Molecular markers of Plasmodium falciparum drug resistance in southern highland Rwanda

Zeile, Irene; Gahutu, Jean Bosco; Shyirambere, Cyprien; Steininger, Christian; Musemakweri, Andre; Sebahungu, Fidèle; Karema, Corine; Harms, Gundel; Eggelte, Teunis A.; Mockenhaupt, Frank P.

doi:10.1016/j.actatropica.2011.09.009

Cited by 19 publications

(13 citation statements)

References 37 publications

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“…This observation was also made among children under 5 years of age in the study area [18] and may stem from recurring parasitaemia following treatment. Drug resistance markers associated with reappearing parasitaemia following artemether-lumefantrine treatment are established in the study area [33, 34], but reports on actual treatment failure are absent. No information on the completeness of treatment was collected, i.e., on adherence to the 3-days regimen, but incomplete drug intake, e.g., in the community or after the first dose in a health facility, may have contributed to reappearing parasitaemia.…”

Section: Discussionmentioning

confidence: 99%

Asymptomatic only at first sight: malaria infection among schoolchildren in highland Rwanda

Sifft

Geus

Mukampunga

et al. 2016

Malar J

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Background Plasmodium infection and malaria in school children are increasingly recognized as a relevant public health problem, but data on actual prevalence and health consequences are insufficient. The present study from highland southern Rwanda aimed at estimating infection prevalence among children attending school, at identifying associated factors and at assessing the clinical consequences of these infections.MethodsIn a survey including 12 schools in the Huye district of Rwanda, 1089 children aged 6–10 years were clinically and anthropometrically examined, malaria parasites were diagnosed by microscopy and PCR, haemoglobin concentrations were measured, and socio-economic and behavioural parameters as well as medical histories were obtained.ResultsUpon examination, the vast majority of children was asymptomatic (fever 2.7%). Plasmodium infection was detected in 22.4% (Plasmodium falciparum, 18.8%); 41% of these were submicroscopic. Independent predictors of infection included low altitude, higher age, preceding antimalarial treatment, and absence of electricity or a bicycle in the household. Plasmodium infection was associated with anaemia (mean haemoglobin difference of −1.2 g/dL; 95% CI, −0.8 to −1.5 g/dL), fever, underweight, clinically assessed malnutrition and histories of fever, tiredness, weakness, poor appetite, abdominal pain, and vomiting. With the exception of underweight, these conditions were also increased at submicroscopic infection.ConclusionMalaria infection is frequent among children attending school in southern highland Rwanda. Although seemingly asymptomatic in the vast majority of cases, infection is associated with a number of non-specific symptoms in the children´s histories, in addition to the impact on anaemia. This argues for improved malaria surveillance and control activities among school children.

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Section: Discussionmentioning

confidence: 99%

Asymptomatic only at first sight: malaria infection among schoolchildren in highland Rwanda

Sifft

Geus

Mukampunga

et al. 2016

Malar J

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“…In Kabale and Rukungiri, Uganda, samples from 2005 showed a high prevalence of the A581G mutation at 45% and 46%, respectively ( 27 ); studies during 2005–2006 in Rukara and Mahesha, Rwanda, observed prevalences of 60% and 29%, respectively ( 28 ). A study in 2010 in Huye District, Southern Province, Rwanda, reported a prevalence of 63% ( 35 ). In eastern Sudan, a study found an increase in the prevalence of the A581G mutation from 14% in 2003 to 34% in 2012 ( 36 ).…”

Section: Discussionmentioning

confidence: 99%

Independent Origin ofPlasmodium falciparumAntifolate Super-Resistance, Uganda, Tanzania, and Ethiopia

Alifrangis¹,

Nag²,

Schousboe³

et al. 2014

Emerg. Infect. Dis.

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“…Overall, the present study reported a progressive mutation in dhfr and dhps of P. falciparum isolates in the interior division of Sabah, where triple mutations are now prevalent in both genes compared to the previous study with double mutations on both genes. A sextuple allele combination of pfdhfr-pfdhps is associated with high-grade clinical resistance to SDX/PYR, which was found mainly in Africa [22,23]. The other three alleles found in Sabah range from triple mutation to quintuple mutations (ANRNI-SGKAA, AIRNI-AAKAA, ANRNL-SGKGA), which could modulate varying degree of resistance to SDX/PYR therapy.…”

Section: Discussionmentioning

confidence: 99%

Mutational analysis of Plasmodium falciparum dihydrofolate reductase and dihydropteroate synthase genes in the interior division of Sabah, Malaysia

Lau

Sylvi

William

2013

Malar J

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BackgroundThe sulphadoxine/pyrimethamine (SDX/PYR) combination had been chosen to treat uncomplicated falciparum malaria in Malaysia for more than 30 years. Non-silent mutations in dihydrofolate reductase (dhfr) and dihydropteroate synthase (dhps) genes are responsible for the resistance to pyrimethamine and sulphadoxine, respectively. This study reports the mutational analysis of pfdhfr and pfdhps in single Plasmodium falciparum infection isolates from the interior division of Sabah, Malaysian Borneo.MethodsA total of 22 P. falciparum single infection isolates collected from two districts of the interior division of Sabah from February to November 2010 were recruited for the mutational study of pfdhfr and pfdhps. Both genes were amplified by nested PCR prior to DNA sequencing and mutational analysis.ResultsA total of three pfdhfr and four pfdhps alleles were identified. The most prevalent pfdhfr allele is ANRNL (86%) involving triple mutation at position 108(S to N), 59(C to R) and 164(I to L). In pfdhps, two novel alleles, SGTGA (73%) and AAKAA (5%) were identified. Alleles involving triple mutation in both pfdhfr (ANRNL) and pfdhps (SGTGA), which were absent in Sabah in a study conducted about 15 years ago, are now prevalent.ConclusionsHigh prevalence of mutations in SDX/PYR associated drug resistance genes are reported in this study. This mutational study of pfdhps and pfdhfr indicating that SDX/PYR should be discontinued in this region.

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Molecular markers of Plasmodium falciparum drug resistance in southern highland Rwanda

Cited by 19 publications

References 37 publications

Asymptomatic only at first sight: malaria infection among schoolchildren in highland Rwanda

Asymptomatic only at first sight: malaria infection among schoolchildren in highland Rwanda

Independent Origin ofPlasmodium falciparumAntifolate Super-Resistance, Uganda, Tanzania, and Ethiopia

Mutational analysis of Plasmodium falciparum dihydrofolate reductase and dihydropteroate synthase genes in the interior division of Sabah, Malaysia

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