Department of Biomedical Sciences, School of Allied Health Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana.
Department of Medical Laboratory Science, University of Cape Coast, Cape Coast, Ghana.
Malar J. 2021 Nov 25;20(1):447. doi: 10.1186/s12936-021-03985-8.
The return of chloroquine-sensitive Plasmodium falciparum in sub-Saharan Africa countries offers the opportunity for the reintroduction of chloroquine (CQ) either in combination with other drugs or as a single therapy for the management of malaria. This study assesses the influence of individual study sites on the selection of CQ sensitive P. falciparum markers in the Central region of Ghana.
Genomic DNA was extracted from an archived filter paper blood blot from Cape Coast, Elmina, Assin Fosu, and Twifo Praso using the Chelex DNA extraction method. The age metadata of the patients from whom the blood spots were taken was collected. The prevalence of CQ-sensitive markers of pfcrt K76 and pfmdr1 N86 was performed using nested PCR and RFLP. The data were analysed using Chi-square and Odd ratio.
The overall prevalence of CQ-sensitive P. falciparum markers, pfcrt K76 and pfmdr1 N86 in the Central Region of Ghana were 142 out of 184 (77.17%) and 180 out of 184 (97.83%), respectively. The distribution of pfcrt K76 was assessed among the age groups per the individual study sites. 12 out of 33 (36.36%), 8 out of 33 (24.24%) and 6 out of 33 (18.18%) of pfcrt K76 CQ-sensitive marker were isolated from age 0 to 5 years, 16 to 30 years and 31 to 45 years old respectively at Cape Coast. Assin Fosu and Twifo Praso had the highest pfcrt K76 prevalence in 0-5 years, followed by 16-30 years and 6-15 years of age. The results showed that there was a significant prevalence of pfcrt K76 in all study sites; Cape Coast (χ = 26.48, p < 0.0001), Assin Fosu (χ = 37.67, p < 0.0001), Twifo Praso (χ = 32.25, p < 0.0001) and Elmina (χ = 17.88, p < 0.0001). Again, the likelihood to detect pfcrt K76 (OR (95% CI) was 7.105 (3.118-17.14), p < 0.0001 and pfmdr1 (2.028 (1.065-3.790), p < 0.001) among P. falciparum isolates from Cape Coast to be seven times and two times, respectively.
The study showed a significant selection and expansion of chloroquine-sensitive P. falciparum markers in all the selected study areas in the Central region. This finding has a significant implication for the future treatment, management, and control of P. falciparum malaria.
在撒哈拉以南非洲国家，对氯喹敏感的恶性疟原虫的回归为氯喹（CQ）的重新引入提供了机会，无论是与其他药物联合使用还是作为单一疗法用于疟疾的治疗。本研究评估了个体研究地点对加纳中部地区选择氯喹敏感恶性疟原虫标志物的影响。
使用 Chelex DNA 提取方法从科海岸、埃尔米纳、阿辛福索和特威福拉索的存档滤纸片血斑中提取基因组 DNA。收集了从患者身上采集血斑的年龄元数据。使用巢式 PCR 和 RFLP 检测 CQ 敏感标志物 pfcrt K76 和 pfmdr1 N86 的流行率。使用卡方检验和优势比进行数据分析。
加纳中部地区 CQ 敏感恶性疟原虫标志物 pfcrt K76 和 pfmdr1 N86 的总流行率分别为 184 例中的 142 例（77.17%）和 180 例（97.83%）。根据各个研究地点评估了 pfcrt K76 在年龄组中的分布。在科海岸，12 例（36.36%）、8 例（24.24%）和 6 例（18.18%）的 pfcrt K76 CQ 敏感标志物分别来自 0 至 5 岁、16 至 30 岁和 31 至 45 岁的人群。阿辛福索和特威福拉索的 pfcrt K76 患病率最高，0-5 岁年龄组最高，其次是 16-30 岁和 6-15 岁年龄组。结果表明，所有研究地点均存在显著的 pfcrt K76 流行率；科海岸（χ2=26.48，p<0.0001）、阿辛福索（χ2=37.67，p<0.0001）、特威福拉索（χ2=32.25，p<0.0001）和埃尔米纳（χ2=17.88，p<0.0001）。同样，在科海岸检测到 pfcrt K76 的可能性（OR（95%CI）为 7.105（3.118-17.14），p<0.0001）和 pfmdr1（2.028（1.065-3.790），p<0.001）分别是来自科海岸的恶性疟原虫分离株的七倍和两倍。
该研究表明，在加纳中部地区所有选定的研究区域中，氯喹敏感的恶性疟原虫标志物均发生了显著的选择和扩增。这一发现对未来恶性疟原虫疟疾的治疗、管理和控制具有重要意义。
