scholarly journals Assessment of antimalarial drug resistant markers in asymptomatic Plasmodium falciparum infections after 4 years of indoor residual spraying in Northern Ghana

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0233478
Author(s):  
James L. Myers-Hansen ◽  
Benjamin Abuaku ◽  
Muyiwa K. Oyebola ◽  
Benedicta A. Mensah ◽  
Collins Ahorlu ◽  
...  
Keyword(s):  
Plasmodium Falciparum ◽  
Artemisinin Combination Therapy ◽  
Scale Up ◽  
Gene Mutations ◽  
Indoor Residual Spraying ◽  
Northern Ghana ◽  
Drug Resistant ◽  
Nucleotide Polymorphisms ◽  
Control Activity ◽  
Cross Sectional

Background Drug resistance remains a concern for malaria control and elimination. The effect of interventions on its prevalence needs to be monitored to pre-empt further selection. We assessed the prevalence of Plasmodium falciparum gene mutations associated with resistance to the antimalarial drugs: sulfadoxine-pyrimethamine (SP), chloroquine (CQ) and artemisinin combination therapy (ACTs) after the scale-up of a vector control activity that reduced transmission. Methods A total of 400 P. falciparum isolates from children under five years were genotyped for seventeen single nucleotide polymorphisms (SNPs) in pfcrt, pfmdr1, pfdhfr, pfdhps and pfk13 genes using polymerase chain reaction (PCR) and high resolution melting (HRM) analysis. These included 80 isolates, each randomly selected from cross-sectional surveys of asymptomatic infections across 2010 (baseline), 2011, 2012, 2013 (midline: post-IRS) and 2014 (endline: post-IRS) during the peak transmission season, when IRS intervention was rolled out in Bunkpurugu Yunyoo (BY) District, Ghana. The proportions of isolates with drug resistant alleles were assessed over this period. Results There were significant decreases in the prevalence of pfdhfr- I51R59N108 haplotype from 2010 to 2014, while the decline in pfdhfr/pfdhps- I51R59N108G437 during the same period was not significant. The prevalence of lumefantrine (LM), mefloquine (MQ) and amodiaquine (AQ) resistance-associated haplotypes pfmdr1-N86F184D1246 and pfmdr1-Y86Y184Y1246 showed decreasing trends (z = -2.86, P = 0.004 and z = -2.71, P = 0.007, respectively). Each of pfcrt-T76 and pfmdr1-Y86 mutant alleles also showed a declining trend in the asymptomatic reservoir, after the IRS rollout in 2014 (z = -2.87, P = 0.004 and z = -2.65, P = 0.008, respectively). Similarly, Pyrimethamine resistance mediating polymorphisms pfdhfr-N108, pfdhfr-I51 and pfdhfr-R59 also declined (z = -2.03, P = 0.042, z = -3.54, P<0.001 and z = -4.63, P<0.001, respectively), but not the sulphadoxine resistance mediating pfdhps-G437 and pfdhps-F436 (z = -0.36, P = 0.715 and z = 0.41, P = 0.684, respectively). No mutant pfk13-Y580 were detected during the study period. Conclusion The study demonstrated declining trends in the prevalence of drug resistant mutations in asymptomatic P. falciparum infections following transmission reduction after an enhanced IRS intervention in Northern Ghana.

scholarly journals Absence of Plasmodium falciparum artemisinin resistance gene mutations eleven years after the adoption of artemisinin-based combination therapy in Nigeria

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Moses Ikegbunam ◽  
Johnson A. Ojo ◽  
Kossiwa Kokou ◽  
Ugonna Morikwe ◽  
Chukwuemeka Nworu ◽  
...  
Keyword(s):  
Plasmodium Falciparum ◽  
Combination Therapy ◽  
Gene Mutations ◽  
Artemisinin Resistance ◽  
Cross Sectional Study ◽  
Nucleotide Polymorphisms ◽  
Cross Sectional ◽  
Two Samples ◽  
Group A

