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de Aguiar-Barros J, Granja F, de Abreu-Fernandes R, de Queiroz LT, da Silva e Silva D, Citó AC, Mocelin NKADO, Daniel-Ribeiro CT, Ferreira-da-Cruz MDF. Molecular Surveillance of Artemisinin-Resistant Plasmodium falciparum Parasites in Mining Areas of the Roraima Indigenous Territory in Brazil. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:679. [PMID: 38928926 PMCID: PMC11203648 DOI: 10.3390/ijerph21060679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Revised: 05/15/2024] [Accepted: 05/23/2024] [Indexed: 06/28/2024]
Abstract
Multidrug- and artemisinin-resistant (ART-R) Plasmodium falciparum (Pf) parasites represent a challenge for malaria elimination worldwide. Molecular monitoring in the Kelch domain region (pfk13) gene allows tracking mutations in parasite resistance to artemisinin. The increase in illegal miners in the Roraima Yanomami indigenous land (YIL) could favor ART-R parasites. Thus, this study aimed to investigate ART-R in patients from illegal gold mining areas in the YIL of Roraima, Brazil. A questionnaire was conducted, and blood was collected from 48 patients diagnosed with P. falciparum or mixed malaria (Pf + P. vivax). The DNA was extracted and the pfk13 gene was amplified by PCR. The amplicons were subjected to DNA-Sanger-sequencing and the entire amplified fragment was analyzed. Among the patients, 96% (46) were from illegal mining areas of the YIL. All parasite samples carried the wild-type genotypes/ART-sensitive phenotypes. These data reinforce the continued use of artemisinin-based combination therapies (ACTs) in Roraima, as well as the maintenance of systematic monitoring for early detection of parasite populations resistant to ART, mainly in regions with an intense flow of individuals from mining areas, such as the YIL. This is especially true when the achievement of falciparum malaria elimination in Brazil is planned and expected by 2030.
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Affiliation(s)
- Jacqueline de Aguiar-Barros
- Malaria Control Center, Epidemiological Surveillance Department, General Health Surveillance Coordination, SESAU-RR, Roraima 69305-080, Brazil;
- Postgraduate Program in Biodiversity and Biotechnology–BIONORTE Network/Roraima Federal University (UFRR), Roraima 69310-000, Brazil;
| | - Fabiana Granja
- Postgraduate Program in Biodiversity and Biotechnology–BIONORTE Network/Roraima Federal University (UFRR), Roraima 69310-000, Brazil;
- Biodiversity Research Centre, Roraima Federal University (UFRR), Roraima 69304-000, Brazil;
- Graduate Program in Natural Resources, Federal University of Roraima (UFRR), Roraima 69304-000, Brazil
| | - Rebecca de Abreu-Fernandes
- Laboratório de Pesquisa em Malária, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro 21040-360, Brazil; (R.d.A.-F.); (L.T.d.Q.); (N.K.A.-d.-O.M.); (C.T.D.-R.)
- Centro de Pesquisa, Diagnóstico e Treinamento em Malária (CPD-Mal)/Reference Center for Malaria in the Extra-Amazon Region of the Brazilian Ministry of Health, Fiocruz, Rio de Janeiro 21040-900, Brazil
| | - Lucas Tavares de Queiroz
- Laboratório de Pesquisa em Malária, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro 21040-360, Brazil; (R.d.A.-F.); (L.T.d.Q.); (N.K.A.-d.-O.M.); (C.T.D.-R.)
- Centro de Pesquisa, Diagnóstico e Treinamento em Malária (CPD-Mal)/Reference Center for Malaria in the Extra-Amazon Region of the Brazilian Ministry of Health, Fiocruz, Rio de Janeiro 21040-900, Brazil
| | | | - Arthur Camurça Citó
- Research Support Center in Roraima (NAPRR) of the National Institute for Amazonian Research (INPA), Roraima 69301-150, Brazil;
| | - Natália Ketrin Almeida-de-Oliveira Mocelin
- Laboratório de Pesquisa em Malária, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro 21040-360, Brazil; (R.d.A.-F.); (L.T.d.Q.); (N.K.A.-d.-O.M.); (C.T.D.-R.)
