期刊
PATHOGENS
卷 11, 期 5, 页码 -出版社
MDPI
DOI: 10.3390/pathogens11050554
关键词
malaria; Plasmodium falciparum; pfk13; artemisinin; ACTs; Angola; resistance
类别
资金
- Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq)
- Fundacao Carlos Chagas Filho de Amparo a Pesquisa do Estado de Rio de Janeiro (FAPERJ)
- Departamento de Ciencia e Tecnologia em Saude/Ministerio da Saude (DECIT/MS)
- Programa Nacional de Controle da Malaria/Secretaria de Vigilancia em Saude/Ministerio da Saude (SVS/MS)
- Fiocruz
- Angolan Ministry of Health (MINSA)
- TheWorld Academy of Sciences (TWAS) [17-368 RG/BIO/AF/AC_I]
- [310445/20175]
- [306025/2018-3]
- [E-26/202.921/2018]
- [E-26/203.295/2015]
Artemisinin is recommended as the first-line drug for P. falciparum infections, but resistance is a concern. A study in Angola found little polymorphism in the Pfkelch13 gene, but the limited sample size may not be representative of all endemic areas.
Artemisinin (ART) is recommended as the first-line drug for P. falciparum infections combined with a long-acting partner drug. The emergence of P. falciparum resistance to ART (ARTR) is a concern for malaria. The most feared threat remains the spread of ARTR from Southeast Asia to Africa or the independent emergence of ARTR in Africa, where malaria accounts for 93% of all malaria cases and 94% of deaths. To avoid this worst-case scenario, surveillance of Pfkelch13 mutations is essential. We investigated mutations of Pfkelch13 in 78 P. falciparum samples from Huambo, Angola. Most of the parasites had a wild-type Pfkelch13 allele. We identified one synonymous mutation (R471R) in 10 isolates and one non-synonymous mutation (A578S) in two samples. No Pfkelch13 validated or candidate ARTR mutants were identified. The finding suggests that there is little polymorphism in Pfkelch13 in Huambo. Since cases of late response to ART in Africa and the emergence of ARTR mutations in Rwanda and Uganda have been reported, efforts should be made toward continuous molecular surveillance of ARTR. Our study has some limitations. Since we analyzed P. falciparum parasites from a single health facility, the study may not be representative of all Angolan endemic areas.
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