%0 Journal Article
%9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES
%A Chauvin, P.
%A Menard, S.
%A Iriart, X.
%A Nsango, S. E.
%A Tchioffo, M. T.
%A Abate, Luc
%A Awono-Ambene, P. H.
%A Morlais, Isabelle
%A Berry, A.
%T Prevalence of Plasmodium falciparum parasites resistant to sulfadoxine/pyrimethamine in pregnant women in Yaounde, Cameroon : emergence of highly resistant pfdhfr/pfdhps alleles
%D 2015
%L fdi:010065397
%G ENG
%J Journal of Antimicrobial Chemotherapy
%@ 0305-7453
%K CAMEROUN ; YAOUNDE
%M ISI:000363248300021
%N 9
%P 2566-2571
%R 10.1093/jac/dkv160
%U https://www.documentation.ird.fr/hor/fdi:010065397
%> https://www.documentation.ird.fr/intranet/publi/2015/11/010065397.pdf
%V 70
%W Horizon (IRD)
%X Objectives: To determine, 6 years after the adoption of intermittent preventive treatment of pregnant women with sulfadoxine/pyrimethamine (IPTp-SP) in Cameroon, (i) the polymorphism and prevalence of Plasmodium falciparum dihydrofolate reductase (pfdhfr) and dihydropteroate synthase (pfdhps) gene mutations associated with sulfadoxine/pyrimethamine resistance and (ii) the consequences of sulfadoxine/pyrimethamine use in the selection of pfdhfr/pfdhps alleles. Methods: pfdhfr and pfdhps genes from P. falciparum isolates collected in Yaounde (Cameroon) from pregnant women with symptomatic malaria before taking IPTp-SP [SP2 group (control) (n = 51)] or afterwards [SP+ group (n = 49)] were sequenced. Results: The pfdhfr N51I, C59R, S108N triple mutant had a prevalence close to 100% (96/100) and no mutations at codons 50 and 164 were detected in either of the groups. The most frequent pfdhps mutation was A437G with a prevalence of 76.5% (39/51) in the SP2 group, which was significantly higher in pregnant women who took sulfadoxine/pyrimethamine [95.9% (47/49)] (P = 0.012). Our study confirmed the presence of the pfdhps K540E mutation in Cameroon, but it remained rare. The prevalence of pfdhps A581G and A613S mutations had increased [5.9% (3/51) and 11.8% (6/51) in the control group, respectively] since the last studies in 2005. Surprisingly, the new pfdhps I431V mutation was detected, at a prevalence of 9.8% (5/51), and was found to be associated with other pfdhfr/pfdhps alleles to form an octuple N51I, C59R, S108N/I431V, S436A, A437G, A581G, A613S mutant. Conclusions: Significant changes were found in pfdhps polymorphism. In particular, we observed several parasites carrying eight mutations in pfdhfr/pfdhps genes, which are very susceptible to having a high level of resistance to sulfadoxine/pyrimethamine.
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