Dataset Information

Molecular markers of anti-malarial drug resistance in southwest Ethiopia over time: regional surveillance from 2006 to 2013.

ABSTRACT: Drug resistance is one of the main reasons of anti-malarial treatment failures and impedes malaria containment strategies. As single nucleotide polymorphisms (SNPs) have been found to correlate with anti-malarial drug resistance, the surveillance strategy includes continuous monitoring of known molecular markers and detection of new mutation patterns. With the introduction of artemisinin-based combination therapy, selection of specific patterns has been observed worldwide.From March to June 2013, whole blood was collected on filter paper from microscopically malaria positive patients in Jimma zone (District), southwestern Ethiopia. Plasmodium falciparum, Plasmodium vivax and mixed infections were included. SNPs were investigated by conventional or real-time PCR, restriction fragment length pattern analysis or sequencing. Results were compared to molecular patterns from Ethiopian isolates in 2004, 2006 and 2008/9.Plasmodium falciparum, P. vivax, and mixed infections were molecularly confirmed in 177, 80, and 14 samples, respectively. In P. falciparum, mutations in the pfcrt, pfmdr 1and pfATP 6 (SERCA) gene were investigated. Whereas the mutation in the pfcrt gene at codon 76 K was still found in 95.6% of all samples, the pfmdr 1 86 T mutation fell to 1.2% (2/163) in 2013 compared to 9% in 2008/9 and 86% in 2006 (P<0.001). The pfmdr 1 184 F mutation dominated with 100.0% (172/172) in 2013. Sequencing of the recently reported PF3D7_1343700 kelch propeller domain showed no mutation at codon 476. First sequencing data of the pvmdr 1 gene from Jimma region revealed a prevalence of the mutations 976 F and 1076 L in 72.7% (16/23) and 100.0% (19/19) of the isolates, respectively.Since the introduction of artemether-lumefantrine (AL) in Jimma, Ethiopia, in 2006, the prevalence of certain SNPs associated with AL use has increased. Markers for chloroquine resistance in P. vivax were highly frequent. Continuous molecular and clinical surveillance are of paramount importance.

SUBMITTER: Heuchert A

PROVIDER: S-EPMC4490604 | biostudies-literature | 2015

REPOSITORIES: biostudies-literature

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Molecular markers of anti-malarial drug resistance in southwest Ethiopia over time: regional surveillance from 2006 to 2013.

Heuchert Alexander A Abduselam Nuredin N Zeynudin Ahmed A Eshetu Teferi T Löscher Thomas T Wieser Andreas A Pritsch Michael M Berens-Riha Nicole N

Malaria journal 20150519

<h4>Background</h4>Drug resistance is one of the main reasons of anti-malarial treatment failures and impedes malaria containment strategies. As single nucleotide polymorphisms (SNPs) have been found to correlate with anti-malarial drug resistance, the surveillance strategy includes continuous monitoring of known molecular markers and detection of new mutation patterns. With the introduction of artemisinin-based combination therapy, selection of specific patterns has been observed worldwide.<h4> ...[more]

PMID: 25986047

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Project description:BackgroundPrompt care seeking and appropriate use of anti-malarial drugs are critical components of malaria prevention and control. This study assessed malaria related perceptions, care seeking behavior and anti-malarial drug use in malaria endemic settings of Ethiopia.MethodsData were generated from a community based cross-sectional study conducted among 798 households during January 2014 as part of a larger household behavioral study in three malaria endemic districts of Jimma Zone, Southwest Ethiopia. Both quantitative and qualitative data were collected and analyzed using SPSS 17.0 and STATA 12.0.ResultsIn this study, only 76.1% of the respondents associated malaria to mosquito bite, and incorrect beliefs and perceptions were noted. Despite moderate level of knowledge (estimated mean = 62.2, Std Err = 0.7, 95% CI: 60.6-63.8%), quite high favorable attitude (overall estimated mean = 91.5, Std Err = 0.6, 95% CI: 90.1-92.9%) were recorded towards malaria preventive measures. The mean attitude score for prompt care seeking, appropriate use of anti-malarial drugs, LLIN use and Indoor Residual Spray acceptance was 98.5 (Std Err = 0.4, 95% CI:97.5-99.4), 92.7 (Std Err = 0.6 95% CI:91.5-93.9), 88.8 (Std Err = 0.5, 95% CI:85.5-92.1) and 86.5 (Std Err = 1.2, 95% CI: 83.9-89.1), respectively. The prevalence of fever was 2.9% (116/4107) and of the study participants with fever, 71.9% (95% CI: 65.5-78.3%) sought care and all of them consulted formal health care system. However, only 17 (19.8%) sought care within 24 hours after onset of fever. The frequency of care seeking was higher (77.8%, n = 21/27) and more prompt (28.6%, 6/21) for children under five as compared to old age groups despite it was not statistically significant (p > 0.05). However, higher median time of seeking first care was observed among Muslims and people who did not attend school (p < 0.05). Of those who used anti-malarial drugs, 9.1% indicated that they used it inappropriately through saving and/or sharing. Irregular availability of anti-malarial drugs; irregular presence of frontline health workers and misconceptions were mentioned to contribute to delayed care seeking and irrational use of anti-malarial drugs.ConclusionsAlthough care seeking behavior for febrile illness was quite high in this community, the habit of prompt care seeking was very limited. Thus, malaria prevention and control programs need to take into account local misconceptions and wrong perceptions, and health system factors to achieve optimal health seeking behavior in such malaria endemic settings.

