Evolution of Plasmodium falciparum antimalarial drug resistance markers post-adoption of artemisinin-based combination therapies in Yaounde, Cameroon

Peter Thelma Ngwa Niba; Akindeh Mbuh Nji; Jean Paul Kengne Chedjou; Helle Hansson; Emma Filtenborg Hocke; Innocent Mbulli Ali; Olivia Achonduh-Atijegbe; Marie-Solange B. Evehe; Marie Helene Munck Jørgensen; Calvino Tah Fomboh; Liwang Cui; Gillian Stresman; Jude D. Bigoga; Michael Alifrangis; Wilfred F. Mbacham

International Journal of Infectious Diseases (Jul 2023)

Evolution of Plasmodium falciparum antimalarial drug resistance markers post-adoption of artemisinin-based combination therapies in Yaounde, Cameroon

Peter Thelma Ngwa Niba,
Akindeh Mbuh Nji,
Jean Paul Kengne Chedjou,
Helle Hansson,
Emma Filtenborg Hocke,
Innocent Mbulli Ali,
Olivia Achonduh-Atijegbe,
Marie-Solange B. Evehe,
Marie Helene Munck Jørgensen,
Calvino Tah Fomboh,
Liwang Cui,
Gillian Stresman,
Jude D. Bigoga,
Michael Alifrangis,
Wilfred F. Mbacham

Affiliations

Peter Thelma Ngwa Niba: MARCAD-DELTAS Program, Laboratory for Public Health Research Biotechnologies, University of Yaounde I, Yaounde, Cameroon; The Biotechnology Center, University of Yaounde I, Yaounde, Cameroon; Department of Biochemistry, Faculty of Science, University of Yaounde I, Yaounde, Cameroon
Akindeh Mbuh Nji: MARCAD-DELTAS Program, Laboratory for Public Health Research Biotechnologies, University of Yaounde I, Yaounde, Cameroon; The Biotechnology Center, University of Yaounde I, Yaounde, Cameroon; Department of Biochemistry, Faculty of Science, University of Yaounde I, Yaounde, Cameroon
Jean Paul Kengne Chedjou: MARCAD-DELTAS Program, Laboratory for Public Health Research Biotechnologies, University of Yaounde I, Yaounde, Cameroon; The Biotechnology Center, University of Yaounde I, Yaounde, Cameroon; Department of Biochemistry and Molecular Biology, Faculty of Science, University of Buea, Buea, Cameroon
Helle Hansson: Center for Medical Parasitology, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Infectious Diseases, Copenhagen University Hospital, Copenhagen, Denmark
Emma Filtenborg Hocke: Center for Medical Parasitology, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Infectious Diseases, Copenhagen University Hospital, Copenhagen, Denmark
Innocent Mbulli Ali: MARCAD-DELTAS Program, Laboratory for Public Health Research Biotechnologies, University of Yaounde I, Yaounde, Cameroon; The Biotechnology Center, University of Yaounde I, Yaounde, Cameroon; Department of Biochemistry, Faculty of Science, University of Dschang, Dschang, Cameroon
Olivia Achonduh-Atijegbe: MARCAD-DELTAS Program, Laboratory for Public Health Research Biotechnologies, University of Yaounde I, Yaounde, Cameroon; The Biotechnology Center, University of Yaounde I, Yaounde, Cameroon
Marie-Solange B. Evehe: MARCAD-DELTAS Program, Laboratory for Public Health Research Biotechnologies, University of Yaounde I, Yaounde, Cameroon; The Biotechnology Center, University of Yaounde I, Yaounde, Cameroon
Marie Helene Munck Jørgensen: Center for Medical Parasitology, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Infectious Diseases, Copenhagen University Hospital, Copenhagen, Denmark
Calvino Tah Fomboh: MARCAD-DELTAS Program, Laboratory for Public Health Research Biotechnologies, University of Yaounde I, Yaounde, Cameroon; The Biotechnology Center, University of Yaounde I, Yaounde, Cameroon; Department of Biochemistry, Faculty of Science, University of Yaounde I, Yaounde, Cameroon
Liwang Cui: Center for Global Health and Infectious Disease Research, University of South Florida, Tampa, United States of America
Gillian Stresman: Epidemiology Concentration, College of Public Health, University of South Florida, Tampa, United States of America; Department of Infection Biology, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
Jude D. Bigoga: MARCAD-DELTAS Program, Laboratory for Public Health Research Biotechnologies, University of Yaounde I, Yaounde, Cameroon; The Biotechnology Center, University of Yaounde I, Yaounde, Cameroon; Department of Biochemistry, Faculty of Science, University of Yaounde I, Yaounde, Cameroon
Michael Alifrangis: Center for Medical Parasitology, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Infectious Diseases, Copenhagen University Hospital, Copenhagen, Denmark
Wilfred F. Mbacham: MARCAD-DELTAS Program, Laboratory for Public Health Research Biotechnologies, University of Yaounde I, Yaounde, Cameroon; The Biotechnology Center, University of Yaounde I, Yaounde, Cameroon; Department of Biochemistry, Faculty of Science, University of Yaounde I, Yaounde, Cameroon; Fobang Institutes for Innovations in Science and Technology, Yaounde, Cameroon; Faculty of Natural and Agricultural Sciences, North-West University, Mmabatho, South Africa; Corresponding author:

Journal volume & issue: Vol. 132
pp. 108 – 117

Abstract

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Objectives: This study aimed to investigate the evolution of Plasmodium falciparum antimalarial drug resistance markers by comparing the pre- and post-adoption of artemisinin-based combination therapies (ACTs) in Yaounde, Cameroon. Methods: The molecular characterization of known antimalarial drug resistance markers (Pfcrt, Pfmdr1, Pfdhfr, Pfdhps, and Pfk13) in P. falciparum-positive samples collected in 2014 and 2019-2020 was achieved using nested polymerase chain reaction, followed by targeted amplicon deep sequencing on the Illumina MiSeq platform. Data derived were compared with those published during the pre-ACT adoption period from 2004 to 2006. Results: A high prevalence of Pfmdr1 184F, Pfdhfr 51I/59R/108N, and Pfdhps 437G mutant alleles was observed during the post-ACT adoption period. The Pfcrt 76T and Pfmdr1 86Y mutant alleles significantly declined between 2004 and 2020 (P <0.0001). Conversely, the resistance markers to antifolates, Pfdhfr 51I/59R/108N and Pfdhps 437G, significantly increased during the same study period (P <0.0001). We identified nine mutations in the propeller domains of Pfk13; although they were all present in single parasite isolates, none of them are known to confer artemisinin resistance. Conclusion: This study documented a near-complete reversion to sensitive parasites for markers conferring resistance to the 4-aminoquinolines and arylamino alcohols in Yaounde. In contrast, the Pfdhfr mutations associated with pyrimethamine resistance are moving toward saturation.

Published in International Journal of Infectious Diseases

ISSN: 1201-9712 (Print); 1878-3511 (Online)
Publisher: Elsevier
Country of publisher: Netherlands
LCC subjects: Medicine: Internal medicine: Infectious and parasitic diseases
Website: http://www.journals.elsevier.com/international-journal-of-infectious-diseases/

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