Ofori Michael Fokuo, Kploanyi Emma E, Mensah Benedicta A, Dickson Emmanuel K, Kyei-Baafour Eric, Gyabaa Sampson, Tetteh Mary, Koram Kwadwo A, Abuaku Benjamin K, Ghansah Anita
Immunology Department, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana.
Epidemiology Department, Noguchi Memorial Institute for Medical Research,University of Ghana, Legon, Accra, Ghana.
Infect Drug Resist. 2021 Jan 28;14:267-276. doi: 10.2147/IDR.S295277. eCollection 2021.
Malaria continues to be a major health issue globally with almost 85% of the global burden and deaths borne by sub-Saharan Africa and India. Although the current artemisinin derived combination therapies in Ghana are still efficacious against the () parasite, compounding evidence of artemisinin and amodiaquine resistance establish the need for a full, up-to-date understanding and monitoring of antimalarial resistance to provide evidence for planning control strategies.
The study was cross-sectional and was conducted during the peak malaria transmission seasons of 2015, 2016, and 2017 in two ecological zones of Ghana. Study participants included children aged 6 months to 14 years. Using ex vivo 4,6-diamidino-2-phenylindole (DAPI) drug sensitivity assay, 330 isolates were used to investigate susceptibility to five antimalarial drugs: chloroquine (CQ), amodiaquine (AMD) dihydroartemisinin (DHA), artesunate (ART) and mefloquine (MFQ).
The pooled geometric mean ICS (GMIC) of the five drugs against the parasites from Cape Coast and Begoro were 15.5, 42.4, 18.9, 4.6 and 27.3nM for CQ, AMD, DHA, ART, and MFQ, respectively. The GMIC values for CQ (p<0.001), ART (p<0.011) and DHA (p<0.018) were significantly higher for Cape Coast isolates as compared to Begoro isolates. However, GMIC estimates for MFQ (p<0.022) were significantly higher for Begoro isolates. Positive correlations were found between each pair of drugs with the weakest found between MFQ and DHA ( = 0.34;p<0.001), and the strongest between ART and DHA ( =0.66; p<0.001).
The parasites showed reduced sensitivities to three (AMD, DHA and MFQ) out of the five drugs assessed. The study also demonstrated the continual return of chloroquine-sensitive parasites after 13 years of its withdrawal as the first-line drug for the treatment of uncomplicated malaria in Ghana. The ex vivo DAPI assay is a reliable method for assessing antimalarial drug sensitivities of field isolates under field settings.
疟疾仍是全球主要的健康问题，全球近85%的负担和死亡病例由撒哈拉以南非洲和印度承担。尽管加纳目前的青蒿素联合疗法对（）寄生虫仍然有效，但青蒿素和阿莫地喹耐药性的证据不断增加，这表明需要全面、最新地了解和监测抗疟药物耐药性，为制定控制策略提供依据。
本研究为横断面研究，于2015年、2016年和2017年疟疾传播高峰期在加纳的两个生态区进行。研究参与者包括6个月至14岁的儿童。使用体外4,6-二脒基-2-苯基吲哚（DAPI）药物敏感性试验，330株分离株用于研究对五种抗疟药物的敏感性：氯喹（CQ）、阿莫地喹（AMD）、双氢青蒿素（DHA）、青蒿琥酯（ART）和甲氟喹（MFQ）。
来自海岸角和贝戈罗的寄生虫对五种药物的合并几何平均抑制浓度（GMIC），CQ、AMD、DHA、ART和MFQ分别为15.5、42.4、18.9、4.6和27.3nM。与贝戈罗分离株相比，海岸角分离株的CQ（p<0.001）、ART（p<0.011）和DHA（p<0.018）的GMIC值显著更高。然而，贝戈罗分离株的MFQ的GMIC估计值（p<0.022）显著更高。在每对药物之间发现了正相关，其中MFQ和DHA之间的相关性最弱（=0.34；p<0.001），ART和DHA之间的相关性最强（=0.66；p<0.001）。
在所评估的五种药物中，寄生虫对三种药物（AMD、DHA和MFQ）的敏感性降低。该研究还表明，在加纳将氯喹作为治疗非复杂性疟疾的一线药物停用13年后，对氯喹敏感的寄生虫持续出现。体外DAPI试验是在现场环境中评估现场分离株抗疟药物敏感性的可靠方法。
需注意，原文括号处内容缺失，翻译时保留原样。
