [PMID: 25217396 PMCID: PMC4177171 DOI: 10.1186/1475-2875-13-358] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Accepted: 09/02/2014] [Indexed: 11/16/2022] Open
Abstract
Background In sub-Saharan Africa, artemisinin-based combination therapy (ACT) and injectable artesunate are the first-line treatments for uncomplicated and severe Plasmodium falciparum malaria, respectively. However, recent studies suggest that delayed anaemia is associated with these treatments in non-immune travellers. This paper aimed to assess the risk factors associated with delayed anaemia after falciparum malaria treatment with artemisinin-containing drugs in malaria-endemic populations. Methods Pooled, individual malaria patient data were extracted from 13 clinical trials performed from 2002 to 2011 in various settings of Mali. Treatment regimens were artemether-lumefantrine, artesunate plus amodiaquine, artesunate plus sulphadoxine-pyrimethamine, artesunate plus sulphamethoxypyrazine-pyrimethamine, artesunate plus mefloquine, artesunate-pyronaridine, artesunate monotherapy, chloroquine, sulphadoxine-pyrimethamine, amodiaquine and sulphadoxine-pyrimethamine plus amodiaquine. Univariate and multivariate analyses were performed using the generalized linear and latent mixed model procedures to assess risk factors associated with haemoglobin concentration evolution and anaemia during the treatment follow-up. Results A total of 5,990 participants were recruited and followed from day 0 to day 28. The participants’ median age was five years, ranging from three months to 70 years. There was a decrease in haemoglobin level on day 7 in all treatment arms, but the magnitude varied across treatments. There was a significant risk of haemoglobin level decrease on day 7 in the artemisinin-based therapy compared to the non-artemisinin treatments. The risk of haemoglobin concentration drop was associated with age group < five years old (0.61 g/dL 95% CI (0.71 to 0.51), p < 0.001), baseline high parasite density (0.43 g/dL 95% CI (0.51 to 0.35), p < 0.001) and treatment failure (0.40 g/dL 95% CI (0.59 to 0.20), p = 0.018), while high haemoglobin level at baseline was a protective factor (0.53 to 0.59) p < 0.001). No association was found between artemisinin-based therapy and severe delayed anaemia. Conclusions Oral artemisinin derivative treatments for uncomplicated P. falciparum malaria are associated with a transient and clinically moderate haemoglobin decrease by day 7 but not associated with a delayed severe anaemia. Electronic supplementary material The online version of this article (doi:10.1186/1475-2875-13-358) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Issaka Sagara
- Malaria Research and Training Center, Department of Epidemiology of Parasitic Diseases, Faculty of Medicine and Odonto-Stomatogy, University of Sciences, Techniques and Technologies of Bamako, BP 1805 Point G Bamako, Mali.
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Maiga H, Barger B, Sagara I, Doumbo O, Djimde A. School performance after intermittent preventive treatment using artemisinin-based combination. Int J Infect Dis 2014. [DOI: 10.1016/j.ijid.2014.03.996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Zwang J, Dorsey G, Mårtensson A, d'Alessandro U, Ndiaye JL, Karema C, Djimde A, Brasseur P, Sirima SB, Olliaro P. Plasmodium falciparum clearance in clinical studies of artesunate-amodiaquine and comparator treatments in sub-Saharan Africa, 1999-2009. Malar J 2014; 13:114. [PMID: 24666562 PMCID: PMC3987158 DOI: 10.1186/1475-2875-13-114] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2014] [Accepted: 03/11/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Artemisinin-based combination therapy (ACT) is the recommended first-line therapy for uncomplicated Plasmodium falciparum malaria worldwide but decreased artemisinin susceptibility, phenotypically characterized as slow parasite clearance time (PCT), has now been reported in Southeast Asia. This makes it all too important to measure the dynamics of parasite clearance in African patients treated with ACT over time, to understand trends and detect changes early enough to intervene METHODS Individual patient data from 27 