- Centro de Pesquisa, Diagnóstico e Treinamento em Malária (CPD-Mal)/Reference Center for Malaria in the Extra-Amazon Region of the Brazilian Ministry of Health, Fiocruz, Rio de Janeiro 21040-900, Brazil
| | - Cláudio Tadeu Daniel-Ribeiro
- Laboratório de Pesquisa em Malária, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro 21040-360, Brazil; (R.d.A.-F.); (L.T.d.Q.); (N.K.A.-d.-O.M.); (C.T.D.-R.)
- Centro de Pesquisa, Diagnóstico e Treinamento em Malária (CPD-Mal)/Reference Center for Malaria in the Extra-Amazon Region of the Brazilian Ministry of Health, Fiocruz, Rio de Janeiro 21040-900, Brazil
| | - Maria de Fátima Ferreira-da-Cruz
- Laboratório de Pesquisa em Malária, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro 21040-360, Brazil; (R.d.A.-F.); (L.T.d.Q.); (N.K.A.-d.-O.M.); (C.T.D.-R.)
- Centro de Pesquisa, Diagnóstico e Treinamento em Malária (CPD-Mal)/Reference Center for Malaria in the Extra-Amazon Region of the Brazilian Ministry of Health, Fiocruz, Rio de Janeiro 21040-900, Brazil
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Sandoval-Bances J, Saavedra-Samillán M, Huyhua-Gutiérrez S, Rojas LM, Tejada-Muñoz S, Tapia-Limonchi R, Chenet SM. Molecular characterization of the Plasmodium falciparum k13 gene helix domain in samples from native communities of Condorcanqui, Amazonas, Perú. BIOMEDICA : REVISTA DEL INSTITUTO NACIONAL DE SALUD 2023; 43:352-359. [PMID: 37871569 PMCID: PMC10624420 DOI: 10.7705/biomedica.6849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 07/27/2023] [Indexed: 10/25/2023]
Abstract
Introduction. Resistance of Plasmodium falciparum to different antimalarial drugs is an obstacle to disease elimination. The artemisinin-resistant genotype of P. falciparum can be assessed by examining polymorphisms in the helix domain of the Pfk13 gene. The World Health Organization recommends these mutations as molecular markers to detect artemisinin-resistant in countries where P. falciparum malaria is endemic. Objective. To identify artemisinin resistance-related mutations present in the helix domain of the P. falciparum k13 gene. Materials and methods. We collected a total of 51 samples through passive case detection, positive for Plasmodium by microscopy, from six communities in the district of Río Santiago in Condorcanqui, Amazonas. Molecular species confirmation was performed by real-time PCR and Pfk13 helix domain was amplified and sequenced by capillary electrophoresis. The obtained sequences were compared with the wild type 3D7 reference strain. Results. A total of 51 positive samples were confirmed for P. falciparum from the communities of Ayambis, Chapiza, Palometa, Muchinguis, Alianza Progreso and Caterpiza. DNA sequences alignment showed the absence of resistance-associated mutations in the k13 gene of the collected samples. Discussion. The obtained results are consistent with similar studies conducted in other South American countries, including Perú, so these data provide a baseline for artemisinin-resistance molecular surveillance in the Amazon region and reinforce the efficacy of artemisinin-based combination therapy in this area.
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Affiliation(s)
- Julio Sandoval-Bances
- nstituto de Enfermedades Tropicales, Universidad Nacional Toribio Rodríguez de Mendoza de Amazonas, Triunfo, Chachapoyas, Perú.
| | - Milagros Saavedra-Samillán
- nstituto de Enfermedades Tropicales, Universidad Nacional Toribio Rodríguez de Mendoza de Amazonas, Triunfo, Chachapoyas, Perú.
| | - Sonia Huyhua-Gutiérrez
- Instituto de Enfermedades Tropicales, Universidad Nacional Toribio Rodríguez de Mendoza de Amazonas, Triunfo, Chachapoyas, Perú; Facultad de Ciencias de la Salud, Universidad Nacional Toribio Rodríguez de Mendoza de Amazonas, Triunfo, Chachapoyas, Perú.
| | - Luis M Rojas
- Dirección Regional de Salud de Amazonas, Chachapoyas, Perú.