Abstract Background The occurrence of artemisinin resistance (ART)-associated polymorphism of Plasmodium falciparum K13-propeller (pfk13) gene before and after the introduction of artemisinin-based combination therapy (ACT) in two regions of Nigeria was investigated in this study. Regular surveillance is necessary to make a definite conclusion on the emergence and pattern of possible resistance to ART. Methods This cross-sectional study was carried out in the Southwestern and Southeastern geopolitical zones of Nigeria. A total of 150, 217, and 475 participants were enrolled for the study in the Southwest (2004_Group A), Southwest (2015_Group B), and southeast (2015_Group C), respectively. Blood samples were collected from the study participants for DNA extraction and a nested PCR for P. falciparum identification. Samples that were positive for P. falciparum were genotyped for the pfk13 gene using the Sanger sequencing method. The single nucleotide polymorphisms were analysed using the Bioedit software. Results A total of 116, 125, and 83 samples were positive for P. falciparum, respectively for the samples collected from the Southwest (2004 and 2015) and southeast (2015). Parasite DNA samples collected from febrile children in 2004 (Group A; n = 71) and 2015 (Group B; n = 73) in Osogbo Western Nigeria and 2015_Group C (n = 36) in southeast Nigeria were sequenced successfully. This study did not observe mutations associated with the in vitro resistance in southeast Asia, such as Y493H, R539T, I543T, and C580Y. Two new polymorphisms V520A and V581I were observed in two samples collected in Osogbo, Southwest Nigeria. These two mutations occurred in the year 2004 (Group A) before the introduction of ACT. Six mutations were identified in 17% of the samples collected in southeast Nigeria. One of these mutations (D547G) was non-synonymous, while the remaining (V510V, R515R, Q613Q, E688E, and N458N) were synonymous. Also, one (2%) heterozygote allele was identified at codon 458 in the 2015 (Group C) samples. Conclusions None of the mutations observed in this study were previously validated to be associated with ART resistance. These results, therefore, suggest that artemisinin is likely to remain highly effective in treating malaria in the study areas that are malarious zone.

scholarly journals Large-Scale Surveillance of Plasmodium falciparum crt(K76T) in Northern Ghana

2007 ◽  
Vol 51 (9) ◽  
pp. 3407-3409 ◽  
Author(s):  
Stephan Ehrhardt ◽  
Teunis A. Eggelte ◽  
Sarah Kaiser ◽  
Lydia Adjei ◽  
Gerd D. Burchard ◽  
...  
Keyword(s):  
Plasmodium Falciparum ◽  
Combination Therapy ◽  
Life Span ◽  
Large Scale ◽  
Artemisinin Combination Therapy ◽  
Dry Season ◽  
Chloroquine Resistance ◽  
Northern Ghana ◽  
Resistance Marker

ABSTRACT Surveillance of Plasmodium falciparum crt(K76T) [Pfcrt(K76T)], a resistance marker of chloroquine and, limitedly, amodiaquine, in >4,000 children in northern Ghana revealed a prevalence of 79%. Pfcrt(K76T) was heterogeneously distributed and associated with chloroquine use, low parasitemia, and the dry season. Widespread chloroquine resistance challenges the regional life span of amodiaquine as a partner drug in artemisinin combination therapy.

scholarly journals Evidence of Selective Sweeps in Genes Conferring Resistance to Chloroquine and Pyrimethamine in Plasmodium falciparum Isolates in India

2009 ◽  
Vol 54 (3) ◽  
pp. 997-1006 ◽  
Author(s):  
Tonya Mixson-Hayden ◽  
Vidhan Jain ◽  
Andrea M. McCollum ◽  
Amanda Poe ◽  
Avinash C. Nagpal ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Plasmodium Falciparum ◽  
Cerebral Malaria ◽  
Direct Sequencing ◽  
Point Mutations ◽  
Drug Resistant ◽  
Nucleotide Polymorphisms ◽  
Single Nucleotide ◽  
Mild Malaria ◽  
Resistant Genotypes