Project description:BackgroundBecause of the loss of chloroquine (CQ) effectiveness, the Democratic Republic of Congo (DRC)'s malaria treatment policy replaced CQ by sulfadoxine-pyrimethamine (SP) as first-line treatment of uncomplicated malaria in 2003, which in turn was replaced by artemisinin-based combination therapies (ACT) in 2005. The World Health Organization (WHO) recommends monitoring of anti-malarial drug resistance every 2 years. The study aimed to provide baseline data for biennial molecular surveillance of anti-malarial drug resistance by comparing data from a study conducted in 2019 to previously published data from a similar study conducted in 2017 in the DRC.MethodsFrom July to November 2019, a cross-sectional study was conducted in ten sites which were previously selected for a similar study conducted in 2017 across the DRC. P. falciparum malaria was diagnosed by a rapid diagnostic test (RDT) or by microscopy and dried blood samples (DBS) were taken from patients who had a positive test. Segments of interest in pfcrt and pfk13 genes were amplified by conventional PCR before sequencing.ResultsOut of 1087 enrolled patients, 906 (83.3%) were PCR-confirmed for P. falciparum. Like in the 2017-study, none of the mutations known to be associated with Artemisinine (ART) resistance in Southeast Asia was detected. However, non-synonymous (NS) mutations with unknown functions were observed among which, A578S was detected in both 2017 and 2019-studies. The overall prevalence of pfcrt-K76T mutation that confers CQ-resistance was 22.7% in 2019-study compared to 28.5% in 2017-study (p-value = 0.069), but there was high variability between sites in the two studies. Like in 2017-study, the pfcrt 72-76 SVMNT haplotype associated with resistance to amodiaquine was not detected.ConclusionThe study reported, within 2 years, the non-presence of molecular markers currently known to be associated with resistance to ART and to AQ in P. falciparum isolated in the DRC. However, the presence of polymorphisms with as-yet unknown functions was observed, requiring further characterization. Moreover, an overall decrease in the prevalence of CQ-resistance marker was observed in the DRC, but this prevalence remained highly variable from region to region.

Project description:BackgroundAnemia defined as a low blood hemoglobin concentration is public health importance. The adolescence age group is the most neglected in public health and nutrition research as priorities are usually given to pregnant women, lactating mothers, and their children less than 2 years. Current Ethiopian Food and Nutrition policy included adolescent girls in the most at-risk group for nutritional demands; however, only a few published studies have assessed a deficiency of anemia and associated factors to tackle the intergenerational cycle of malnutrition.ObjectiveTo assess the prevalence of anemia and associated factors among high school adolescent girls in Jimma town.MethodsData were collected from 528 secondary school adolescent girls by a school-based cross-sectional study design in Jimma town from 1/1/2019 to 1/2/2019, southwest Ethiopia. A multistage sampling technique was used to select the study participants. A portable battery-operated HemoCue Hb 301+ analyzer was used to measure the hemoglobin level, and then reading was classified as normal Hb ≥ 12 g\dl and anemic if the hemoglobin value <12 g/dl based on the WHO 2011 recommended cutoff points after adjustments to altitude was made. Bivariate analysis at p value ≤0.25 was considered as a candidate for multivariable logistic regression. Multivariable logistic regression was done to control for confounders and to identify factors independently associated with anemia. Level of statistical significance was declared at p < 0.05.ResultsA total of 528 adolescent girls were included in the study yielding a response rate of 95.8%. The prevalence of anemia was found to be 26.7%, 95% CI (22.7, 30.50). In multivariate logistic regression analysis, those living separately from their family (AOR = 4.430, 95% CI (2.20, 8.90)), low dietary diversity score (AOR = 3.57, 95% CI (1.88, 6.75)), menstrual bleeding more than 5 days (AOR = 2.25, 95% CI (1.17, 4.33)), and low economic status (AOR = 2.16, 95% CI (1.17, 4.33)) were positively associated factors with anemia and only having at least a secondary school in mother's educational status AOR = 0.43, 95% CI (0.18, 0.97) was negatively associated with anemia in the study area.ConclusionPrevalence of anemia among school adolescent girls was moderate public health importance according to the World Health Organization prevalence estimation of anemia. The living condition of the adolescent girls, dietary diversity score, duration of menses, and low economic status were positive predictor variables, whereas mothers who are being secondary school and above was a protective factor for anemia. Therefore, iron-rich and diversified food consumption should be given attention.

Dataset Information

Molecular markers of anti-malarial drug resistance in southwest Ethiopia over time: regional surveillance from 2006 to 2013.

Publications

Molecular markers of anti-malarial drug resistance in southwest Ethiopia over time: regional surveillance from 2006 to 2013.

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