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Salazar YEAR, Louzada J, Puça MCSDB, Guimarães LFF, Vieira JLF, de Siqueira AM, Gil JP, de Brito CFA, de Sousa TN. Delayed gametocyte clearance in Plasmodium vivax malaria is associated with polymorphisms in the cytochrome P450 reductase (CPR). Antimicrob Agents Chemother 2024; 68:e0120423. [PMID: 38411047 PMCID: PMC10989009 DOI: 10.1128/aac.01204-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 01/31/2024] [Indexed: 02/28/2024] Open
Abstract
Primaquine (PQ) is the main drug used to eliminate dormant liver stages and prevent relapses in Plasmodium vivax malaria. It also has an effect on the gametocytes of Plasmodium falciparum; however, it is unclear to what extent PQ affects P. vivax gametocytes. PQ metabolism involves multiple enzymes, including the highly polymorphic CYP2D6 and the cytochrome P450 reductase (CPR). Since genetic variability can impact drug metabolism, we conducted an evaluation of the effect of CYP2D6 and CPR variants on PQ gametocytocidal activity in 100 subjects with P. vivax malaria. To determine gametocyte density, we measured the levels of pvs25 transcripts in samples taken before treatment (D0) and 72 hours after treatment (D3). Generalized estimating equations (GEEs) were used to examine the effects of enzyme variants on gametocyte densities, adjusting for potential confounding factors. Linear regression models were adjusted to explore the predictors of PQ blood levels measured on D3. Individuals with the CPR mutation showed a smaller decrease in gametocyte transcript levels on D3 compared to those without the mutation (P = 0.02, by GEE). Consistent with this, higher PQ blood levels on D3 were associated with a lower reduction in pvs25 transcripts. Based on our findings, the CPR variant plays a role in the persistence of gametocyte density in P. vivax malaria. Conceptually, our work points to pharmacogenetics as a non-negligible factor to define potential host reservoirs with the propensity to contribute to transmission in the first days of CQ-PQ treatment, particularly in settings and seasons of high Anopheles human-biting rates.
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Affiliation(s)
- Yanka Evellyn Alves Rodrigues Salazar
- Molecular Biology and Malaria Immunology Research Group, Instituto René Rachou, Fundação Oswaldo Cruz (FIOCRUZ), Belo Horizonte, Minas Gerais, Brazil
| | - Jaime Louzada
- Universidade Federal de Roraima, Boa Vista, Roraima, Brazil
| | - Maria Carolina Silva de Barros Puça
- Molecular Biology and Malaria Immunology Research Group, Instituto René Rachou, Fundação Oswaldo Cruz (FIOCRUZ), Belo Horizonte, Minas Gerais, Brazil
| | - Luiz Felipe Ferreira Guimarães
- Molecular Biology and Malaria Immunology Research Group, Instituto René Rachou, Fundação Oswaldo Cruz (FIOCRUZ), Belo Horizonte, Minas Gerais, Brazil
| | | | - André Machado de Siqueira
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Rio de Janeiro, Brazil
| | - José Pedro Gil
- Department of Microbiology, Tumor and Cell biology, Karolinska Institutet, Solna, Sweden
| | - Cristiana Ferreira Alves de Brito
- Molecular Biology and Malaria Immunology Research Group, Instituto René Rachou, Fundação Oswaldo Cruz (FIOCRUZ), Belo Horizonte, Minas Gerais, Brazil
| | - Tais Nobrega de Sousa
- Molecular Biology and Malaria Immunology Research Group, Instituto René Rachou, Fundação Oswaldo Cruz (FIOCRUZ), Belo Horizonte, Minas Gerais, Brazil
- Department of Microbiology, Tumor and Cell biology, Karolinska Institutet, Solna, Sweden
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Gunderson AK, Recalde-Coronel C, Zaitchick BF, Yori PP, Rengifo Pinedo S, Paredes Olortegui M, Kosek M, Vinetz JM, Pan WK. A prospective cohort study linking migration, climate, and malaria risk in the Peruvian Amazon. Epidemiol Infect 2023; 151:e202. [PMID: 38031496 PMCID: PMC10753477 DOI: 10.1017/s0950268823001838] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 11/02/2023] [Accepted: 11/07/2023] [Indexed: 12/01/2023] Open
Abstract
Migration is an important risk factor for malaria transmission for malaria transmission, creating networks that connect Plasmodium between communities. This study aims to understand the timing of why people in the Peruvian Amazon migrated and how characteristics of these migrants are associated with malaria risk. A cohort of 2,202 participants was followed for three years (July 2006 - October 2009), with thrice-weekly active surveillance to record infection and recent travel, which included travel destination(s) and duration away. Migration occurred more frequently in the dry season, but the 7-day rolling mean (7DRM) streamflow was positively correlated with migration events (OR 1.25 (95% CI: 1.138, 1.368)). High-frequency and low-frequency migrant populations reported 9.7 (IRR 7.59 (95% CI:.381, 13.160)) and 4.1 (IRR 2.89 (95% CI: 1.636, 5.099)) times more P. vivax cases than those considered non-migrants and 30.7 (IRR 32.42 (95% CI: 7.977, 131.765)) and 7.4 (IRR 7.44 (95% CI: 1.783, 31.066)) times more P. falciparum cases, respectively. High-frequency migrants employed in manual labour within their community were at 2.45 (95% CI: 1.113, 5.416) times higher risk than non-employed low-frequency migrants. This study confirms the importance of migration for malaria risk as well as factors increasing risk among the migratory community, including, sex, occupation, and educational status.
