1
|
Kouna LC, Oyegue-Liabagui SL, Voumbo-Matoumona DF, Lekana-Douki JB. Malaria Prevalence in Asymptomatic and Symptomatic Children Living in Rural, Semi-Urban and Urban Areas in Eastern Gabon. Acta Parasitol 2024; 69:471-482. [PMID: 38194048 PMCID: PMC11001662 DOI: 10.1007/s11686-023-00783-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 12/12/2023] [Indexed: 01/10/2024]
Abstract
BACKGROUND Malaria remains a major public health issue in the world despite a decline in the disease burden. However, though symptomatic malaria is diagnosed and treated, asymptomatic infections remain poorly known and support transmission. This study assessed the prevalence of symptomatic and asymptomatic Plasmodium spp. infections in three areas in Gabon to monitor and evaluate the impact of malaria. METHODS AND RESULTS A cross-sectional study was conducted in three areas of Gabon. Febrile and afebrile children aged 6 months to 15 years were included in this study. Malaria prevalence was determined by microscopy of and using rapid diagnostic test (RDT). Plasmodium spp. species were identified by PCR according to the Snounou method. The data were recorded in Excel, and the statistical analyses were performed using the software R version R 64 × 3.5.0. A total of 2381(333 asymptomatic and 107 symptomatic) children were included. The overall prevalence of malaria was 40% (952/2381), with the majority (77% symptomatic and 98% asymptomatic) of infections caused by Plasmodium falciparum. A high prevalence of malaria was found in infected children in rural and semi-rural areas. In these two areas, a higher prevalence of Plasmodium malariae was observed in asymptomatic. Furthermore, mixed infections were more prevalent in asymptomatic children than in symptomatic. CONCLUSION This study showed that the prevalence of Plasmodium spp. infection varied according to the regions. The main species was Plasmodium falciparum, but in asymptomatic children the prevalence of Plasmodium malariae was high in rural areas. To help fight malaria more effectively asymptomatic infections should be taken into account and treated.
Collapse
Affiliation(s)
- Lady Charlène Kouna
- Unité d'Evolution, Epidémiologie et Résistances Parasitaires(UNEEREP), Centre international de Recherche Médicales de Franceville, Franceville, Gabon
| | - Sandrine Lydie Oyegue-Liabagui
- Unité d'Evolution, Epidémiologie et Résistances Parasitaires(UNEEREP), Centre international de Recherche Médicales de Franceville, Franceville, Gabon
- Ecole Doctorale Régionale d'Afrique Centrale en Infectiologie Tropicale, Franceville, Gabon
- Département de Biologie, Faculté des Sciences, Université des Sciences et Techniques de Masuku, Franceville, Gabon
| | - Dominique Fatima Voumbo-Matoumona
- Département Masters/Licences, parcours types des sciences Biologiques, faculté des sciences et Techniques, Université Marien Ngouabi, Brazzaville, Congo
| | - Jean Bernard Lekana-Douki
- Unité d'Evolution, Epidémiologie et Résistances Parasitaires(UNEEREP), Centre international de Recherche Médicales de Franceville, Franceville, Gabon.
- Ecole Doctorale Régionale d'Afrique Centrale en Infectiologie Tropicale, Franceville, Gabon.
- Département de Parasitologie Mycologie et de Médecine Tropicale, Université des Science de la Santé, Libreville, Gabon.
