The return of chloroquine-susceptible Plasmodium falciparum malaria in Zambia

Mwanza, Sydney; Joshi, Sudhaunshu; Nambozi, Michael; Chileshe, Justin; Malunga, Phidelis; Kabuya, Jean-Bertin; Hachizovu, Sebastian; Manyando, Christine; Mulenga, Modest; Laufer, Miriam K.

doi:10.1186/s12936-016-1637-3

Cited by 59 publications

(59 citation statements)

References 26 publications

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“…Recently, a study carried out in Zambia found the disappearance of chloroquine-resistant malaria after the removal of chloroquine drug pressure. 27 Similarly, Kiarie et al 28 reported that the prevalence of pfcrt K76T diminished 13 years after cessation of chloroquine use in Kenya. These results are consistent with our study; we did not detect the K76T mutation in samples from Kenya and Zambia.…”

Section: Discussionmentioning

confidence: 98%

Surveillance of Antimalarial Resistance Molecular Markers in Imported Plasmodium falciparum Malaria Cases in Anhui, China, 2012–2016

Zhang

Jiang

et al. 2018

The American Journal of Tropical Medicine and Hygiene

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Between 2012 and 2016, over 80% of registered malaria cases in Anhui province were returned from Africa. However, drug-resistance marker polymorphisms in imported cases have not been assessed. This study looked at the distribution of antimalarial-drug resistance by evaluating K13-propeller, , and gene mutations. Fourteen synonymous and 15 nonsynonymous mutations in the K13-propeller gene were detected in samples from nine African countries, yet no candidate and validated K13 resistance mutations were found. The prevalence of K76T and N86Y mutants was 27.7% and 19.9%, respectively. Six different genotypes were found, with CVMNT being the most common (89.2%). The 76- 86 haplotype combination was evaluated in 173 isolates, and the NT genotype was the most prevalent (50.3%). Notably, the prevalence of the N86Y mutation in Africa marked a decline from 31.0% in 2012 to 8.2% in 2016. Our findings suggest that there is no immediate threat to artemisinin efficacy in imported infections returned from Africa to Anhui province. Nevertheless, K76T and N86Y mutations were modestly prevalent, suggesting the presence of chloroquine resistance in these cases. Accordingly, dihydroartemisinin + piperaquine may be a better choice than artesunate + amodiaquine for the treatment of uncomplicated infections in Anhui province. In addition to, artemether-lumefantrine can be introduced as an alternative measure.

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Section: Discussionmentioning

confidence: 98%

Surveillance of Antimalarial Resistance Molecular Markers in Imported Plasmodium falciparum Malaria Cases in Anhui, China, 2012–2016

Zhang

Jiang

et al. 2018

The American Journal of Tropical Medicine and Hygiene

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“…This has been shown in several—unintended—natural experiments that monitored drug resistance in the years following changes in first‐line treatment. Several years after chloroquine use was abandoned, resistant mutants were only observed at a low frequency or even completely absent (e.g., Laufer et al., ; Mekonnen et al., ; Mwanza et al., ). A recent clinical trial with chloroquine in asymptomatic adults in Mozambique demonstrated that chloroquine may actually be effective again in curing infected patients (Galatas et al., ).…”

Section: Antimalarial Interventions and Their Evolutionary Consequencesmentioning

confidence: 99%

Putting evolution in elimination: Winning our ongoing battle with evolving malaria mosquitoes and parasites

Huijben

Paaijmans

2017

Evolutionary Applications

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Since 2000, the world has made significant progress in reducing malaria morbidity and mortality, and several countries in Africa, South America and South‐East Asia are working hard to eliminate the disease. These elimination efforts continue to rely heavily on antimalarial drugs and insecticide‐based interventions, which remain the cornerstones of malaria treatment and prevention. However, resistance has emerged against nearly every antimalarial drug and insecticide that is available. In this review we discuss the evolutionary consequences of the way we currently implement antimalarial interventions, which is leading to resistance and may ultimately lead to control failure, but also how evolutionary principles can be applied to extend the lifespan of current and novel interventions. A greater understanding of the general evolutionary principles that are at the core of emerging resistance is urgently needed if we are to develop improved resistance management strategies with the ultimate goal to achieve a malaria‐free world.

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“…On the other hand, countries with restricted used of CQ observed CQ-susceptible P. falciparum parasites have reemerged and are now predominant (4,13,14,23). In contrary to this, high levels of CQ resistance have persisted in countries with unrestricted use of CQ, i.e., Nigeria (24).…”

Section: Discussionmentioning

confidence: 99%

“…Countries with restricted use and/or withdrawal of CQ for treatment of malaria infection. Following withdrawal of CQ use as rst line malaria treatment, studies have reported increasing number of CQ susceptible species in several countries with subsequent dropping of CQ resistance (4,13,14,21). Invitro prevalence of chloroquine resistant P. falciparum and/ or prevalence of chloroquine sensitive P. falciparum using pfcrt and pfmdr1 molecular markers.…”

Section: Types Of Interventions and Outcomesmentioning

confidence: 99%

The return of chloroquine susceptible Plasmodium falciparum in Sub-Saharan Africa: a protocol for systematic review

Bwire¹,

Mutagonda²,

Tindamanyile³

et al. 2020

Preprint

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Background: Following withdrawal and/or restricted use of chloroquine (CQ) as first line malaria treatment in many countries, studies have reported an increased number of CQ susceptible Plasmodium falciparum in several countries with subsequent dropping of CQ resistance. Since the future of malaria control and elimination is still uncertain with rising resistance in currently available antimalarials such as artemisinin based combination therapy (ACT), a review on current resistance profile of CQ in P. falciparum is of paramount importance.Methods: A systematic search in PubMed/MEDLINE, EMBASE, COCHRANE central, Google Scholar and Web of science will be done. We will consult thesis repositories to identify additional studies and search the websites of key healthcare organizations (World Health Organization (WHO), public health agencies). Similarly, a grey literature search will be done with help of Google. Data from 2000 and onwards published in English will be included and the reporting will be done in accordance with the Preferred Reporting Items for Systematic Reviews and Meta- Analyses Protocol (PRISMA-P).Discussion: This article provides a detailed account of this systematic review protocol that will be used to report the current status of CQ resistance in P. falciparum following its restricted use and/ or withdrawal as the first-line treatment of uncomplicated malaria. Mutations in P. falciparum chloroquine transporter (pfcrt) gene and P. falciparum multidrug resistance (pfmdr1) gene, predict the clinical outcomes following treatment using CQ. On the other hand, countries with restricted use of CQ observed CQ-susceptible P. falciparum reemergence and are now predominant. Subject to its susceptibility profile that will be generated from this review, CQ may still be considered for malaria prevention in some population groups such as children with sickle cell disease and pregnant women. Additionally, CQ may be reintroduced in future, ideally in combination with other antimalarial drugs, especially in areas where disappearance of chloroquine resistance is evident while safe and affordable alternatives antimalarials are limited.Systematic review registration: PROSPERO registration number CRD42020154844

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The return of chloroquine-susceptible Plasmodium falciparum malaria in Zambia

Cited by 59 publications

References 26 publications

Surveillance of Antimalarial Resistance Molecular Markers in Imported Plasmodium falciparum Malaria Cases in Anhui, China, 2012–2016

Surveillance of Antimalarial Resistance Molecular Markers in Imported Plasmodium falciparum Malaria Cases in Anhui, China, 2012–2016

Putting evolution in elimination: Winning our ongoing battle with evolving malaria mosquitoes and parasites

The return of chloroquine susceptible Plasmodium falciparum in Sub-Saharan Africa: a protocol for systematic review

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