ABSTRACT Treatment of Plasmodium falciparum is complicated by the emergence and spread of parasite resistance to many of the first-line drugs used to treat malaria. Antimalarial drug resistance has been associated with specific point mutations in several genes, suggesting that these single nucleotide polymorphisms can be useful in tracking the emergence of drug resistance. In India, P. falciparum infection can manifest itself as asymptomatic, mild, or severe malaria, with or without cerebral involvement. We tested whether chloroquine- and antifolate drug-resistant genotypes would be more commonly associated with cases of cerebral malaria than with cases of mild malaria in the province of Jabalpur, India, by genotyping the dhps, dhfr, pfmdr-1, and pfcrt genes using pyrosequencing, direct sequencing, and real-time PCR. Further, we used microsatellites surrounding the genes to determine the origins and spread of the drug-resistant genotypes in this area. Resistance to chloroquine was essentially fixed, with 95% of the isolates harboring the pfcrt K76T mutation. Resistant genotypes of dhfr, dhps, and pfmdr-1 were found in 94%, 17%, and 77% of the isolates, respectively. Drug-resistant genotypes were equally likely to be associated with cerebral malaria as with mild malaria. We found evidence of a selective sweep in pfcrt and, to a lesser degree, in dhfr, indicating high levels of resistance to chloroquine and evolving resistance to pyrimethamine. Microsatellites surrounding pfcrt indicate that the resistant genotypes (SVMNT) were most similar to those found in Papua New Guinea.

scholarly journals Partial indoor residual spraying with pirimiphos-methyl as an effective and cost-saving measure for the control of Anopheles gambiae s.l. in northern Ghana

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Sylvester Coleman ◽  
Yemane Yihdego ◽  
Ellie Sherrard-Smith ◽  
Churcher S. Thomas ◽  
Dereje Dengela ◽  
...  
Keyword(s):  
Cost Saving ◽  
Anopheles Gambiae ◽  
Malaria Control ◽  
Scale Up ◽  
Indoor Residual Spraying ◽  
Transmission Model ◽  
Northern Ghana ◽  
Small Scale ◽  
Experimental Huts ◽  
Pirimiphos Methyl

AbstractThe scale up of indoor residual spraying (IRS) and insecticide treated nets have contributed significantly to global reductions in malaria prevalence over the last two decades. However, widespread pyrethroid resistance has necessitated the use of new and more expensive insecticides for IRS. Partial IRS with pirimiphos-methyl in experimental huts and houses in a village-wide trial was evaluated against Anopheles gambiae s.l. in northern Ghana. Four different scenarios in which either only the top or bottom half of the walls of experimental huts were sprayed, with or without also spraying the ceiling were compared. Mortality of An. gambiae s.l. on partially sprayed walls was compared with the standard procedures in which all walls and ceiling surfaces are sprayed. A small-scale trial was then conducted to assess the effectiveness, feasibility, and cost of spraying only the upper walls and ceiling as compared to full IRS and no spraying in northern Ghana. Human landing catches were conducted to estimate entomological indices and determine the effectiveness of partial IRS. An established transmission dynamics model was parameterized by an analysis of the experimental hut data and used to predict the epidemiological impact and cost effectiveness of partial IRS for malaria control in northern Ghana. In the experimental huts, partial IRS of the top (IRR 0.89, p = 0.13) or bottom (IRR 0.90, p = 0.15) half of walls and the ceiling was not significantly less effective than full IRS in terms of mosquito mortality. In the village trial, the annual entomological inoculation rate was higher for the unsprayed control (217 infective bites/person/year (ib/p/yr)) compared with the fully and partially sprayed sites, with 28 and 38 ib/p/yr, respectively. The transmission model predicts that the efficacy of partial IRS against all-age prevalence of malaria after six months would be broadly equivalent to a full IRS campaign in which 40% reduction is expected relative to no spray campaign. At scale, partial IRS in northern Ghana would have resulted in a 33% cost savings ($496,426) that would enable spraying of 36,000 additional rooms. These findings suggest that partial IRS is an effective, feasible, and cost saving approach to IRS that could be adopted to sustain and expand implementation of this key malaria control intervention.

