在肯尼亚的症状感染中,抗疟疾药物耐药性标志物的发展模式,2013-2022年
John Magudha1,2, Leonard Ndwiga1, Mercy Y Akinyi1
1Centre for Geographic Medicine Research (Coast), Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya.
Parasites & vectors
|February 7, 2026
概括
肯尼亚的抗疟疾药物耐药性监测显示,克洛洛耐药转运体 (Pfcrt) 突变正在下降,没有世界卫生组织验证的13 (PfK13) 突变. 然而,新的Pfnfs和Pfcoronin突变表明抗性模式正在演变.
科学领域:
- 传染病的分子流行病学.
- 寄生虫学和药物耐药性机制
背景情况:
- 对抗疟疾药物耐药性的监测对于有效的治疗策略至关重要.
- 已确立的标记物包括Pfcrt用于洛昆和Pfdhfr/Pfdhps用于硫黄素-甲 (SP).
- 世界卫生组织 (WHO) 验证的鱼13 (PfK13) 突变表明部分抗素.
研究的目的:
- 描述肯尼亚疟疾寄生虫中已确定的耐药性标记物 (Pfcrt, PfK13) 和潜在标记物 (Pfnfs, Pfcoronin) 的时间趋势.
- 从2013年到2022年,分析肯尼亚不同传输环境中的电阻演变.
主要方法:
- 从肯尼亚各地的治疗疗效研究中对1750个Plasmodium falciparum阳性干血斑点 (DBS) 的查.
- 使用Pf18S实时PCR进行基因组DNA提取和确认.
- 使用毛细管电泳和下一代测序平台对Pfk13,Pfcrt,Pfnfs和Pfcoronin基因进行测序.
主要成果:
- 与克洛洛奎因耐药性相关的Pfcrt突变的流行率下降.
- 没有世卫组织验证的PfK13突变与甲美西宁耐药性相关;同义替代已注明.
- 新型非同义Pfcoronin突变的高频率和Pfnfs-K65Q的检测,与降低的 lumefantrine 敏感性相关.
结论:
- 到2022年,没有发现WHO验证的k13突变,证实了随着时间的推移减少了Pfcrt耐药性基因型.
- 显而易见的Pfcoronin突变和Pfnfs-K65Q的出现表明东非独特的耐药性进化途径.
- 强调需要持续进行分子监测,以监测不断发展的抗疟疾药物耐药性.
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