| |
Collapse
|
2
|
Guémas E, Coppée R, Ménard S, du Manoir M, Nsango S, Makaba Mvumbi D, Nakoune E, Eboumbou Moukoko CE, Bouyou Akotet MK, Mirabeau TY, Manguin S, Malekita Yobi D, Akiana J, Kouna LC, Mawili Mboumba DP, Voumbo-Matoumona DF, Otam AL, Rubbo PA, Lombart JP, Kwanai E, Cohen O, Iriart X, Ayong L, Lekana-Douki JB, Ariey F, Berry A. Evolution and spread of Plasmodium falciparum mutations associated with resistance to sulfadoxine-pyrimethamine in central Africa: a cross-sectional study. Lancet Microbe 2023; 4:e983-e993. [PMID: 37865113 DOI: 10.1016/s2666-5247(23)00211-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 06/26/2023] [Accepted: 06/28/2023] [Indexed: 10/23/2023]
Abstract
BACKGROUND Efficacy of sulfadoxine-pyrimethamine, the malaria chemoprophylaxis used in pregnant women, and in children when combined with amodiaquine, is threatened by the accumulation of mutations in the Plasmodium falciparum dihydropteroate synthase (pfdhps) and dihydrofolate reductase (pfdhfr) genes. Data on the prevalence of resistant alleles in central Africa and the new pfdhps I431V mutation, particularly associated with other mutations to form the pfdhps vagKgs allele, are scarce. We explored the frequency and geographical distribution of pfdhps and pfdhfr mutations in central Africa in 2014-18, and assessed the evolutionary origin of the vagKgs allele. METHODS Samples were collected at 18 health-care centres in seven countries (Angola, Cameroon, Central African Republic, Democratic Republic of the Congo, Gabon, Nigeria, and Republic of the Congo) from patients who showed possible symptoms of malaria between March 1, 2014, and Oct 31, 2018. Samples that were positive for P falciparum were transported to a laboratory in Toulouse, France, and genotyped. The frequency of pfdhfr and pfdhps mutations was studied in 1749 samples. Microsatellites in pfdhps flanking regions and whole-genome analysis compared with parasite genomes from the data-sharing network MalariaGEN were performed on samples carrying the vagKgs allele. FINDINGS Mapping of the prevalence of single nucleotide polymorphisms and corresponding alleles of pfdhfr and pfdhps showed a substantial spread of alleles associated with sulfadoxine-pyrimethamine resistance in central Africa during the 2014-18 period, especially an increase going west to east in pfdhps alleles carrying the K540E and A581G mutations. A high prevalence of the pfdhps I431V mutation was observed in Cameroon (exceeding 50% in the northern region) and Nigeria. Genomic analysis showed a recent African emergence and a clonal expansion of the most frequent pfdhps vagKgs allele. INTERPRETATION Reduced sulfadoxine-pyrimethamine efficacy due to increased resistance is a worrying situation, especially because the malaria transmission level is high in central Africa. Although the resistance phenotype remains to be confirmed, the emergence and spread of the vagKgs allele in west and central Africa could challenge the use of sulfadoxine-pyrimethamine. FUNDING Toulouse Institute for Infectious and Inflammatory Diseases.
Collapse
Affiliation(s)
- Emilie Guémas
- Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity), Université de Toulouse, CNRS UMR5051, INSERM UMR 1291, UPS, Toulouse, France; Département de Parasitologie et Mycologie, CHU Toulouse, Toulouse, France; LAAS-CNRS, Université de Toulouse, CNRS, UPS, Toulouse, France
| | - Romain Coppée
- Université Paris Cité and Sorbonne Paris Nord, INSERM, IAME, Paris, France
| | - Sandie Ménard
- Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity), Université de Toulouse, CNRS UMR5051, INSERM UMR 1291, UPS, Toulouse, France
| | - Milena du Manoir
- Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity), Université de Toulouse, CNRS UMR5051, INSERM UMR 1291, UPS, Toulouse, France
| | - Sandrine Nsango
- Faculté de Médecine et des Sciences Pharmaceutiques, Université de Douala, Douala, Cameroon; Malaria Research Unit, Centre Pasteur du Cameroun, Yaoundé, Cameroon
| | - Dieudonné Makaba Mvumbi
- Department of Basic Sciences, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of the Congo; Institute for Medical Immunology, Université Libre de Bruxelles, Brussells, Belgium
| | | | - Carole Else Eboumbou Moukoko
- Faculté de Médecine et des Sciences Pharmaceutiques, Université de Douala, Douala, Cameroon; Malaria Research Unit, Centre Pasteur du Cameroun, Yaoundé, Cameroon
| | - Marielle Karine Bouyou Akotet
- Département de Parasitologie Mycologie Médecine Tropicale, Faculté de Médecine de l'Université des Sciences de la Santé, Libreville, Gabon; Centre de Recherche Biomédicale en Pathogènes Infectieux et Pathologies Associées, CREIPA, Université des Sciences de la Santé, Libreville, Gabon