scholarly journals Identification of rpoB, gyrA and embB Gene Mutations in Mycobacterium Tuberculosis Isolates from Retreatment Tuberculosis Patients in Nepal

2018 ◽  
Vol 14 (2) ◽  
pp. 39-50
Author(s):  
Dhruba Kumar Khadka ◽  
Rajendra Prasad Pant ◽  
Bikash Lamichhane ◽  
Sharat Chandra Verma ◽  
R. P. Bichha ◽  
...  
Keyword(s):  
Gene Mutations ◽  
Rpob Gene ◽  
Drug Susceptibility ◽  
Cross Sectional Study ◽  
Molecular Techniques ◽  
Reference Laboratory ◽  
Drug Resistant ◽  
Cross Sectional ◽  
Mdr Tb ◽  
Embb Gene

Introduction: Tuberculosis remains one of the major public health problems in Nepal and increasing trend of multi drug resistant and extensively drug resistant tuberculosis (MDR /XDR TB) is a big challenge. Rapid diagnosis and appropriate treatment of MDR/XDR TB is crucial. Identification and comparison of MDR TB using rapid molecular techniques (for rpob, gyrA, rrs and embB gene mutations) with reference to drug susceptibility test (DST) were the main objectives of this study.Methodology: A cross sectional study was carried out in National TB Centre (NTC). Gene Xpert, proportion method and Line Probe Assay (LPA) were used for first and second line drugs susceptibility testing (FLD-DST and SLD-DST). A total of 29 mucopurulent sputum samples were freshly collected from retreatment TB patients (Female 41.4%, Male 58.6%) with median age of 40 years attending to the four MDR TB treatment centres of eastern and central Nepal (via private courier and directly to National TB Reference Laboratory (NRL) at NTC from April 2013 to October 2017.Results: Among 29 sputum samples (Female 41.4%; all smear+ve, Male 58.6%; 16 smear+ve and 1 smear-ve), Gene Xpert MTB/RIF assay detected 100% M. tuberculosis and rifampicin resistance (rpoB gene resistant) of which, 100% were culture positive by conventional Lowenstein–Jensen (LJ) method. FLDDST was performed on all culture positives of which, 96.6% showed MDR TB and 3.4% showed mono resistance to isonizid only. SLD-DST on 29 MDRTB strains by LPA showed 100%, 58.6%, 44.8% wild type for rrs, gyrA and emb B genes respectively. Mutation for gyrA and emb B genes was 41.4% and 51.2% respectively, rrs genes none. Twelve (Female 6, Male 6) MDR TB strains were identified  as pre-XDR-TB. Chi square (χ2) for trend was used to analyze Gene Xpert, smear, FLD-DST and LPA results.Conclusion: From this study, 29(100%) MDRTB were detected from retreatment TB cases by Gene Xpert and FLDDST. Almost 41.4% MDR TB strains were detected as pre-XDR TB by LPA, which were found to be higher in 15-60 years group of females and males. Samples from retreatment TB patients need to be tested by rapid molecular techniques with reference to culture and DST.SAARC Journal of Tuberculosis, Lung Diseases and HIV/AIDS, Vol. 14, No. 2, 2017, Page: 39-50

scholarly journals Characterizing the molecular and metabolic mechanisms of insecticide resistance in Anopheles gambiae s.l. in Faranah, Guinea

2019 ◽  
Author(s):  
Caleb Stica ◽  
Claire L. Jeffries ◽  
Seth R. Irish ◽  
Yaya Barry ◽  
Denka Camara ◽  
...  
Keyword(s):  
Plasmodium Falciparum ◽  
Insecticide Resistance ◽  
Anopheles Gambiae ◽  
Scale Up ◽  
Indoor Residual Spraying ◽  
Control Program ◽  
Sub Saharan Africa ◽  
Health Concern ◽  
Global Public Health ◽  
Metabolic Resistance