| | - Sonia Tejada-Muñoz
- Instituto de Enfermedades Tropicales, Universidad Nacional Toribio Rodríguez de Mendoza de Amazonas, Triunfo, Chachapoyas, Perú 2 Facultad de Ciencias de la Salud, Universidad Nacional Toribio Rodríguez de Mendoza de Amazonas, Triunfo, Chachapoyas, Perú.
| | - Rafael Tapia-Limonchi
- Instituto de Enfermedades Tropicales, Universidad Nacional Toribio Rodríguez de Mendoza de Amazonas, Triunfo, Chachapoyas, Perú; Instituto de Investigaciones en Ciencias Biomédicas, Universidad Ricardo Palma, Lima, Perú.
| | - Stella M Chenet
- Instituto de Enfermedades Tropicales, Universidad Nacional Toribio Rodríguez de Mendoza de Amazonas, Triunfo, Chachapoyas, Perú; Instituto de Investigaciones en Ciencias Biomédicas, Universidad Ricardo Palma, Lima, Perú.
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Mathieu LC, Singh P, Monteiro WM, Magris M, Cox H, Lazrek Y, Melo GC, Marchesini P, Alexandre JSF, Alvarez AM, Demar M, Douine M, Ade MP, Lacerda MVG, Musset L. Kelch13 mutations in Plasmodium falciparum and risk of spreading in Amazon basin countries. J Antimicrob Chemother 2021; 76:2854-2862. [PMID: 34379746 PMCID: PMC8521405 DOI: 10.1093/jac/dkab264] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 06/28/2021] [Indexed: 11/30/2022] Open
Abstract
Background The first potential focus for artemisinin resistance in South America was recently confirmed with the presence of the C580Y mutation in the Plasmodium falciparum kelch 13 gene (pfk13) in Guyana. Objectives This study aimed to strengthen pfk13 monitoring in the Amazon basin countries, to compile the available data and to evaluate the risk of spreading of mutations. Methods Sanger sequencing was done on 862 samples collected between 1998 and 2019, and a global map of pfk13 genotypes available for this region was constructed. Then, the risk of spreading of mutations based on P. falciparum case importation between 2015 and 2018 within countries of the Amazon basin was evaluated. Results No additional pfk13 C580Y foci were identified. Few mutations (0.5%, 95% CI = 0.3%–0.8%) in the propeller domain were observed in the general parasite population of this region despite a high proportion of K189T mutations (49.1%, 95% CI = 46.2%–52.0%) in the non-propeller domain. Case information revealed two patterns of intense human migration: Venezuela, Guyana and the Roraima State in Brazil; and French Guiana, Suriname and the Amapá State in Brazil. Conclusions There are few pfk13 mutant foci, but a high risk of dispersion in the Amazon basin, mainly from the Guiana Shield, proportionate to mining activities. Therefore, access to prompt diagnosis and treatment, and continuous molecular monitoring is essential in these geographical areas.
