Ontoua Steede Seinnat, Kouna Lady Charlene, Oyegue-Liabagui Sandrine Lydie, Voumbo-Matoumona Dominique Fatima, Moukodoum Diamella Nancy, Imboumy-Limoukou Romeo Karl, Lekana-Douki Jean Bernard
Unité d'Evolution, Epidémiologie et Résistance Parasitaire (UNEEREP), Centre Interdisciplinaire des Recherches Médicales de Franceville (CIRMF), Franceville, BP 769, Gabon.
Ecole Doctorale Régionale d'Afrique Centrale en Infectiologie Tropicale (ECODRAC), Université de Sciences et Techniques de Masuku (USTM), Franceville, BP 876, Gabon.
Infect Drug Resist. 2021 Jul 24;14:2873-2882. doi: 10.2147/IDR.S304361. eCollection 2021.
malaria remains a major public health challenge in sub-Saharan Africa. drug resistance mediated by polymorphisms in the gene contributes to the persistence of the disease on the African continent. This study investigated infection features and differences in the genotypes between symptomatic and asymptomatic malaria cases in a rural area in east-central Gabon.
A total of 875 children aged from 5 to 185 months were screened for infection using Optima-IT rapid diagnostic tests and standard microscopy. polymorphisms at codons 86, 184 and 1246 were investigated using PCR-RFLP.
Among the 448 -infected children, 57.08% (n=250) were symptomatic and 42.92% (n=198) were asymptomatic ( < 0.0001). In a sub-set of 79 isolates, the wild-type N86 was more prevalent in symptomatic (100%) than in asymptomatic infections (70.7%) (=0.007). The mutant 86Y and mixed 86N/Y genotypes were observed only in asymptomatic infections. The Y184 and 184F genotype prevalences (39.1% vs 19.4% and 60.9% vs 80.6%, respectively) were not significantly different between the two groups (=0.097). The prevalence of the wild-type D1246 differed significantly between symptomatic (10.3%) and asymptomatic (100%) ( < 0.0001). The NFD and YFD haplotypes were more prevalent in asymptomatic than in symptomatic infections [(61.9% vs 31%; =0.005) and (16.7% vs 0.0%; =0.01)], whereas the NYD and YYD haplotypes were not significantly different between the two groups [(21.4% vs 14.3%, =0.39) and (0.0% vs 7.1%, =0.24)].
Our results confirm a high transmission of infection in rural Gabon, with a high prevalence of asymptomatic carriage. The higher prevalences of wild-type N86 in symptomatic infections and of D1246 in asymptomatic infections suggest a pathogenicity associated with polymorphisms in . These results highlight the need to monitor the efficacy of artemisinin-based combination therapies in Gabon.
疟疾仍是撒哈拉以南非洲地区的一项重大公共卫生挑战。由该基因多态性介导的耐药性导致了这种疾病在非洲大陆持续存在。本研究调查了加蓬中东部一个农村地区有症状和无症状疟疾病例的感染特征以及该基因的基因型差异。
使用Optima-IT快速诊断检测和标准显微镜检查对875名年龄在5至185个月的儿童进行疟原虫感染筛查。采用聚合酶链反应-限制性片段长度多态性（PCR-RFLP）方法研究第86、184和1246位密码子的多态性。
在448名感染疟原虫的儿童中，57.08%（n = 250）有症状，42.92%（n = 198）无症状（P < 0.0001）。在79个分离株的亚组中，野生型N86在有症状感染中更为普遍（100%），高于无症状感染（70.7%）（P = 0.007）。突变型86Y和混合型86N/Y基因型仅在无症状感染中观察到。两组之间Y184和184F基因型的患病率（分别为39.1%对19.4%和60.9%对80.6%）无显著差异（P = 0.097）。野生型D1246在有症状（10.3%）和无症状（100%）感染中的患病率差异显著（P < 0.0001）。NFD和YFD单倍型在无症状感染中比在有症状感染中更普遍[（61.9%对31%；P = 0.005）和（16.7%对0.0%；P = 0.01）]，而NYD和YYD单倍型在两组之间无显著差异[（21.4%对14.3%，P = 0.39）和（0.0%对7.1%，P = 0.24）]。
我们的结果证实加蓬农村地区疟原虫感染传播率很高，无症状携带率也很高。野生型N86在有症状感染中的较高患病率以及D1246在无症状感染中的较高患病率表明与该基因的多态性存在致病性关联。这些结果凸显了监测加蓬基于青蒿素的联合疗法疗效的必要性。