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Affiliation(s)
- Annika K. Gunderson
- Department of Epidemiology, Gilling School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Cristina Recalde-Coronel
- Department of Earth and Planetary Sciences, Johns Hopkins University, Baltimore, MD, USA
- Facultad de Ingeniería Marítima y Ciencias del Mar, Escuela Superior Politécnica del Litoral, Guayaquil, Ecuador
| | - Benjamin F. Zaitchick
- Department of Earth and Planetary Sciences, Johns Hopkins University, Baltimore, MD, USA
| | - Pablo Peñataro Yori
- Asociación Benéfica Prisma, Iquitos, Peru
- Division of Infectious Diseases, University of Virginia, Charlottesville, Virginia, USA
| | | | | | - Margaret Kosek
- Asociación Benéfica Prisma, Iquitos, Peru
- Division of Infectious Diseases, University of Virginia, Charlottesville, Virginia, USA
| | - Joseph M. Vinetz
- Section of Infectious Diseases, Department of Internal Medicine, School of Medicine, Yale University, New Haven, USA
- International Centers of Excellence for Malaria Research – Amazonia, Laboratorio de Investigación y Desarrollo, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru
- Laboratorios de Investigación y Desarrollo, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru
- VA Connecticut Healthcare System, West Haven, CT, USA
- Institute of Tropical Medicine Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - William K. Pan
- Duke Global Health Institute, Duke University, Durham, NC, USA
- Nicholas School of the Environment, Duke University, Durham, NC, USA
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Fonseca F, Martinez JM, Balieiro A, Orellana J, Santos JD, Filizola N. Relationship between the colours of the rivers in the Amazon and the incidence of malaria. Malar J 2023; 22:358. [PMID: 37996920 PMCID: PMC10668518 DOI: 10.1186/s12936-023-04789-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 11/13/2023] [Indexed: 11/25/2023] Open
Abstract
BACKGROUND Malaria is transmitted by different Anopheles species. In Brazil, the disease is concentrated in the Amazon region. Rivers play an important role in the life cycle of malaria since the vector reproduces in aquatic environments. The waters of the rivers in the Amazon have distinct chemical characteristics, which affect the colour of the water and therefore, the study analysed whether the colour of the waters of the rivers have an on influence the distribution of malaria. The goal of the study was to correlate the different colourations of the water (black, white and mixed water) and the malaria incidence in 50 municipalities of the Amazonas state, Brazil, and then test hypotheses about the characteristics of the colour of the rivers and disease incidence. METHODS This study was conducted for a period of seventeen years (2003-2019) in 50 municipalities in the state of Amazonas, Brazil. A conditionally Gaussian dynamic linear model was developed to analyse the association of malaria incidence and three types of river colour: white, black and mixed. RESULTS The analyses indicate that the distribution of malaria is related to the colouration of the rivers. The results showed that places located near black-water rivers have a higher malaria incidence when compared to places on the banks of white-water rivers. CONCLUSIONS Historically, the hydrological regime has played an important role in the dynamics of malaria in the Amazon, but little is known about the relationship between river colours and the incidence of the disease. This research was carried out in a region with hydrographic characteristics that were heterogeneous enough to allow an analysis that contrasted different colours of the rivers and covered almost the whole of the state of Amazonas. The results help to identify the places with the highest risk of malaria transmission and it is believed that they will be able to contribute to more precise planning of actions aimed at controlling the disease in the region.
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Affiliation(s)
- Fernanda Fonseca
- Instituto Leônidas e Maria Deane, Fiocruz Amazônia, Manaus, Amazonas, Brasil.
- Pós-Graduação em Clima e Ambiente-CLIAMB (INPA/UEA), Manaus, Amazonas, Brasil.
