Huijben S., Macete E., Mombo-Ngoma G., Ramharter M., Kariuki S., Desai M., Shi Y. P., Mwangoka G., Massougbodji A., Cot Michel, Tuikue Ndam Nicaise, Uberegui E., Gupta H., Cistero P., Aponte J. J., Gonzalez R., Menendez C., Mayor A. (2020). Counter-selection of antimalarial resistance polymorphisms by intermittent preventive treatment in pregnancy. Journal of Infectious Diseases, 221 (2), p. 293-303. ISSN 0022-1899.
Titre du document
Counter-selection of antimalarial resistance polymorphisms by intermittent preventive treatment in pregnancy
Année de publication
2020
Auteurs
Huijben S., Macete E., Mombo-Ngoma G., Ramharter M., Kariuki S., Desai M., Shi Y. P., Mwangoka G., Massougbodji A., Cot Michel, Tuikue Ndam Nicaise, Uberegui E., Gupta H., Cistero P., Aponte J. J., Gonzalez R., Menendez C., Mayor A.
Source
Journal of Infectious Diseases, 2020,
221 (2), p. 293-303 ISSN 0022-1899
Background. Innovative approaches are needed to limit antimalarial resistance evolution. Understanding the role of intermittent preventive treatment in pregnancy (IPTp) on the selection for resistance and the impact such selection has on pregnancy outcomes can guide future interventions. Methods. Plasmodium fakiparum isolates (n = 914) from 2 randomized clinical trials were screened for pfmdrl copy number variation and pfcrt, pfmdrl, pfdhfr, and pfdhps resistance markers. The trials were conducted between 2010 and 2013 in Benin, Gabon, Kenya, and Mozambique to establish the efficacy of IPTp-mefloquine (MQ) compared with IPTp-sulphadoxine-pyrimethamine (SP) in human immunodeficiency virus (HIV)-uninfected and to IPTp-placebo in HIV-infected women. Results. In HIV-uninfected women, the prevalence of pfcrt mutants, pfdhfr/pfdhps quintuple mutants, and pfmdrl copy number was similar between women receiving IPT-SP and IPTp-MQ. However, prevalence of pfmdr1 polymorphism 86Y was lower in the IPTp-MQ group than in the IPTp-SP group, and within the IPTp-MQ group it was lower at delivery compared with recruitment. No effect of IPTp-MQ on resistance markers was observed among HIV-infected women. The carriage of resistance markers was not associated with pregnancy outcomes. Conclusions. Selection of wild-type pfmdrl polymorphism N86 by IPTp-MQ highlights the strong selective pressure IPTp can exert and the opportunity for using negative cross-resistance in drug choice for clinical treatment and IPTp.
Plan de classement
Santé : généralités [050]
;
Entomologie médicale / Parasitologie / Virologie [052]
Description Géographique
BENIN ; GABON ; KENYA ; MOZAMBIQUE
Localisation
Fonds IRD [F B010078892]
Identifiant IRD
fdi:010078892