| | - Tatfeng Youtchou Mirabeau
- Department of Medical Laboratory Science, Faculty of Basic Medical Sciences, College of Health Sciences, Niger Delta University, Wilberforce Island, Nigeria
| | - Sylvie Manguin
- Hydro Sciences Montpellier, Université de Montpellier, CNRS, IRD, Montpellier, France
| | - Doudou Malekita Yobi
- Department of Basic Sciences, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Jean Akiana
- Laboratoire National de Santé Publique, Université Marien Ngouabi, Brazzaville, Republic of the Congo
| | - Lady Charlène Kouna
- Unité d'Evolution Epidémiologie et Résistances Parasitaires, Centre Interdisciplinaire de Recherches Médicales de Franceville, Franceville, Gabon; Département de Parasitologie-Mycologie, Université des Sciences de la Santé, Libreville, Gabon
| | - Denise Patricia Mawili Mboumba
- Département de Parasitologie Mycologie Médecine Tropicale, Faculté de Médecine de l'Université des Sciences de la Santé, Libreville, Gabon; Centre de Recherche Biomédicale en Pathogènes Infectieux et Pathologies Associées, CREIPA, Université des Sciences de la Santé, Libreville, Gabon
| | - Dominique Fatima Voumbo-Matoumona
- Laboratoire National de Santé Publique, Université Marien Ngouabi, Brazzaville, Republic of the Congo; Unité d'Evolution Epidémiologie et Résistances Parasitaires, Centre Interdisciplinaire de Recherches Médicales de Franceville, Franceville, Gabon; Département de Parasitologie-Mycologie, Université des Sciences de la Santé, Libreville, Gabon
| | - Alliance-Laure Otam
- Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity), Université de Toulouse, CNRS UMR5051, INSERM UMR 1291, UPS, Toulouse, France
| | | | | | - Elisabeth Kwanai
- Coordination diocésaine de la Santé, Diocèse de Maroua-Mokolo, Maroua, Cameroon
| | - Olivia Cohen
- Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity), Université de Toulouse, CNRS UMR5051, INSERM UMR 1291, UPS, Toulouse, France
| | - Xavier Iriart
- Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity), Université de Toulouse, CNRS UMR5051, INSERM UMR 1291, UPS, Toulouse, France; Département de Parasitologie et Mycologie, CHU Toulouse, Toulouse, France
| | - Lawrence Ayong
- Malaria Research Unit, Centre Pasteur du Cameroun, Yaoundé, Cameroon
| | - Jean Bernard Lekana-Douki
- Unité d'Evolution Epidémiologie et Résistances Parasitaires, Centre Interdisciplinaire de Recherches Médicales de Franceville, Franceville, Gabon; Département de Parasitologie-Mycologie, Université des Sciences de la Santé, Libreville, Gabon
| | - Frédéric Ariey
- INSERM U1016, Institut Cochin, Laboratoire de Parasitologie-Mycologie, Hôpital Cochin, AP-HP, Université Paris Cité, Paris, France
| | - Antoine Berry
- Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity), Université de Toulouse, CNRS UMR5051, INSERM UMR 1291, UPS, Toulouse, France; Département de Parasitologie et Mycologie, CHU Toulouse, Toulouse, France.
| |
Collapse
|
3
|
Imboumy-Limoukou RK, Biteghe-Bi-Essone JC, Lendongo Wombo JB, Lekana-Douki SE, Rougeron V, Ontoua SS, Oyegue-Liabagui LS, Mbani Mpega Ntigui CN, Kouna LC, Lekana-Douki JB. Detection of Plasmodium falciparum in Saliva and Stool Samples from Children Living in Franceville, a Highly Endemic Region of Gabon. Diagnostics (Basel) 2023; 13:3271. [PMID: 37892092 PMCID: PMC10606300 DOI: 10.3390/diagnostics13203271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 09/04/2023] [Accepted: 09/14/2023] [Indexed: 10/29/2023] Open
Abstract
Due to the difficulty of obtaining blood samples, which is the invasive method that is currently used for the detection of Plasmodium spp., alternative diagnostic sampling methods that are effective and non-invasive are needed, particularly for long-term studies. Saliva and stool samples from malaria-infected individuals contain trace amounts of Plasmodium DNA and therefore could be used as alternatives. Malaria was screened using rapid diagnosis tests and confirmed via microscopy. Nested PCR tests targeting the Plasmodium falciparum-specific STEVOR gene were performed for blood, saliva and stool samples that were positive for malaria. Three hundred sixty-seven (367) children were enrolled and eighty (22.22%) were confirmed to be positive for malaria. Matched blood, saliva and stool samples were available for 35 children. By using blood smears as the gold standard for the diagnosis of malaria, our study indicates that Plasmodium DNA was more detectable in blood (100%) than in saliva (22.86%) and stools (14.29%). Applying qPCR to the STEVOR gene to detect Plasmodium falciparum DNA in saliva and stool samples cannot be considered as an alternative to the current malaria detection processes using blood specimens.