clinical trials of artesunate-amodiaquine (ASAQ) vs comparators conducted between 1999 and 2009 were analysed for parasite clearance on modified intent-to-treat (ITT) basis. RESULTS Overall 15,017 patients treated for uncomplicated P. falciparum malaria at 44 sites in 20 sub-Saharan African countries were included in the analysis; 51% (n=7,660) vs 49% (n=7,357) were treated with ASAQ and comparator treatments, respectively. Seventy-seven per cent (77%) were children under six years of age. The proportion of the patients treated with ASAQ with persistent parasitaemia on Day 2 was 8.6%, and 1.5% on Day 3. Risk factor for not clearing parasites on Day 2 and Day 3 calculated by multivariate logistic regression with random effect on site and controlling for treatment were: high parasitaemia before treatment was (adjusted risk ratios (AOR) 2.12, 95% CI 1.91-2.35, AOR 2.43, 95% CI 1.98-3.00, respectively); non-ACT treatment (p=0.001, for all comparisons). Anaemia (p=0.001) was an additional factor for Day 2 and young age (p=0.005) for Day 3.In patients treated with ASAQ in studies who had complete parasitaemia data every 24 hours up to Day 3 and additionally Day 7, the parasite reduction ratio was 93.9% by Day 1 and 99.9% by Day 2. Using the median parasitaemia before treatment (p0=27,125 μL) and a fitted model, the predicted PCT (pPCT = 3.614*ln (p0) - 6.135, r(2) = 0.94) in ASAQ recipients was 31 hours. CONCLUSION Within the period covered by these studies, rapid Plasmodium falciparum clearance continues to be achieved in Sub-Saharan African patients treated with ACT, and in particular with ASAQ. The prediction formula for parasite clearance time could be a pragmatic tool for studies with binary outcomes and once-daily sampling, both for research and monitoring purposes.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Piero Olliaro
- UNICEF/UNDP/WB/WHO Special Programme for Research & Training in Tropical Diseases (TDR), Geneva, Switzerland.
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Manske M, Miotto O, Campino S, Auburn S, Almagro-Garcia J, Maslen G, O'Brien J, Djimde A, Doumbo O, Zongo I, Ouedraogo JB, Michon P, Mueller I, Siba P, Nzila A, Borrmann S, Kiara SM, Marsh K, Jiang H, Su XZ, Amaratunga C, Fairhurst R, Socheat D, Nosten F, Imwong M, White NJ, Sanders M, Anastasi E, Alcock D, Drury E, Oyola S, Quail MA, Turner DJ, Ruano-Rubio V, Jyothi D, Amenga-Etego L, Hubbart C, Jeffreys A, Rowlands K, Sutherland C, Roper C, Mangano V, Modiano D, Tan JC, Ferdig MT, Amambua-Ngwa A, Conway DJ, Takala-Harrison S, Plowe CV, Rayner JC, Rockett KA, Clark TG, Newbold CI, Berriman M, MacInnis B, Kwiatkowski DP. Analysis of Plasmodium falciparum diversity in natural infections by deep sequencing. Nature 2012; 487:375-9. [PMID: 22722859 PMCID: PMC3738909 DOI: 10.1038/nature11174] [Citation(s) in RCA: 384] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2010] [Accepted: 04/30/2012] [Indexed: 02/02/2023]
Abstract
Malaria elimination strategies require surveillance of the parasite population for genetic changes that demand a public health response, such as new forms of drug resistance. Here we describe methods for the large-scale analysis of genetic variation in Plasmodium falciparum by deep sequencing of parasite DNA obtained from the blood of patients with malaria, either directly or after short-term culture. Analysis of 86,158 exonic single nucleotide polymorphisms that passed genotyping quality control in 227 samples from Africa, Asia and Oceania provides genome-wide estimates of allele frequency distribution, population structure and linkage disequilibrium. By comparing the genetic diversity of individual infections with that of the local parasite population, we derive a metric of within-host diversity that is related to the level of inbreeding in the population. An open-access web application has been established for the exploration of regional differences in allele frequency and of highly differentiated loci in the P. falciparum genome.
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Affiliation(s)
- Magnus Manske
- Wellcome Trust Sanger Institute, Hinxton, Cambridge CB10 1SA, UK
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