在厄立特里亚,阿尔特米西宁耐药HRP2-阴性疟疾的患病率不断增加
Selam Mihreteab1, Lucien Platon1, Araia Berhane1
1From the National Malaria Control Program (S.M.) and the Communicable Diseases Control Division (A.B.), Ministry of Health, and the World Health Organization (A.Z.K.) - both in Asmara, Eritrea; the Malaria Genetic and Resistance Unit, INSERM Unité 1201 (L.P., N.P., E.L., D.M.), the Malaria Parasite Biology and Vaccines Unit (L.P., E.L. D.M.), the Bioinformatics and Biostatistics Hub (P.C., A.C.), and the Biomics Platform, Center for Technological Resources and Research (L.M.), Institut Pasteur, Université Paris Cité, and Collège Ecole Doctorale Complexité du Vivant, Sorbonne Université (L.P.), Paris, and the Institute of Parasitology and Tropical Diseases, Dynamics of Host-Pathogen Interactions, Université de Strasbourg (C.D.-L., D.M.), and the Laboratory of Parasitology and Medical Mycology, Centre Hospitalier Universitaire Strasbourg (D.M.), Strasbourg - all in France; the Department of Microbiology and Immunology (B.H.S., K.E.W., D.A.F.) and the Center for Malaria Therapeutics and Antimicrobial Resistance, Division of Infectious Diseases, Department of Medicine (D.A.F.), Columbia University Irving Medical Center, New York; the School of Public Health and Social Medicine, Gothenburg University, Gothenburg, Sweden (M.W.); and the Global Malaria Program, World Health Organization, Geneva (P.R.).
在厄立特里亚的Plasmodium falciparum疟疾中出现的素抗性令人担忧. 这项研究发现,3日阳性和Pfkelch13突变的增加,以及HRP2/HRP3的删除,威胁着疟疾控制工作.
科学领域:
- 分子寄生虫学 分子寄生虫学
- 抗疟疾药物耐药性 抗疟疾药物耐药性
- 传染病的流行病学传染病的流行病学.
背景情况:
- 基于美素的组合疗法 (ACT) 对非洲的疟疾治疗至关重要.
- 由于有限的替代治疗方法,Plasmodium falciparum中出现部分甲美西宁耐药性的出现是一个重大的公共卫生问题.
- 监测耐药性标志物和诊断测试性能对于有效控制疟疾至关重要.
研究的目的:
- 估计在厄立特里亚接受ACT治疗的患者的第3天阳性率.
- 评估Pfkelch13基因突变与素抗性相关的患病率.
- 选影响快速诊断测试准确性的HRP2和HRP3基因缺失.
主要方法:
- 2016-2019年对厄立特里亚未复杂疟疾的药物疗效数据的分析.
- 在为期3天的ACT疗程 (artsunate-amodiaquine或artemether-lumefantrine) 后估计的第3天阳性率.
- 针对Pfkelch13突变和hrp2/hrp3缺失的Plasmodium falciparum分离物的基因定型.
主要成果:
- 第三天的阳性率从2016年的0.4%增加到2019年的4.2%.
- 在研究期间,Pfkelch13 R622I突变的患病率从8.6%上升到21.0%.
- R622I突变显著增加了第3天阳性的几率,并与hrp2/hrp3删除有关,影响了RDT性能.
结论:
- 在厄立特里亚,存在并日益增加的部分素耐药性,由Pfkelch13 R622I表示.
- 素抗性标志物和HRP2/HRP3缺失的同时出现对疟疾控制构成双重威胁.
- 这些发现凸显了加强监测和替代治疗策略的迫切需要,以打击该地区的疟疾.
更多相关视频
10:22Methods to Investigate the Regulatory Role of Small RNAs and Ribosomal Occupancy of Plasmodium falciparum
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10:50Detection and Quantification of Plasmodium falciparum in Aqueous Red Blood Cells by Attenuated Total Reflection Infrared Spectroscopy and Multivariate Data Analysis
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