Collapse
Affiliation(s)
- Roméo Karl Imboumy-Limoukou
- Unité Evolution Epidémiologie et Résistance Parasitaire (UNEEREP), Centre International de Recherches Médicales de Franceville (CIRMF), Franceville BP 769, Gabon; (J.-C.B.-B.-E.); (J.B.L.W.); (S.-S.O.); (L.S.O.-L.); (C.N.M.M.N.); (L.C.K.); (J.-B.L.-D.)
| | - Jean-Claude Biteghe-Bi-Essone
- Unité Evolution Epidémiologie et Résistance Parasitaire (UNEEREP), Centre International de Recherches Médicales de Franceville (CIRMF), Franceville BP 769, Gabon; (J.-C.B.-B.-E.); (J.B.L.W.); (S.-S.O.); (L.S.O.-L.); (C.N.M.M.N.); (L.C.K.); (J.-B.L.-D.)
| | - Judicael Boris Lendongo Wombo
- Unité Evolution Epidémiologie et Résistance Parasitaire (UNEEREP), Centre International de Recherches Médicales de Franceville (CIRMF), Franceville BP 769, Gabon; (J.-C.B.-B.-E.); (J.B.L.W.); (S.-S.O.); (L.S.O.-L.); (C.N.M.M.N.); (L.C.K.); (J.-B.L.-D.)
- Laboratoire de Biologie Moléculaire et Cellulaire (LABMC), Université des Sciences et Techniques de Masuku, Franceville BP 943, Gabon
| | - Sonia Etenna Lekana-Douki
- Unité des Maladies Virales Emergentes (UMVE), Centre International de Recherches Médicales de Franceville, Franceville BP 769, Gabon;
| | - Virginie Rougeron
- MIVEGEC, IRD, CNRS, University of Montpellier, 34900 Montpellier, France;
| | - Steede-Seinnat Ontoua
- Unité Evolution Epidémiologie et Résistance Parasitaire (UNEEREP), Centre International de Recherches Médicales de Franceville (CIRMF), Franceville BP 769, Gabon; (J.-C.B.-B.-E.); (J.B.L.W.); (S.-S.O.); (L.S.O.-L.); (C.N.M.M.N.); (L.C.K.); (J.-B.L.-D.)
- Ecole Doctoral Régional en Infectiologie Tropical, Franceville BP 876, Gabon
| | - Lydie Sandrine Oyegue-Liabagui
- Unité Evolution Epidémiologie et Résistance Parasitaire (UNEEREP), Centre International de Recherches Médicales de Franceville (CIRMF), Franceville BP 769, Gabon; (J.-C.B.-B.-E.); (J.B.L.W.); (S.-S.O.); (L.S.O.-L.); (C.N.M.M.N.); (L.C.K.); (J.-B.L.-D.)
- Ecole Doctoral Régional en Infectiologie Tropical, Franceville BP 876, Gabon
| | - Cherone Nancy Mbani Mpega Ntigui
- Unité Evolution Epidémiologie et Résistance Parasitaire (UNEEREP), Centre International de Recherches Médicales de Franceville (CIRMF), Franceville BP 769, Gabon; (J.-C.B.-B.-E.); (J.B.L.W.); (S.-S.O.); (L.S.O.-L.); (C.N.M.M.N.); (L.C.K.); (J.-B.L.-D.)
- Ecole Doctoral Régional en Infectiologie Tropical, Franceville BP 876, Gabon
| | - Lady Charlène Kouna
- Unité Evolution Epidémiologie et Résistance Parasitaire (UNEEREP), Centre International de Recherches Médicales de Franceville (CIRMF), Franceville BP 769, Gabon; (J.-C.B.-B.-E.); (J.B.L.W.); (S.-S.O.); (L.S.O.-L.); (C.N.M.M.N.); (L.C.K.); (J.-B.L.-D.)
| | - Jean-Bernard Lekana-Douki
- Unité Evolution Epidémiologie et Résistance Parasitaire (UNEEREP), Centre International de Recherches Médicales de Franceville (CIRMF), Franceville BP 769, Gabon; (J.-C.B.-B.-E.); (J.B.L.W.); (S.-S.O.); (L.S.O.-L.); (C.N.M.M.N.); (L.C.K.); (J.-B.L.-D.)