| | | | - Antônio Balieiro
- Instituto Leônidas e Maria Deane, Fiocruz Amazônia, Manaus, Amazonas, Brasil
| | - Jesem Orellana
- Instituto Leônidas e Maria Deane, Fiocruz Amazônia, Manaus, Amazonas, Brasil
| | - James D Santos
- Universidade Federal do Amazonas, Manaus, Amazonas, Brasil
| | - Naziano Filizola
- Pós-Graduação em Clima e Ambiente-CLIAMB (INPA/UEA), Manaus, Amazonas, Brasil
- Universidade Federal do Amazonas, Manaus, Amazonas, Brasil
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Hydrological Scenarios and Malaria Incidence in the Amazonian Context. WATER 2022. [DOI: 10.3390/w14081283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In Brazil, approximately 99% of malaria cases are concentrated in the Amazon region. An acute febrile infectious disease, malaria is closely related to climatic and hydrological factors. Environmental variables such as rainfall, flow, level, and color of rivers, the latter associated with the suspended sediment concentration, are important factors that can affect the dynamics of the incidence of some infectious diseases, including malaria. This study explores the possibility that malaria incidence is influenced by precipitation, fluctuations in river levels, and suspended sediment concentration. The four studied municipalities are located in two Brazilian states (Amazonas and Pará) on the banks of rivers with different hydrological characteristics. The results suggest that precipitation and river level fluctuations modulate the seasonal pattern of the disease and evidence the existence of delayed effects of river floods on malaria incidence. The seasonality of the disease has a different influence in each municipality studied. However, municipalities close to rivers with the same characteristic color of waters (as a function of the concentration of suspended sediments) have similar responses to the disease.
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Impact of El Niño on the dynamics of American cutaneous leishmaniasis in a municipality in the western Amazon. Acta Trop 2021; 222:106032. [PMID: 34245685 DOI: 10.1016/j.actatropica.2021.106032] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 05/26/2021] [Accepted: 06/25/2021] [Indexed: 11/23/2022]
Abstract
Vector-borne diseases are some of the leading public health problems in the tropics, and their association with climatic anomalies is well known. The current study aimed to evaluate the trend of American cutaneous leishmaniasis cases in the municipality of Manaus, Amazonas-Brazil, and its relationship with climatic extremes (ENSO). The study was carried out using a series of secondary data from notifications on the occurrence of several American cutaneous leishmaniasis cases in the municipality of Manaus between 1990 and 2017 obtained through the Sistema de Informação de Agravos de Notificação. Data regarding temperature, relative humidity, and precipitation for this municipality were derived from the Instituto Nacional de Meteorologia (INMET) and the National Oceanic and Atmospheric Administration (NOAA) websites. Coherence and wavelet phase analysis was conducted to measure the degree of relationship of the occurrence of the cases of cutaneous leishmaniasis and the El Niño-Southern Oscillation (ENSO). The results show that during La Niña events, an increase in American cutaneous leishmaniasis (ACL) cases is anticipated after the increase in rainfall from November, resulting in a more significant number of cases in January, February, and March. It was observed that in the municipality of Manaus, the dynamics of ACL cases are directly influenced by ENSO events that affect environmental variables such as precipitation, temperature, and humidity. Therefore, climatic variations consequently change the ACL incidence dynamics, leading to subsequent increases or decreases in the incidence of ACL cases in the area.
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Seasonality modulates the direct and indirect influences of forest cover on larval anopheline assemblages in western Amazônia. Sci Rep 2021; 11:12721. [PMID: 34135444 PMCID: PMC8208974 DOI: 10.1038/s41598-021-92217-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 06/07/2021] [Indexed: 11/15/2022] Open
Abstract
Serious concerns have arisen regarding urbanization processes in western Amazônia, which result in the creation of artificial habitats, promoting the colonization of malaria vectors. We used structural equation modelling to investigate direct and indirect effects of forest cover on larval habitats and anopheline assemblages in different seasons. We found 3474 larvae in the dry season and 6603 in the rainy season, totalling ten species and confirming the presence of malaria vectors across all sites. Forest cover had direct and indirect (through limnological variables) effects on the composition of larval anopheline assemblages in the rainy season. However, during the dry season, forest cover directly affected larval distribution and habitat variables (with no indirect affects). Additionally, artificial larval habitats promote ideal conditions for malaria vectors in Amazonia, mainly during the rainy season, with positive consequences for anopheline assemblages. Therefore, the application of integrated management can be carried out during both seasons. However, we suggest that the dry season is the optimal time because larval habitats are more limited, smaller in volume and more accessible for applying vector control techniques.
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Malaria Transmission and Spillover across the Peru-Ecuador Border: A Spatiotemporal Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17207434. [PMID: 33066022 PMCID: PMC7600436 DOI: 10.3390/ijerph17207434] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 10/04/2020] [Accepted: 10/06/2020] [Indexed: 11/24/2022]
Abstract
Border regions have been implicated as important hot spots of malaria transmission, particularly in Latin America, where free movement rights mean that residents can cross borders using just a national ID. Additionally, rural livelihoods largely depend on short-term migrants traveling across borders via the Amazon’s river networks to work in extractive industries, such as logging. As a result, there is likely considerable spillover across country borders, particularly along the border between Peru and Ecuador. This border region exhibits a steep gradient of transmission intensity, with Peru having a much higher incidence of malaria than Ecuador. In this paper, we integrate 13 years of weekly malaria surveillance data collected at the district level in Peru and the canton level in Ecuador, and leverage hierarchical Bayesian spatiotemporal regression models to identify the degree to which malaria transmission in Ecuador is influenced by transmission in Peru. We find that increased case incidence in Peruvian districts that border the Ecuadorian Amazon is associated with increased incidence in Ecuador. Our results highlight the importance of coordinated malaria control across borders.
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