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

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 s...

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Main Authors: Ruimin Zhou, Suhua Li, Penghui Ji, Shucheng Ruan, Ying Liu, Chengyun Yang, Dan Qian, Zhiquan He, Dan Wang, Deling Lu, Hongwei Zhang, Yan Deng
Format: Article
Language:English
Published: Nature Portfolio 2024-11-01
Series:Scientific Reports
Online Access:https://doi.org/10.1038/s41598-024-75828-w
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author Ruimin Zhou
Suhua Li
Penghui Ji
Shucheng Ruan
Ying Liu
Chengyun Yang
Dan Qian
Zhiquan He
Dan Wang
Deling Lu
Hongwei Zhang
Yan Deng
author_facet Ruimin Zhou
Suhua Li
Penghui Ji
Shucheng Ruan
Ying Liu
Chengyun Yang
Dan Qian
Zhiquan He
Dan Wang
Deling Lu
Hongwei Zhang
Yan Deng
author_sort Ruimin Zhou
collection DOAJ
description 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).
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spelling doaj-art-587d48084d2b4488a723c15088b97dcc2024-11-10T12:20:21ZengNature PortfolioScientific Reports2045-23222024-11-0114111010.1038/s41598-024-75828-wPrevalence of molecular markers of sulfadoxine-pyrimethamine resistance in Plasmodium falciparum isolates from West Africa during 2012–2022Ruimin Zhou0Suhua Li1Penghui Ji2Shucheng Ruan3Ying Liu4Chengyun Yang5Dan Qian6Zhiquan He7Dan Wang8Deling Lu9Hongwei Zhang10Yan Deng11Department 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 PreventionDepartment 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 PreventionDepartment 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 PreventionDepartment 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 PreventionDepartment 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 PreventionDepartment 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 PreventionDepartment 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 PreventionDepartment 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 PreventionDepartment 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 PreventionDepartment 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 PreventionDepartment 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 PreventionDepartment 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 PreventionAbstract 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).https://doi.org/10.1038/s41598-024-75828-w
spellingShingle Ruimin Zhou
Suhua Li
Penghui Ji
Shucheng Ruan
Ying Liu
Chengyun Yang
Dan Qian
Zhiquan He
Dan Wang
Deling Lu
Hongwei Zhang
Yan Deng
Prevalence of molecular markers of sulfadoxine-pyrimethamine resistance in Plasmodium falciparum isolates from West Africa during 2012–2022
Scientific Reports
title Prevalence of molecular markers of sulfadoxine-pyrimethamine resistance in Plasmodium falciparum isolates from West Africa during 2012–2022
title_full Prevalence of molecular markers of sulfadoxine-pyrimethamine resistance in Plasmodium falciparum isolates from West Africa during 2012–2022
title_fullStr Prevalence of molecular markers of sulfadoxine-pyrimethamine resistance in Plasmodium falciparum isolates from West Africa during 2012–2022
title_full_unstemmed Prevalence of molecular markers of sulfadoxine-pyrimethamine resistance in Plasmodium falciparum isolates from West Africa during 2012–2022
title_short Prevalence of molecular markers of sulfadoxine-pyrimethamine resistance in Plasmodium falciparum isolates from West Africa during 2012–2022
title_sort prevalence of molecular markers of sulfadoxine pyrimethamine resistance in plasmodium falciparum isolates from west africa during 2012 2022
url https://doi.org/10.1038/s41598-024-75828-w
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