- Département de Parasitologie-Mycologie, Université des Sciences de la Santé, Libreville BP 4008, Gabon
| |
Collapse
|
4
|
Voumbo-Matoumona DF, Kouna LC, Madamet M, Maghendji-Nzondo S, Pradines B, Lekana-Douki JB. Prevalence of Plasmodium falciparum antimalarial drug resistance genes in Southeastern Gabon from 2011 to 2014. Infect Drug Resist 2018; 11:1329-1338. [PMID: 30214253 PMCID: PMC6118251 DOI: 10.2147/idr.s160164] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
PURPOSE The introduction of artemisinin-based combination therapies (ACTs) in treating uncomplicated malaria and sulfadoxine-pyrimethamine (SP) as intermittent preventive treatment during pregnancy drastically decreased the burden of malarial disease around the world. However, ACTs are known to select for drug resistance markers. In Gabon, artemether-lumefantrine induced an increase in the prevalence of N86-Pfmdr1, which is associated with treatment failure. However, little data are available regarding resistance markers in Southeastern Gabon. This study aimed to evaluate the evolution of resistance haplotypes in the Pfcrt, Pfdhps, Pfdhfr, and PfK13 genes from 2011 to 2014 in Southeastern Gabon. METHODS A total of 233 Plasmodium falciparum DNA samples were collected from febrile pediatric patients in South Gabon: Franceville, an urban area; Koulamoutou, a semi-urban area; and Lastourville, a rural area. Pfcrt, Pfdhps, Pfdhfr, and the propeller domain of PfK13 were sequenced for all isolates. RESULTS The overall prevalence (3.7%-11.5%) of the wild-type haplotype Pfcrt 72-76 CVMNK was not significantly different between 2011 and 2014 in Southeast Gabon. For Pfdhfr (codons 51, 59, 108, 164), the IRNI triple-mutant haplotype was the most prevalent (>89.0%). The ICNI and NCNI mutant haplotypes and the NCSI wild-type haplotype showed a minor prevalence. There were no differences in the distributions of these haplotypes across the 4 years and the three study sites. For Pfdhps, the AAKAA and SGKAA mutant haplotypes and the SAKAA wild-type haplotype were similarly present in the three areas during the study period. The AGKAA double mutant was first observed in 2013 in Franceville and in 2014 in Koulamoutou and Lastourville. Interestingly, only the A578S mutation (0.4%) and two new A494V (0.4%) and V504A (0.9%) mutations were found in PfK13. CONCLUSION Despite the withdrawal of chloroquine, the frequency of the resistant allele 76T remained high in the south of Gabon. Moreover, a high level of resistant haplotypes against IPTp-SP was found.
Collapse
Affiliation(s)
- Dominique Fatima Voumbo-Matoumona
- Unit of Evolution, Epidemiology and Parasitic Resistances (UNEEREP), International Medical Research Center of Franceville (CIRMF), Franceville, Gabon,
- Parasitology and Entomology Unit, Department of Infectious Diseases, Biomedical Research Institute of Army, Marseille, France
- Regional Doctoral School of Central Africa in Tropical Infectiology, Franceville, Gabon
| | - Lady Charlène Kouna
- Department of Parasitology, Mycology and Tropical Medicine, University of Health Sciences, Libreville, Gabon,
| | - Marylin Madamet
- Parasitology and Entomology Unit, Department of Infectious Diseases, Biomedical Research Institute of Army, Marseille, France
- Research Unit on Infectious and Tropical Emerging Diseases, Aix Marseille University, Marseille, France
- National Malaria Reference Center, Marseille, France
| | - Sydney Maghendji-Nzondo
- Department of Parasitology, Mycology and Tropical Medicine, University of Health Sciences, Libreville, Gabon,
| | - Bruno Pradines
- Parasitology and Entomology Unit, Department of Infectious Diseases, Biomedical Research Institute of Army, Marseille, France
- Research Unit on Infectious and Tropical Emerging Diseases, Aix Marseille University, Marseille, France
- National Malaria Reference Center, Marseille, France
| | - Jean Bernard Lekana-Douki
- Unit of Evolution, Epidemiology and Parasitic Resistances (UNEEREP), International Medical Research Center of Franceville (CIRMF), Franceville, Gabon,