AbstractBackgroundIn recent years, the scale-up of long-lasting insecticidal nets (LLINs) and indoor residual spraying (IRS) has greatly reduced malaria transmission. However, malaria remains a global public health concern with the majority of disease burden in sub-Saharan Africa. Insecticide resistance is a growing problem among Anopheles vector populations, with potential implications for the continued effectiveness of available control interventions. Improved understanding of current resistance levels and underlying mechanisms is essential to design appropriate management strategies and to mitigate future selection for resistance.MethodsAnopheles gambiae s.l. mosquitoes were collected from three villages in Faranah Prefecture, Guinea and their levels of susceptibility to seven insecticides were measured using CDC resistance intensity bioassays. Synergist assays with piperonyl butoxide (PBO) were also undertaken to assess the role of elevated mixed-function oxidases in resistance. RNA was extracted from 563 individuals and PCR was performed on cDNA to determine vector species, presence of target site mutations (L1014F kdr, N1575Y and G119S Ace-1), Plasmodium falciparum infection, and relative expression of three metabolic genes (CYP6M2, CYP6P3 and GSTD3).ResultsIn Faranah, resistance to permethrin and deltamethrin was observed, as well as possible resistance to bendiocarb. All assayed vector populations were fully susceptible to alpha-cypermethrin, pirimiphos-methyl, clothianidin and chlorfenapyr. Plasmodium falciparum infection was detected in 7.3% (37/508) mosquitoes tested. The L1014F kdr mutation was found in 100% of a sub-sample of 60 mosquitoes, supporting its fixation in the region. The N1575Y mutation was identified in 20% (113/561) of individuals, with ongoing selection evidenced by significant deviations from Hardy-Weinberg equilibrium. The G119S Ace-1 mutation was detected in 62.1% (18/29) of mosquitoes tested and was highly predictive of bendiocarb bioassay survival. The metabolic resistance genes, CYP6M2, CYP6P3 and GSTD3, were found to be overexpressed in wild resistant and susceptible An. gambiae s.s. populations, compared to a susceptible G3 colony. Furthermore, CYP6P3 was significantly overexpressed in bendiocarb survivors, implicating its potential role in carbamate resistance in Faranah.ConclusionsIdentification of intense resistance to permethrin and deltamethrin in Faranah, is of concern, as the Guinea National Malaria Control Program (NMCP) relies exclusively on the distribution of pyrethroid-treated LLINs for vector control. Study findings will be used to guide current and future control strategies in the region.

scholarly journals Infection of Plasmodium falciparum and helminths among school children in communities in Southern and Northern Ghana

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
G. Akosah-Brempong ◽  
S. K. Attah ◽  
I. A. Hinne ◽  
A. Abdulai ◽  
K. Addo-Osafo ◽  
...  
Keyword(s):  
Plasmodium Falciparum ◽  
Schistosoma Mansoni ◽  
School Children ◽  
Cross Sectional Study ◽  
Control Measures ◽  
Northern Ghana ◽  
Malaria Vector Control ◽  
Remote Communities ◽  
Cross Sectional ◽  
Concentration Technique

