論文

査読有り 最終著者 責任著者 国際誌
2020年2月18日

Recovery and stable persistence of chloroquine sensitivity in Plasmodium falciparum parasites after its discontinued use in Northern Uganda.

Malaria journal
  • Betty Balikagala
  • Miki Sakurai-Yatsushiro
  • Shin-Ichiro Tachibana
  • Mie Ikeda
  • Masato Yamauchi
  • Osbert T Katuro
  • Edward H Ntege
  • Makoto Sekihara
  • Naoyuki Fukuda
  • Nobuyuki Takahashi
  • Shouki Yatsushiro
  • Toshiyuki Mori
  • Makoto Hirai
  • Walter Opio
  • Paul S Obwoya
  • Denis A Anywar
  • Mary A Auma
  • Nirianne M Q Palacpac
  • Takafumi Tsuboi
  • Emmanuel I Odongo-Aginya
  • Eisaku Kimura
  • Martin Ogwang
  • Toshihiro Horii
  • Toshihiro Mita
  • 全て表示

19
1
開始ページ
76
終了ページ
76
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1186/s12936-020-03157-0
出版者・発行元
BMC

BACKGROUND: Usage of chloroquine was discontinued from the treatment of Plasmodium falciparum infection in almost all endemic regions because of global spread of resistant parasites. Since the first report in Malawi, numerous epidemiological studies have demonstrated that the discontinuance led to re-emergence of chloroquine-susceptible P. falciparum, suggesting a possible role in future malaria control. However, most studies were cross-sectional, with few studies looking at the persistence of chloroquine recovery in long term. This study fills the gap by providing, for a period of at least 6 years, proof of persistent re-emergence/stable recovery of susceptible parasite populations using both molecular and phenotypic methods. METHODS: Ex vivo drug-susceptibility assays to chloroquine (n = 319) and lumefantrine (n = 335) were performed from 2013 to 2018 in Gulu, Northern Uganda, where chloroquine had been removed from the official malaria treatment regimen since 2006. Genotyping of pfcrt and pfmdr1 was also performed. RESULTS: Chloroquine resistance (≥ 100 nM) was observed in only 3 (1.3%) samples. Average IC50 values for chloroquine were persistently low throughout the study period (17.4-24.9 nM). Parasites harbouring pfcrt K76 alleles showed significantly lower IC50s to chloroquine than the parasites harbouring K76T alleles (21.4 nM vs. 43.1 nM, p-value = 3.9 × 10-8). Prevalence of K76 alleles gradually increased from 71% in 2013 to 100% in 2018. CONCLUSION: This study found evidence of stable persistence of chloroquine susceptibility with the fixation of pfcrt K76 in Northern Uganda after discontinuation of chloroquine in the region. Accumulation of similar evidence in other endemic areas in Uganda could open channels for possible future re-use of chloroquine as an option for malaria treatment or prevention.

リンク情報
DOI
https://doi.org/10.1186/s12936-020-03157-0
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/32070358
PubMed Central
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7026951
Web of Science
https://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=JSTA_CEL&SrcApp=J_Gate_JST&DestLinkType=FullRecord&KeyUT=WOS:000517260200003&DestApp=WOS_CPL
ID情報
  • DOI : 10.1186/s12936-020-03157-0
  • eISSN : 1475-2875
  • PubMed ID : 32070358
  • PubMed Central 記事ID : PMC7026951
  • Web of Science ID : WOS:000517260200003

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