- Department of Parasitology, Mycology and Tropical Medicine, University of Health Sciences, Libreville, Gabon,
| |
Collapse
|
5
|
Voumbo-Matoumona DF, Akiana J, Madamet M, Kouna LC, Lekana-Douki JB, Pradines B. High prevalence of Plasmodium falciparum antimalarial drug resistance markers in isolates from asymptomatic patients from the Republic of the Congo between 2010 and 2015. J Glob Antimicrob Resist 2018; 14:277-283. [PMID: 30121345 DOI: 10.1016/j.jgar.2018.08.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2018] [Revised: 08/01/2018] [Accepted: 08/02/2018] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES This study investigated the prevalence of haplotypes of the Pfdhps, Pfdhfr, Pfcrt, Pfmdr1 and PfK13 resistance markers in isolates from asymptomatic patients from the Republic of the Congo following implementation of artemisinin based-combination therapy (ACT). METHODS Peripheral blood was collected from asymptomatic children in 2010 and 2015 from Brazzaville in the south and in 2013 in the north of the Congo. Genotypes of Pfmdr1, Pfcrt, Pfdhps, Pfdhfr and PfK13 were assessed by PCR. RESULTS Children from 2010 were younger than those from 2015 (mean age 5.38 years vs. 8.67 years; P=0.003). The main Pfcrt haplotype was the wild-type CVMNK (84.85%) in 2010, whereas the mutant CVIET (61.64%) predominated in 2015 (P<0.001). In the north, 45.00% of samples were CVMNK and 10.00% were CVIET. Other samples harboured new haplotypes in the country or mixed alleles. No significant difference in Pfmdr1 haplotypes was observed in 2010 and 2015 and the main haplotypes were NYD and NFD (30.56% vs. 28.57% and 61.11% vs. 42.86% for 2010 and 2015, respectively). In the south, the Pfdhps haplotypes observed were AAKAA, AGKAA, SGKAA and SGEGA (87.50% vs. 0%, 12.50% vs. 33.33%, 0% vs. 33.33% and 0% vs. 33.33% for 2010 and 2015, respectively). For Pfdhfr, the IRNI haplotype was most prevalent (85.71% for 2010, 87.50% for 2013 and 100% for 2015). No PfK13 mutations were found. CONCLUSIONS Monitoring the efficacy of ACT and intermittent preventive treatment with sulfadoxine-pyrimethamine is necessary to ensure an epidemiological survey of asymptomatic malaria.
Collapse
Affiliation(s)
- Dominique Fatima Voumbo-Matoumona
- Unité d'Evolution, Epidémiologie et Résistances Parasitaires (UNEEREP), Centre International de Recherche Médicales de Franceville, BP 769 Franceville, Gabon; Unité Parasitologie et Entomologie, Département des Maladies Infectieuses, Institut de Recherche Biomédicale des Armées, Marseille, France; Ecole Doctorale Régionale d'Afrique Centrale en Infectiologie Tropicale, BP 876 Franceville, Gabon
| | - Jean Akiana
- Départements des Masters/Licences, Parcours-Types des Sciences Biologiques, Faculté des Sciences et Techniques, Université Marien Ngouabi, BP 69, Brazzaville, Congo; Direction de la Médecine Préventive et des Essais Cliniques, Laboratoire National de Santé Publique, BP 120 Brazzaville, Congo
| | - Marylin Madamet
- Unité Parasitologie et Entomologie, Département des Maladies Infectieuses, Institut de Recherche Biomédicale des Armées, Marseille, France; Aix-Marseille Univ., IRD, AP-HM, SSA, VITROME, IHU Méditerranée Infection, Marseille, France; Centre National de Référence du Paludisme, Marseille, France
| | - Lady Charlène Kouna
- Unité d'Evolution, Epidémiologie et Résistances Parasitaires (UNEEREP), Centre International de Recherche Médicales de Franceville, BP 769 Franceville, Gabon
| | - Jean Bernard Lekana-Douki
- Unité d'Evolution, Epidémiologie et Résistances Parasitaires (UNEEREP), Centre International de Recherche Médicales de Franceville, BP 769 Franceville, Gabon; Département de Parasitologie Mycologie et de Médecine Tropicale, Université des Science de la Santé, BP 4005 Libreville, Gabon
| | - Bruno Pradines
- Unité Parasitologie et Entomologie, Département des Maladies Infectieuses, Institut de Recherche Biomédicale des Armées, Marseille, France; Aix-Marseille Univ., IRD, AP-HM, SSA, VITROME, IHU Méditerranée Infection, Marseille, France; Centre National de Référence du Paludisme, Marseille, France.
