Emerging Plasmodium vivax resistance to chloroquine in South America: an overview

Gonçalves, Lígia Antunes; Cravo, Pedro Vitor Lemos; Ferreira, Marcelo U.

doi:10.1590/0074-0276130579

Cited by 62 publications

(67 citation statements)

References 50 publications

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“…these therapies provide fast parasite clearance and prevent recrudescences [16] as first-line treatment for P. vivax [1]. In Latin America, where P. vivax is the most prevalent species causing malaria [1] despite recent evidence of CQR [11, 17–20], no studies comparing the efficacy of ACTs to that of CQ have been reported.…”

mentioning

confidence: 99%

Fixed-Dose Artesunate–Amodiaquine Combination vs Chloroquine for Treatment of Uncomplicated Blood Stage P. vivax Infection in the Brazilian Amazon: An Open-Label Randomized, Controlled Trial

Siqueira

Alencar

Melo

et al. 2016

CLINID

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confidence: 99%

Fixed-Dose Artesunate–Amodiaquine Combination vs Chloroquine for Treatment of Uncomplicated Blood Stage P. vivax Infection in the Brazilian Amazon: An Open-Label Randomized, Controlled Trial

Siqueira

Alencar

Melo

et al. 2016

CLINID

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“…Indeed, Peru is one of the few countries in the Americas with reports of CQ resistance,69 but with no new data reported since 2003. A 28-day drug efficacy trial in the Amazon region and the northern Coast between 1998 and 2001, including 242 P. vivax -infected individuals who received CQ alone (25 mg/kg, over a 3-day period), found four individuals with recurrence of P. vivax parasitemia on days 21 and 28 after treatment.…”

Section: Treatment Efficacy For P Vivax Disease and For Preventing Rmentioning

confidence: 99%

Epidemiology of Plasmodium vivax Malaria in Peru

Aguirre¹,

Gamboa²,

Manrique³

et al. 2016

Am J Trop Med Hyg

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Malaria in Peru, dominated by Plasmodium vivax, remains a public health problem. The 1990s saw newly epidemic malaria emerge, primarily in the Loreto Department in the Amazon region, including areas near to Iquitos, the capital city, but sporadic malaria transmission also occurred in the 1990s–2000s in both north-coastal Peru and the gold mining regions of southeastern Peru. Although a Global Fund-supported intervention (PAMAFRO, 2005–2010) was temporally associated with a decrease of malaria transmission, from 2012 to the present, both P. vivax and Plasmodium falciparum malaria cases have rapidly increased. The Peruvian Ministry of Health continues to provide artemesinin-based combination therapy for microscopy-confirmed cases of P. falciparum and chloroquine–primaquine for P. vivax. Malaria transmission continues in remote areas nonetheless, where the mobility of humans and parasites facilitates continued reintroduction outside of ongoing surveillance activities, which is critical to address for future malaria control and elimination efforts. Ongoing P. vivax research gaps in Peru include the following: identification of asymptomatic parasitemics, quantification of the contribution of patent and subpatent parasitemics to mosquito transmission, diagnosis of nonparasitemic hypnozoite carriers, and implementation of surveillance for potential emergence of chloroquine- and 8-aminoquinoline-resistant P. vivax. Clinical trials of tafenoquine in Peru have been promising, and glucose-6-phosphate dehydrogenase deficiency in the region has not been observed to be a limitation to its use. Larger-scale challenges for P. vivax (and malaria in general) in Peru include logistical difficulties in accessing remote riverine populations, consequences of government policy and poverty trends, and obtaining international funding for malaria control and elimination.

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“…These preliminary data should encourage additional studies on this gene that aim to associate artemisinin or chloroquine resistance based on clinical or in vitro phenotypes to K12 propeller domain protein polymorphism, especially in Indonesia, East Timor, Papua New Guinea, and South America (Guyana, Peru, and Brazil), where chloroquine resistance is frequent (21).…”

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confidence: 94%

Reduced Polymorphism in the Kelch Propeller Domain in Plasmodium vivax Isolates from Cambodia

Popovici

Kao

Eal

et al. 2015

Antimicrob Agents Chemother

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Polymorphism in the ortholog gene of the Plasmodium falciparum K13 gene was investigated in Plasmodium vivax isolates collected in Cambodia. All of them were Sal-1 wild-type alleles except two (2/284, 0.7%), and P. vivax K12 polymorphism was reduced compared to that of the P. falciparum K13 gene. Both mutant allele isolates had the same nonsynonymous mutation at codon 552 (V552I) and were from Ratanak Kiri province. These preliminary data should encourage additional studies for associating artemisinin or chloroquine resistance and K12 polymorphism. In areas in which malaria is endemic and Plasmodium falciparum and Plasmodium vivax are present, such as in Southeast Asia and Pacific Oceania, both species share the same vectors and human hosts, either successively or concomitantly (mixed infections) (1, 2). These two species, in this context, often undergo similar mutation-driven evolution and natural selection. This includes nucleotide substitution, gene duplication/deletion, chromosomal change, and genome duplication (3). In terms of drug resistance, regardless of the fundamental biological differences between the two Plasmodium species, it is well known that antimalarial drug pressure induces a strong selection of resistant parasites for both of these parasite populations. For instance, sequencing of the dhfr gene in P. vivax isolates collected in areas where sulfadoxine-pyrimethamine was used to treat falciparum malaria and the alignment of these alleles with the P. falciparum dhfr gene have clearly demonstrated that mutations in codons 57, 58, 61, 117, and 173 were involved in pyrimethamine resistance and corresponded to the codons 51, 59, 108, and 164 found in P. falciparum pyrimethamine-resistant strains (4). More recently, we observed high frequencies of P. falciparum and P. vivax isolates with increased mdr-1 copy numbers in areas where mefloquine has been extensively used as the first-line treatment in falciparum-uncomplicated malaria, while in areas where mefloquine has never been used, P. falciparum and P. vivax isolates with increased mdr-1 copy numbers are rare (5). These studies clearly show that antimalarial drugs used to treat falciparum malaria have a significant impact on sympatric Plasmodium species, such as P. vivax.Since 2001, artemisinin combination therapies (ACTs) have been recommended as first-line treatment in the national treatment guidelines of most countries in which malaria is endemic. In 2008, the emergence of artemisinin-resistant P. falciparum parasites was observed in Southeast Asia (6-15). Recent molecular and biological studies showed that artemisinin resistance was associated with P. falciparum early ring stages and mutations in the PF3D7_1343700 kelch propeller domain (K13-propeller) (8,14,15). To date, although the role of the P. falciparum K13 protein remains unknown, two pieces of evidence suggest that it is involved in the cellular response to oxidative stress (8): (i) its homology to the KEAP1 human protein, which is involved in cell adaptation to oxidative stress (16), a...

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Emerging Plasmodium vivax resistance to chloroquine in South America: an overview

Cited by 62 publications

References 50 publications

Fixed-Dose Artesunate–Amodiaquine Combination vs Chloroquine for Treatment of Uncomplicated Blood Stage P. vivax Infection in the Brazilian Amazon: An Open-Label Randomized, Controlled Trial

Fixed-Dose Artesunate–Amodiaquine Combination vs Chloroquine for Treatment of Uncomplicated Blood Stage P. vivax Infection in the Brazilian Amazon: An Open-Label Randomized, Controlled Trial

Epidemiology of Plasmodium vivax Malaria in Peru

Reduced Polymorphism in the Kelch Propeller Domain in Plasmodium vivax Isolates from Cambodia

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