Abstract Background Infections of Plasmodium species, Schistosoma species and soil-transmitted helminths (STH) inflict a significant burden on children mostly in deprived communities in Ghana. Despite the deployment of malaria vector control and the annual Mass Drug Administration by National Control Programmes, these infections still pose major public health concerns in Ghana. Some remote communities which are hard-to-reach are not covered by MDA campaigns which is a major challenge to meeting elimination targets. Adequate data is necessary for formulating policies and strengthening interventions to mitigate transmission. This study assessed the infection burden of Plasmodium, Schistosoma species and STH infections among school children in communities in Southern and Northern Ghana. Method School children living in communities in Southern (Ada Foah, Pediatorkope, Tuanikope) and Northern (Kpalsogu) Ghana were enrolled in a cross-sectional study. A total of 493 (241 males and 252 females) school children aged (2–15 years) were enrolled in the study. Stool samples were collected to screen for Schistosoma mansoni and STH infections using the formol-ether concentration technique and urine samples were also collected to screen for S. haematobium using the routine urine examination method. Plasmodium parasitaemia was determined from thick and thin finger-prick blood samples. Results Overall, the prevalence of P. falciparum, S. mansoni, S. haematobium, Trichuris trichiura and hookworm infections were 17.2% (95%CI 12.8–19.7), 22.6% (95%CI 25.2–32.7), 1.6% (95%CI 0.89–5.2), 1.2% (95%CI 0.78–4.8) and 1.2% (95%CI 0.78–4.8) respectively. Plasmodium falciparum infection was generally widespread in all the study sites with Ada Foah recording the highest prevalence (35.3%) and Kpalsogu recording the lowest (5.8%). Schistosoma mansoni was present in only two Southern communities with Tuanikope recording the highest prevalence of 70.3% as against 51.5% recorded in Pediatorkope. A total of 4.5% (95% CI 2.82–10.8) of the children were co-infected with P. falciparum, Schistosoma species and STHs. This occurred only in the Southern communities; of which combination of P. falciparum and S. mansoni were predominant (1.4%). Conclusion A relatively low burden of parasites co-infection among children only in the Southern communities was detected. However, there were a high prevalence of single infections of P. falciparum and S. mansoni in those communities. Control measures for the helminths needs to be restarted in the island communities with a high burden of S. mansoni infections and that of Plasmodium needs to be scaled up in Ada Foah where P. falciparum infections were high.

scholarly journals Predictive markers of transmission in areas with different malaria endemicity in north-eastern Tanzania based on seroprevalence of antibodies against Plasmodium falciparum

2021 ◽  
Author(s):  
Robert Diotrephes Kaaya ◽  
Debora C Kajeguka ◽  
Johnson J Matowo ◽  
Arnold J Ndaro ◽  
Franklin W Mosha ◽  
...  
Keyword(s):  
Plasmodium Falciparum ◽  
Scale Up ◽  
Age Groups ◽  
Malaria Prevalence ◽  
African Countries ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Malaria Burden ◽  
North Eastern ◽  
Chi Squared

Abstract BackgroundDue to the scale-up of different interventions, Malaria burden declined significantly in many African countries between 2000 and 2015. As a result, some areas have become suitable for malaria elimination, and in such a situation, Due to the insensitivity of most commonly used methods, malaria transmission assessment is difficult. In north-eastern Tanzania, we tested for Plasmodium falciparum exposure by using serological markers.MethodsA cross-sectional survey was conducted in Bondo, Tanga and Hai, Kilimanjaro between June and December 2014. A total of 788 participants were enrolled and screened for malaria and IgG antibodies against PfAMA-1 and PfMSP-119 antigens using Enzyme-Linked Immuno-Sorbent Assay (ELISA). Malaria parasites were detected using polymerase chain reaction (PCR). The Mann–Whitney test was used to compare the Antibody levels between two independent groups (i.e. positive versus negative). The non-parametric Kruskal-Wallis test was used for comparisons between more than two age groups. Pearson's Chi-squared (χ2) test was used to compare proportions.ResultsGenerally, malaria prevalence by PCR in two sites was 20.4% (161), with Bondo having a higher prevalence of 28.1% (n= 154) as compared to Hai 2.9%, (n= 7), χ2=64.64, p<0.01. Anti-PfAMA-1 and anti-PfMSP-119 antibody concentrations were higher in malaria positive than malaria negative individuals, Mann-Whitney U test, p=0.07 and p=0.003 respectively. Antibody response against PfAMA-1 was significantly different between the three age groups (Kruskal-Wallis test, p<0.001).ConclusionPlasmodium falciparum exposure immunological indicators have proven useful for explaining the dynamics of transmission, especially in low transmission environments like Hai.

scholarly journals Plasmodium falciparum Isolates Carrying pfk13 Polymorphisms Harbor the SVMNT Allele of pfcrt in Northwestern Indonesia