| |
Collapse
|
6
|
Oyegue-Liabagui SL, Bouopda-Tuedom AG, Kouna LC, Maghendji-Nzondo S, Nzoughe H, Tchitoula-Makaya N, Pegha-Moukandja I, Lekana-Douki JB. Pro- and anti-inflammatory cytokines in children with malaria in Franceville, Gabon. Am J Clin Exp Immunol 2017; 6:9-20. [PMID: 28337387 PMCID: PMC5344990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Accepted: 01/31/2017] [Indexed: 06/06/2023]
Abstract
Severe Plasmodium falciparum malaria anemia (SMA) is a major cause of mortality in pediatric wards. Variations in inflammatory mediator production play an essential role in disease outcomes. Indeed, several studies have shown the involvement of pro- and anti-inflammatory cytokines such as IFN-γ, IL-6, TNF-α and IL-10 in malaria immunopathology. In other hand the exact role of Th17 cytokines such as IL-17, IL-22 and IL-21 in malaria remains poorly documented. Here, we investigated IFN-γ, TNF-α, IL-6, IL-12, IL-10, IL-4, IL-13, IL-17, IL-22 and IL-21 circulating levels and their association with malaria anemia and parasitemia in Gabonese children. Levels of IFN-γ (500 ± 100.2 pg/ml), IL-6 (64 ± 14.2 pg/ml), IL-10 (505 ± 35 pg/ml), IL-13 (30.6 ± 5.6 pg/ml) were significantly higher (P < 0.03) in infected children than in uninfected controls (210 ± 20 pg/ml, 17.5 pg/ml, 50 ± 25.9, pg/ml, 17.48 pg/ml, respectively). IFN-γ levels were significantly lower (P = 0.04) in children with SMA (400 ± 200 pg/ml) than in those with uncomplicated malaria (900 ± 450 pg/ml) and higher in those with parasitemia (P = 0.019). Levels of IL-6 and IL-10 were significantly higher in children with malarial anemia (P < 0.001) and hyperparasitemia (P < 0.0001). A significant association between IL-10 levels and parasite density was observed (P < 0.00001). IL-22 levels were significantly higher (P = 0.01) in infected children (72.57 ± 7.5 pg/ml) than in the controls (54.96 ± 1.93 pg/ml). IL-21 levels (44.46 ± 17.27 pg/ml) decreased with the severity of anemia (P < 0.05), whereas IL-17 levels increased in children with SMA (12.25 ± 1.25 pg/ml) than in those with mild malaria anemia (MMA: 6.2 ± 5.25 pg/ml, P = 0.002). Data suggest possible role of IFN-γ in the protection against SMA and parasite clearance. However, IL-6 and IL-10 could play a role in inflammatory response and pathophysiology of severe malaria anemia. Also, the role of IL-22 and IL-17 in P. falciparum malaria infection should be investigated.
