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首页> 外文期刊>Acta tropica: Journal of Biomedical Sciences >Molecular epidemiology of malaria in Cameroon. XXVII. Clinical and parasitological response to sulfadoxine-pyrimethamine treatment and Plasmodium falciparum dihydrofolate reductase and dihydropteroate synthase alleles in Cameroonian children.
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Molecular epidemiology of malaria in Cameroon. XXVII. Clinical and parasitological response to sulfadoxine-pyrimethamine treatment and Plasmodium falciparum dihydrofolate reductase and dihydropteroate synthase alleles in Cameroonian children.

机译：喀麦隆疟疾的分子流行病学。二十七。喀麦隆儿童对磺胺多辛-乙胺嘧啶治疗和恶性疟原虫二氢叶酸还原酶和二氢蝶呤合酶等位基因的临床和寄生虫学反应。

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摘要

The rapidly changing epidemiology of antifolate-resistant Plasmodium falciparum in Africa requires monitoring. The present study was designed to assess the degree of association between the clinical and parasitological response to sulfadoxine-pyrimethamine and allelic combinations of dihydrofolate reductase (dhfr) and dihydropteroate synthase (dhps) genes. Of 357 children who completed the 14-day follow-up, an adequate clinical and parasitological response was observed in 316 patients (88.5%) and early and late failures occurred in 18 (5%) and 23 (6.4%, mostly due to recrudescence) patients, respectively. The majority of clinical isolates were characterized as "quadruple" (n=196, 55.2%; N51I-C59R-S108N in DHFR and A437G in DHPS) or "triple" mutants (n=97, 27.3%; N51I-C59R-S108N in DHFR and wild-type DHPS; S108N+N51I or C59R in DHFR and A437G in DHPS). Wild-type, single mutation, and double mutation were observed in 29, 20, and 13 parasites, respectively. The comparison of different sets of mutations and early or late failures did not reveal any molecular marker associated with treatment outcome when the follow-up period was limited to 14 days (P>0.05). In this study, the determination of dhfr-dhps genotypes was of limited value to predict the treatment outcome in individual patients, mostly due to few treatment failures and few wild-type haplotypes. Further monitoring will be required to define the relationship between clinical response to SP therapy and parasite genotypes in our epidemiological setting.
机译：非洲抗叶酸耐药性恶性疟原虫的流行病学迅速变化，需要进行监测。本研究旨在评估对磺胺多辛-乙胺嘧啶和二氢叶酸还原酶（dhfr）和二氢蝶呤合酶（dhps）基因的等位基因组合的临床和寄生虫学反应之间的关联程度。在完成14天随访的357名儿童中，有316名患者（88.5％）观察到足够的临床和寄生虫学反应，早期和晚期失败的发生率分别为18（5％）和23（6.4％），主要是由于复发）的患者。大多数临床分离株的特征是“四倍”（n = 196，55.2％; DHFR中的N51I-C59R-S108N，DHPS中的A437G）或“三联”突变体（n = 97，27.3％; N51I-C59R-S108N DHFR和野生型DHPS; DHFR中为S108N + N51I或C59R，DHPS中为A437G）。在29、20和13个寄生虫中分别观察到野生型，单突变和双突变。当随访期限制为14天时，比较不同组突变和早期或晚期失败并没有发现与治疗结果相关的任何分子标记（P> 0.05）。在这项研究中，dhfr-dhps基因型的确定对于预测单个患者的治疗结果具有有限的价值，这主要是由于很少的治疗失败和很少的野生型单倍型。在我们的流行病学背景下，需要进一步的监测来确定对SP疗法的临床反应与寄生虫基因型之间的关系。

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