| Hamtandi Magloire Natama, Rouamba Toussaint, Djamina Line Cerine Bazié, Sékou Samadoulougou, Maminata Coulibaly-Traoré, Halidou Tinto, Fati Kirakoya-Samadoulougou Prevalence and factors associated with carriage of Pfmdr1 polymorphisms among pregnant women receiving intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp-SP) and artemether-lumefantrine for malaria treatment in Burkina Faso (Journal Article) In: Malar. J., vol. 19, no. 1, pp. 399, 2020, ISSN: 1475-2875. @article{Natama2020-bk,
title = {Prevalence and factors associated with carriage of Pfmdr1 polymorphisms among pregnant women receiving intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp-SP) and artemether-lumefantrine for malaria treatment in Burkina Faso},
author = {Hamtandi Magloire Natama and Rouamba Toussaint and Djamina Line Cerine Bazi\'{e} and S\'{e}kou Samadoulougou and Maminata Coulibaly-Traor\'{e} and Halidou Tinto and Fati Kirakoya-Samadoulougou},
doi = {10.1186/s12936-020-03473-5},
issn = {1475-2875},
year = {2020},
date = {2020-11-01},
urldate = {2020-11-01},
journal = {Malar. J.},
volume = {19},
number = {1},
pages = {399},
publisher = {Springer Science and Business Media LLC},
abstract = {BACKGROUND: Single nucleotide polymorphisms occurring in the
Plasmodium falciparum multidrug resistant gene 1 (pfmdr1) are
known to be associated with aminoquinoline resistance and,
therefore, represent key P. falciparum markers for monitoring
resistance both in susceptible groups (children under 5 years
old and pregnant women) and in the general population. This
study aimed to determine prevalence and factors associated with
the carriage of pfmdr1 N86Y, Y184F and D1246Y polymorphisms
among pregnant women in a setting of high malaria transmission
in Burkina Faso. METHODS: Plasmodium falciparum isolates were
collected at the first antenatal care visit (ANC-1) as well as
at delivery from pregnant women participating in the COSMIC
trial (NTC01941264), which assessed malaria preventive
interventions during pregnancy in the Nanoro Health District.
Here, pregnant women received intermittent preventive treatment
with sulfadoxine-pyrimethamine (IPTp-SP) and malaria infections
and/or diseases were treated using artemether-lumefantrine (AL)
during the trial. Parasite DNA was extracted from dried blood
spots and the presence of pfmdr1 mutations at positions 86, 184
and 1246 was determined using nested PCR, followed by
restriction fragment length polymorphism (RFLP) analysis.
RESULTS: A prevalence of 13.2% (20/151) and 12.1% (14/116) of
the pfmdr1 86Y mutant allele was found at ANC-1 and at delivery,
respectively, while no mutant allele was observed for Y184F and
D1246Y codons at both ANC-1 and at delivery. There were no
significant factors associated with pfmdr1 86Y mutant allele
carriage at ANC-1. However, malaria infections at delivery with
a parasite density above the median (2237.2 (IQR:
613.5-11,425.7) parasites/µl) was associated with an increase risk of pfmdr1 86Y mutant allele carriage (AOR = 5.5 (95% CI 1.07-28.0); P = 0.04). In contrast, both three or more IPTp-SP doses (AOR = 0.25 (95% CI 0.07-0.92); P = 0.04) and one or more AL treatment (AOR = 0.25 (95% CI 0.07-0.89); P = 0.03) during
pregnancy were associated with a significant reduce risk of
pfmdr1 86Y mutant allele carriage at delivery. CONCLUSION: These
findings suggest that both high coverage of IPTp-SP and the use
of AL for the treatment of malaria infection/disease during
pregnancy select for pfmdr1 N86 wild-type allele at delivery.},
keywords = {Artemether-lumefantrine; Malaria; Pregnancy; pfmdr1 mutations},
pubstate = {published},
tppubtype = {article}
}
BACKGROUND: Single nucleotide polymorphisms occurring in the
Plasmodium falciparum multidrug resistant gene 1 (pfmdr1) are
known to be associated with aminoquinoline resistance and,
therefore, represent key P. falciparum markers for monitoring
resistance both in susceptible groups (children under 5 years
old and pregnant women) and in the general population. This
study aimed to determine prevalence and factors associated with
the carriage of pfmdr1 N86Y, Y184F and D1246Y polymorphisms
among pregnant women in a setting of high malaria transmission
in Burkina Faso. METHODS: Plasmodium falciparum isolates were
collected at the first antenatal care visit (ANC-1) as well as
at delivery from pregnant women participating in the COSMIC
trial (NTC01941264), which assessed malaria preventive
interventions during pregnancy in the Nanoro Health District.
Here, pregnant women received intermittent preventive treatment
with sulfadoxine-pyrimethamine (IPTp-SP) and malaria infections
and/or diseases were treated using artemether-lumefantrine (AL)
during the trial. Parasite DNA was extracted from dried blood
spots and the presence of pfmdr1 mutations at positions 86, 184
and 1246 was determined using nested PCR, followed by
restriction fragment length polymorphism (RFLP) analysis.
RESULTS: A prevalence of 13.2% (20/151) and 12.1% (14/116) of
the pfmdr1 86Y mutant allele was found at ANC-1 and at delivery,
respectively, while no mutant allele was observed for Y184F and
D1246Y codons at both ANC-1 and at delivery. There were no
significant factors associated with pfmdr1 86Y mutant allele
carriage at ANC-1. However, malaria infections at delivery with
a parasite density above the median (2237.2 (IQR:
613.5-11,425.7) parasites/µl) was associated with an increase risk of pfmdr1 86Y mutant allele carriage (AOR = 5.5 (95% CI 1.07-28.0); P = 0.04). In contrast, both three or more IPTp-SP doses (AOR = 0.25 (95% CI 0.07-0.92); P = 0.04) and one or more AL treatment (AOR = 0.25 (95% CI 0.07-0.89); P = 0.03) during
pregnancy were associated with a significant reduce risk of
pfmdr1 86Y mutant allele carriage at delivery. CONCLUSION: These
findings suggest that both high coverage of IPTp-SP and the use
of AL for the treatment of malaria infection/disease during
pregnancy select for pfmdr1 N86 wild-type allele at delivery. |