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- W4247361447 abstract "Senegal has since 2003 used sulphadoxine-pyrimethamine (SP) for Intermittent Preventive Treatment (IPT) of malaria in risk groups. However, the large-scale IPT strategy may result in increasing drug resistance. Our study investigated the possible impact of SP-IPT given to infants and children on the prevalence of SP-resistant haplotypes in the Plasmodium falciparum genes Pfdhfr and Pfdhps, comparing sites with and without IPTi/c. P. falciparum positives samples (n = 352) were collected from children under 5 years of age during two cross-sectional surveys in 2010 and 2011 in three health districts (two on IPTi/c and one without IPTi/c intervention) located in the southern part of Senegal. The prevalence of SP-resistance-related haplotypes in Pfdhfr and Pfdhps was determined by nested PCR followed by sequence-specific oligonucleotide probe (SSOP)–ELISA. The prevalence of the Pfdhfr double mutant haplotypes (CNRN and CICN) was stable between years at < 10% in the control group (P = 0.69), while it rose significantly in the IPTi/c group from 2% in 2010 to 20% in 2011 (P = 0.008). The prevalence of the Pfdhfr triple mutant haplotype (CIRN) increased in both groups, but only significantly in the IPTi/c group from 41% to 65% in 2011 (P = 0.005). Conversely, the Pfdhps 437G mutation decreased in both groups from 44.6% to 28.6% (P = 0.07) and from 66.7% to 47.5% (P = 0.02) between 2010 and 2011 in the control and the IPTi/c groups, respectively. Combined with Pfdhfr, there was a weak trend for decreasing prevalence of quadruple mutants (triple Pfdhfr + Pfdhps 437G) in both groups (P = 0.15 and P = 0.34). During the two cross-sectional surveys, some significant changes were observed in the SP-resistance-related genes. However, since these changes were observed in the two groups, the IPTi/c strategy does only seem to have limited impact on resistance development and other factors as well. However, continuous monitoring will be needed, due to the up-scaling of the IPTi/c strategy in Senegal according to WHO recommendations. Au Sénégal, depuis 2003, le traitement préventif intermittent utilisant la sulphadoxine-pyriméthamine (TPI/SP) a été adopté comme stratégie de chimio-prévention chez les groupes à risque. Cependant, l’utilisation à grande échelle de cette stratégie pourrait entraîner une augmentation de la résistance à la SP. Notre étude a examiné l’impact possible de la SP/IPT administrée aux nourrissons et aux enfants sur la prévalence des marqueurs moléculaires de résistance, en comparant les sites avec et sans TPI. Des échantillons de sang positifs à P. falciparum (n = 325) ont été collectés sur papier buvard au cours d’enquêtes transversales en 2009 et 2010 chez des enfants de moins de cinq ans vivant dans les districts de Vélingara et Saraya (zone TPI) et le district témoin de Tambacounda. Les mutations situées sur les gènes de résistance à la SP (dhfr/dhps) ont été déterminées par Polymerase Chain Reaction-Sequence-Specific Oligonucleotide Probes et Enzyme-Linked ImmunoSorbent Assay (PCR-SSOP-ELISA). Nos résultats ont montré que la prévalence de la double mutation Pfdhfr (CNRN et CICN) est restée stable (< 10 %) au cours du temps dans le groupe témoin (p = 0,69). Dans le groupe TPI+, cet haplotype double mutant a augmenté de façon significative : de 2 % en 2009 contre 20 % en 2010 (p = 0,008). La prévalence de l’haplotype Pfdhfr triple mutant (CIRN) a augmenté dans les deux groupes, mais seulement de façon significative dans le groupe TPI+ de 41 % à 65 % en 2011 (p = 0,005), respectivement. En revanche, la mutation Pfdhps 437G a diminué dans les deux groupes de 44,6 % à 28,6 % (p = 0,07) et de 66,7 % à 47,5 % (p = 0,02) entre 2009 et 2010 dans les groupes témoin et TPI, respectivement. Au cours de notre étude, des changements importants ont été notés dans les gènes associés à la résistance SP. Toutefois, ces changements sont survenus dans les deux groupes ; la stratégie TPI semble seulement avoir un impact limité sur le développement de la résistance à la SP. Cependant, une surveillance continue sera nécessaire lorsque cette stratégie sera mise en place à l’échelle nationale au Sénégal, conformément aux recommandations de l’Organisation mondiale de la santé (OMS)." @default.
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- W4247361447 date "2013-05-01" @default.
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- W4247361447 title "Selection of antimalarial drug resistance after intermittent preventive treatment of infants and children (IPTi/c) in Senegal" @default.
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- W4247361447 doi "https://doi.org/10.1016/j.crvi.2013.04.016" @default.
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