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Affiliation(s)
- Luana C Mathieu
- Laboratoire de parasitologie, Centre Nationale de Référence du Paludisme, World Health Organization Collaborating Center for surveillance of antimalarial drug resistance, Institut Pasteur de la Guyane, 97306 Cayenne, French Guiana.,Ecole Doctorale n°587 « Diversités, Santé, et Développement en Amazonie », Université de Guyane, 97300 Cayenne, French Guiana
| | - Prabhjot Singh
- Department of Communicable Diseases and Environmental Determinants of Health, Pan American Health Organization/World Health Organization, Washington, DC 20037, USA
| | - Wuelton Marcelo Monteiro
- Diretoria de Ensino e Pesquisa, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, 69040-200 Manaus, Amazonas, Brazil.,Escola de Ciências da Saúde, Universidade do Estado do Amazonas, 69050-010 Manaus, Amazonas, Brazil
| | - Magda Magris
- Amazonic Center for Research and Control of Tropical Diseases "Simón Bolívar", 7101, Puerto Ayacucho, Amazonas State, Venezuela
| | - Horace Cox
- National Malaria Program, Ministry of Public Health, 0592 Georgetown, Guyana
| | - Yassamine Lazrek
- Laboratoire de parasitologie, Centre Nationale de Référence du Paludisme, World Health Organization Collaborating Center for surveillance of antimalarial drug resistance, Institut Pasteur de la Guyane, 97306 Cayenne, French Guiana
| | - Gisely C Melo
- Diretoria de Ensino e Pesquisa, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, 69040-200 Manaus, Amazonas, Brazil.,Escola de Ciências da Saúde, Universidade do Estado do Amazonas, 69050-010 Manaus, Amazonas, Brazil
| | - Paola Marchesini
- Malaria Technical Group, Vector Transmissible and Zoonotic Diseases Coordination, Ministry of Health, 70058-900 Brasilia, Brazil
| | | | | | - Magalie Demar
- Service de Maladies Infectieuses et Tropicales, Centre Hospitalier Andrée Rosemon, 97300 Cayenne, French Guiana.,Ecosystèmes Amazoniens et Pathologie Tropicale (EPAT), EA3593, Université de Guyane, 97300 Cayenne, French Guiana
| | - Maylis Douine
- Ecosystèmes Amazoniens et Pathologie Tropicale (EPAT), EA3593, Université de Guyane, 97300 Cayenne, French Guiana.,Centre d'Investigation Clinique Antilles-Guyane (Inserm 1424), Hôpital de Cayenne, 97300 Cayenne, French Guiana
| | - Maria-Paz Ade
- Department of Communicable Diseases and Environmental Determinants of Health, Pan American Health Organization/World Health Organization, Washington, DC 20037, USA
| | - Marcus V G Lacerda
- Diretoria de Ensino e Pesquisa, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, 69040-200 Manaus, Amazonas, Brazil.,Instituto Leônidas & Maria Deane, Fiocruz, 69057-070 Manaus, Brazil
| | - Lise Musset
- Laboratoire de parasitologie, Centre Nationale de Référence du Paludisme, World Health Organization Collaborating Center for surveillance of antimalarial drug resistance, Institut Pasteur de la Guyane, 97306 Cayenne, French Guiana
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Lucchi NW, Abdallah R, Louzada J, Udhayakumar V, Oliveira-Ferreira J. Molecular Surveillance for Polymorphisms Associated with Artemisinin-Based Combination Therapy Resistance in Plasmodium falciparum Isolates Collected in the State of Roraima, Brazil. Am J Trop Med Hyg 2020; 102:310-312. [PMID: 31833470 DOI: 10.4269/ajtmh.19-0749] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Given that the C580Y polymorphism in the Plasmodium falciparum propeller domain of the kelch 13 gene (pfk13) was documented in Guyana, monitoring for mutations associated with antimalarial resistance was undertaken in neighboring Roraima state in Brazil. Polymorphisms in the pfmdr1 and pfk13 genes were investigated in 275 P. falciparum samples. No pfk13 mutations were observed. Triple mutants 184F, 1042D, and 1246Y were observed in 100% of the samples successfully sequenced for the pfmdr1 gene, with 20.1% of these having an additional mutation at codon 1034C. Among them, 2.5% of samples harbored two copies of the pfmdr1 gene. We found no evidence of the spread of C580Y parasites to Roraima state, Brazil. As previously observed, the 184F, 1042D, and 1246Y mutations in the pfmdr1 gene appear to be fixed in this region. Continued molecular surveillance is essential to detect any potential migration or local emergence of artemisinin-resistant mutation.
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Affiliation(s)
- Naomi W Lucchi
- Malaria Branch and Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Rispah Abdallah
- Malaria Branch and Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Venkatachalam Udhayakumar
- Malaria Branch and Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Joseli Oliveira-Ferreira
- Federal University of Roraima, Roraima, Brazil.,Institute Oswaldo Cruz-Fiocruz, Rio De Janeiro, Brazil
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Rosenthal PJ. Artemisinin Resistance Outside of Southeast Asia. Am J Trop Med Hyg 2018; 99:1357-1359. [PMID: 30426924 PMCID: PMC6283499 DOI: 10.4269/ajtmh.18-0845] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 10/24/2018] [Indexed: 11/27/2022] Open
Affiliation(s)
- Philip J. Rosenthal
- Department of Medicine, University of California, San Francisco, San Francisco, California
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