2020 ◽  
Vol 64 (8) ◽  
Author(s):  
Inke N. D. Lubis ◽  
Hendri Wijaya ◽  
Munar Lubis ◽  
Chairuddin P. Lubis ◽  
Khalid B. Beshir ◽  
...  
Keyword(s):  
Plasmodium Falciparum ◽  
Combination Therapy ◽  
Artemisinin Combination Therapy ◽  
Drug Susceptibility ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Content Type ◽  
Treatment Groups ◽  
Greater Mekong Subregion

ABSTRACT Artemisinin-based combination therapy (ACT) is the first-line antimalarial regimen in Indonesia. Susceptibility of Plasmodium falciparum to artemisinin is falling in the Greater Mekong subregion, but it is not known whether the efficacy of current combinations is also threatened in nearby Sumatera. We evaluated the genetic loci pfcrt, pfmdr1, and pfk13, considered to be under selection by artemisinin combination therapy, among 404 P. falciparum infections identified by PCR detection in a cross-sectional survey of 3,731 residents of three regencies. The pfcrt haplotype SVMNT (codons 72 to 76) was the most prevalent and displayed significant linkage disequilibrium with the pfmdr1 haplotype YY (codons 86 and 184) (odds ratio [OR] 26.7; 95% confidence interval [CI], 5.96 to 239.4; P < 0.001). This contrasts with Mekong countries, where the CVIET haplotype of pfcrt predominates. Among 231 evaluable isolates, only 9 (3.9%) showed any evidence of nonsynonymous gene variants in the propeller domain of pfk13. The Thr474Ala variant was seen in six individuals, and Cys580Tyr was identified with low confidence in only a single isolate from an asymptomatic individual. Among a subset of 117 symptomatic P. falciparum-infected individuals randomized to receive either dihydroartemisinin-piperaquine or artemether-lumefantrine, the treatment outcome was not associated with pretreatment genotype. However, submicroscopic persistent parasites at day 28 or day 42 of follow-up were significantly more likely to harbor the pfmdr1 haplotype NF (codons 86 and 184) than were pretreatment isolates (P < 0.001 for both treatment groups). Current ACT regimens appear to be effective in Sumatera, but evidence of persistent submicroscopic infection in some patients suggests further detailed studies of drug susceptibility should be undertaken.

scholarly journals Acceptance and determinants of indoor residual spraying in two blocks of Tripura: using LQAS technique

2020 ◽  
Vol 8 (1) ◽  
pp. 384
Author(s):  
Sankha Subhra Debnath ◽  
Subrata Baidya ◽  
Rituparna Das ◽  
Durba Deb
Keyword(s):  
Scale Up ◽  
Indoor Residual Spraying ◽  
Malaria Prevention ◽  
Cross Sectional Study ◽  
P Value ◽  
Chi Square ◽  
Cross Sectional ◽  
Community Acceptance ◽  
Factors Influencing ◽  
Chi Square Test

Background: Indoor Residual Spray (IRS) with insecticide (DDT) is one of the most important component of integrated vector management for malaria prevention. Though, NVBDCP targets at least 80% coverage at high risk malaria zone by effective protective measures (eg. IRS) by 2017, but the real coverage is however limited, due to low community acceptance and several other factors. Objectives were to assess the IRS coverage in two blocks of Tripura and to study the factors influencing IRS acceptance.Methods: A cross sectional study was conducted among 600 households of all 30 sub centres of two blocks of Sepahijala district of Tripura 2015 to 2017 using LQAS technique. Head of the families were interviewed to collect information regarding IRS. Data analysis was done in SPSS 20.0.  Statistical analysis used Chi square test was applied to assess the association between different variables. P-value (<0.05) was considered as statistically significant.Results: IRS coverage and acceptance were 61.7% and 75.05% respectively. The factors influencing IRS acceptance were Age of the Head of the family p 0.015, Religion p 0.011, Education p 0.04, Occupation p 0.018, type of Community p.0.000, House type p 0.000, By LQAS analysis, 9 out of 30 lots were accepted for having target coverage of IRS (80%).Conclusions: IRS coverage was lower than the NVBDCP target of 80 % coverage. Sound programmatic management strategy along with IEC, BCC is needed to scale up the coverage.

Sign in / Sign up

Export Citation Format

Share Document