Collapse
Affiliation(s)
- Sandrine Lydie Oyegue-Liabagui
- Ecole Doctorale Régionale d’Afrique Centrale en Infectiologie Tropicale, Université des Sciences et Techniques de Masuku (USTM) FrancevilleB.P. 876 Franceville, Gabon
| | - Aline Gaëlle Bouopda-Tuedom
- Ecole Doctorale Régionale d’Afrique Centrale en Infectiologie Tropicale, Université des Sciences et Techniques de Masuku (USTM) FrancevilleB.P. 876 Franceville, Gabon
| | - Lady Charlène Kouna
- Centre International de Recherches Médicales de Franceville (CIRMF)B.P. 769 Franceville, Gabon
| | - Sydney Maghendji-Nzondo
- Centre International de Recherches Médicales de Franceville (CIRMF)B.P. 769 Franceville, Gabon
| | - Herman Nzoughe
- Centre International de Recherches Médicales de Franceville (CIRMF)B.P. 769 Franceville, Gabon
| | - Nina Tchitoula-Makaya
- Ecole Doctorale Régionale d’Afrique Centrale en Infectiologie Tropicale, Université des Sciences et Techniques de Masuku (USTM) FrancevilleB.P. 876 Franceville, Gabon
| | - Irene Pegha-Moukandja
- Centre International de Recherches Médicales de Franceville (CIRMF)B.P. 769 Franceville, Gabon
| | - Jean-Bernard Lekana-Douki
- Centre International de Recherches Médicales de Franceville (CIRMF)B.P. 769 Franceville, Gabon
- Département de Parasitologie-Mycologie Médecine Tropicale, Faculté de Médecine, Université des Sciences de la SantéB.P. 4009 Libreville, Gabon
| |
Collapse
|
7
|
Mourembou G, Nzondo SM, Ndjoyi-Mbiguino A, Lekana-Douki JB, Kouna LC, Matsiegui PB, Manego RZ, Moukandja IP, Keïta AK, Tissot-Dupont H, Fenollar F, Raoult D. Co-circulation of Plasmodium and Bacterial DNAs in Blood of Febrile and Afebrile Children from Urban and Rural Areas in Gabon. Am J Trop Med Hyg 2016; 95:123-32. [PMID: 27114297 DOI: 10.4269/ajtmh.15-0751] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Accepted: 03/13/2016] [Indexed: 12/11/2022] Open
Abstract
Malaria is considered to be the most common etiology of fever in sub-Saharan Africa while bacteremias exist but are under assessed. This study aimed to assess bacteremias and malaria in children from urban and rural areas in Gabon. DNA extracts from blood samples of 410 febrile and 60 afebrile children were analyzed using quantitative polymerase chain reaction. Plasmodium spp. was the microorganism most frequently detected in febrile (78.8%, 323/410) and afebrile (13.3%, 8/60) children, (P < 0.001). DNA from one or several bacteria were detected in 15 febrile patients (3.7%) but not in the controls (P = 0.1). This DNA was more frequently detected as co-infections among febrile children tested positive for Plasmodium (4.6%, 15/323) than in those tested negative for Plasmodium (0%, 0/87; P = 0.04). The bacteria detected were Streptococcus pneumoniae 2.4% (10/410), Staphylococcus aureus 1.7% (7/410), Salmonella spp. 0.7% (3/410), Streptococcus pyogenes 0.2% (1/410) and Tropheryma whipplei 0.2% (1/410) only in febrile children. Coxiella burnetii, Borrelia spp., Bartonella spp., Leptospira spp., and Mycobacterium tuberculosis were not observed. This paper reports the first detection of bacteremia related to T. whipplei in Gabon and shows that malaria decreases in urban areas but not in rural areas. Co-infections in febrile patients are common, highlighting the need to improve fever management strategies in Gabon.
Collapse
Affiliation(s)
- Gaël Mourembou
- Unité de Recherche sur les Maladies Infectieuses et Tropicales Émergentes (URMITE), Aix Marseille Université, Marseille, France. Ecole Doctorale Régionale d'Afrique Centrale, Franceville, Gabon
| | - Sydney Maghendji Nzondo
- Unité de Parasitologie Médicale, Centre International de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon
| | - Angélique Ndjoyi-Mbiguino
- Département de Microbiologie, Laboratoire National de Référence IST/sida, Faculté de Médecine, Université des Sciences de la Santé, Libreville, Gabon
| | - Jean Bernard Lekana-Douki
- Unité de Parasitologie Médicale, Centre International de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon. Département de Parasitologie Mycologie et de Médecine Tropicale, Université des Sciences de la Santé, Libreville, Gabon
| | - Lady Charlène Kouna
- Unité de Parasitologie Médicale, Centre International de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon
| | | | | | - Irene Pegha Moukandja
- Unité de Parasitologie Médicale, Centre International de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon
| | - Alpha Kabinet Keïta
- Unité de Recherche sur les Maladies Infectieuses et Tropicales Émergentes (URMITE), Aix Marseille Université, Marseille, France
| | - Hervé Tissot-Dupont
- Unité de Recherche sur les Maladies Infectieuses et Tropicales Émergentes (URMITE), Aix Marseille Université, Marseille, France
| | - Florence Fenollar
- Unité de Recherche sur les Maladies Infectieuses et Tropicales Émergentes (URMITE), Aix Marseille Université, Marseille, France
| | - Didier Raoult
- Unité de Recherche sur les Maladies Infectieuses et Tropicales Émergentes (URMITE), Aix Marseille Université, Marseille, France.
| |
Collapse
|