Prevalence of molecular markers of sulfadoxine-pyrimethamine resistance in Plasmodium falciparum isolates from West Africa during 2012–2022

Ruimin Zhou; Suhua Li; Penghui Ji; Shucheng Ruan; Ying Liu; Chengyun Yang; Dan Qian; Zhiquan He; Dan Wang; Deling Lu; Hongwei Zhang; Yan Deng

doi:10.1038/s41598-024-75828-w

Scientific Reports (Nov 2024)

Prevalence of molecular markers of sulfadoxine-pyrimethamine resistance in Plasmodium falciparum isolates from West Africa during 2012–2022

Ruimin Zhou,
Suhua Li,
Penghui Ji,
Shucheng Ruan,
Ying Liu,
Chengyun Yang,
Dan Qian,
Zhiquan He,
Dan Wang,
Deling Lu,
Hongwei Zhang,
Yan Deng

Affiliations

Ruimin Zhou: Department of Parasite Disease Control and Prevention, Henan Provincial Key Laboratory of Pathogenic Microbiology, Henan Provincial Medical Key Laboratory of Parasitic Diseases and Vector, Henan Province Center for Disease Control and Prevention
Suhua Li: Department of Parasite Disease Control and Prevention, Henan Provincial Key Laboratory of Pathogenic Microbiology, Henan Provincial Medical Key Laboratory of Parasitic Diseases and Vector, Henan Province Center for Disease Control and Prevention
Penghui Ji: Department of Parasite Disease Control and Prevention, Henan Provincial Key Laboratory of Pathogenic Microbiology, Henan Provincial Medical Key Laboratory of Parasitic Diseases and Vector, Henan Province Center for Disease Control and Prevention
Shucheng Ruan: Department of Parasite Disease Control and Prevention, Henan Provincial Key Laboratory of Pathogenic Microbiology, Henan Provincial Medical Key Laboratory of Parasitic Diseases and Vector, Henan Province Center for Disease Control and Prevention
Ying Liu: Department of Parasite Disease Control and Prevention, Henan Provincial Key Laboratory of Pathogenic Microbiology, Henan Provincial Medical Key Laboratory of Parasitic Diseases and Vector, Henan Province Center for Disease Control and Prevention
Chengyun Yang: Department of Parasite Disease Control and Prevention, Henan Provincial Key Laboratory of Pathogenic Microbiology, Henan Provincial Medical Key Laboratory of Parasitic Diseases and Vector, Henan Province Center for Disease Control and Prevention
Dan Qian: Department of Parasite Disease Control and Prevention, Henan Provincial Key Laboratory of Pathogenic Microbiology, Henan Provincial Medical Key Laboratory of Parasitic Diseases and Vector, Henan Province Center for Disease Control and Prevention
Zhiquan He: Department of Parasite Disease Control and Prevention, Henan Provincial Key Laboratory of Pathogenic Microbiology, Henan Provincial Medical Key Laboratory of Parasitic Diseases and Vector, Henan Province Center for Disease Control and Prevention
Dan Wang: Department of Parasite Disease Control and Prevention, Henan Provincial Key Laboratory of Pathogenic Microbiology, Henan Provincial Medical Key Laboratory of Parasitic Diseases and Vector, Henan Province Center for Disease Control and Prevention
Deling Lu: Department of Parasite Disease Control and Prevention, Henan Provincial Key Laboratory of Pathogenic Microbiology, Henan Provincial Medical Key Laboratory of Parasitic Diseases and Vector, Henan Province Center for Disease Control and Prevention
Hongwei Zhang: Department of Parasite Disease Control and Prevention, Henan Provincial Key Laboratory of Pathogenic Microbiology, Henan Provincial Medical Key Laboratory of Parasitic Diseases and Vector, Henan Province Center for Disease Control and Prevention
Yan Deng: Department of Parasite Disease Control and Prevention, Henan Provincial Key Laboratory of Pathogenic Microbiology, Henan Provincial Medical Key Laboratory of Parasitic Diseases and Vector, Henan Province Center for Disease Control and Prevention

DOI: https://doi.org/10.1038/s41598-024-75828-w
Journal volume & issue: Vol. 14, no. 1
pp. 1 – 10

Abstract

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Abstract Sulfadoxine-pyrimethamine (SP) is a key drug recommended by the World Health Organization for the chemoprevention of malaria. However, the strategy is affected by the parasite resistance to SP. This study evaluated Plasmodium falciparum dihydrofolate reductase (Pfdhfr) and dihydropteroate synthase (Pfdhps) genes, associated with SP resistance, from 508 P. falciparum isolates imported from West African countries to Henan Province, China, during 2012–2022. High mutant prevalence of the genes Pfdhfr (94.7%) and Pfdhps (96.8%) was observed. The mutants Pfdhfr N51I, C59R, S108N, and Pfdhps A437G were at high frequency in all countries analyzed. The overall prevalence of the mutant Pfdhps K540E was low (3.4%), but with a high frequency in Liberia (24.3%). The frequency of mutants Pfdhps I431V, A581G, and A613S was 11.7%, 9.8%, and 16.2%, respectively, all of which had the highest mutant prevalence in Nigeria. The mutant Pfdhps A581G and A613S were identified in the absence of K540E. The partially resistant haplotype (I51R59N108 - G437) was the most common (72.6%), and the fully resistant haplotype (I51R59N108 - G437E540) had a low prevalence of 3.4% and mainly occurred in Liberia. No super resistant haplotype was identified. The mutant Pfdhps I431V and the octuple mutant haplotype I51R59N108 - V431A436G437G581S613 deserve more attention. In areas of high SP resistance, the intervention still reduces low birthweight and maternal anaemia. SP should continue to be used in areas of high SP resistance until more effective alternatives for malaria chemoprevention are found. It is important to continuously monitor the molecular markers associated with SP resistance to better implement intermittent preventive treatment policies in pregnancy (IPTp) and infants (IPTi).

Published in Scientific Reports

ISSN: 2045-2322 (Online)
Publisher: Nature Portfolio
Country of publisher: United Kingdom
LCC subjects: Medicine; Science
Website: https://www.nature.com/srep/

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