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Brazeau NF, Assefa A, Mohammed H, Seme H, Tsadik AG, Parr JB, Keeler C, Hathaway NJ, Meshnick SR, Bailey JA, Kassa M, Juliano JJ, Woyessa A. Pooled Deep Sequencing of Drug Resistance Loci from Plasmodium falciparum Parasites across Ethiopia. Am J Trop Med Hyg 2020; 101:1139-1143. [PMID: 31516103 DOI: 10.4269/ajtmh.19-0142] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Although Ethiopia has an overall lower prevalence of Plasmodium falciparum among countries in Africa, the emergence of drug resistance could seriously hinder elimination efforts. Using samples collected from five therapeutic efficacy studies conducted in 2007-11, we evaluated the prevalence of putative drug resistance mutations in the pfcrt, pfmdr1, and kelch13 genes at the time of those studies, as well as the ama1 gene for genetic relatedness using a pooled amplicon deep sequencing approach. Among all sites, the kelch13 gene showed no mutations, whereas the pfcrt CVIET genotype was fixed in all populations. By contrast, the mdr1 gene demonstrated frequencies of resistant genotypes ranging from 10 to 100% at amino acid position 86 and from 0% to 57.8% at amino acid position 1246. Although we observed a low degree of haplotype sharing between sites, we did observe considerable haplotype sharing within sites over time. This suggests that P. falciparum populations in Ethiopia are isolated and able to persist through time.
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Affiliation(s)
- Nicholas F Brazeau
- Doctor of Medicine/Doctor of Philosophy Program, School of Medicine, University of North Carolina, Chapel Hill, North Carolina.,Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
| | | | | | - Heven Seme
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Abeba G Tsadik
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Jonathan B Parr
- Division of Infectious Diseases, School of Medicine, University of North Carolina, Chapel Hill, North Carolina
| | - Corinna Keeler
- Department of Geography, University of North Carolina, Chapel Hill, North Carolina
| | - Nicholas J Hathaway
- School of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts
| | - Steven R Meshnick
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
| | - Jeffrey A Bailey
- Division of Transfusion Medicine, Brown University, Providence, Rhode Island
| | - Moges Kassa
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Jonathan J Juliano
- Curriculum in Genetics and Molecular Biology, School of Medicine, University of North Carolina, Chapel Hill, North Carolina.,Division of Infectious Diseases, School of Medicine, University of North Carolina, Chapel Hill, North Carolina.,Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
| | - Adugna Woyessa
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
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Abebe A, Belayneh M, Asrat H, Kassa W, Gashu A, Desale A, Hailu G, Mekonnen T, Girmachew F, Mulugeta A, Abose E, Yenealem D, Tsadik AG, Kebede A, Ayana G, Desta K. Performance evaluation of malaria microscopists working at rechecking laboratories in Ethiopia. Malariaworld J 2017; 8:6. [PMID: 34532230 PMCID: PMC8415073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
BACKGROUND Microscopic diagnosis of Giemsa-stained thick and thin blood films has remained the standard laboratory method for diagnosing malaria. High quality performance of microscopists that examine blood slides in health facilities remains critically important. MATERIALS AND METHODS A cross-sectional study was conducted to assess the performance of 107 malaria microscopists working at 23 malaria rechecking laboratories in Ethiopia. A set of 12 blood film slides was distributed to each microscopist. Data was collected and exported to SPSS version 20 for analysis. Chi-square, sensitivity, specificity, percent agreement, and kappa scores were calculated to assess performance in detecting and identification of Plasmodium species. RESULTS The mean age of the participants was 30 ± 5 yrs and most of them (54; 50.5%) were working at regional reference laboratories. Overall, the sensitivity of participants in detecting and identifying malaria parasite species was 96.8% and 56.7%, respectively. The overall agreement on detection and identification of malaria species was 96.8% (Kappa = 0.9) and 64.8% (Kappa = 0.33), respectively. The least accurately identified malaria parasite species was P. malariae (3/107; 2.8%) followed by P. ovale (35/107; 32.7%). Participants working at hospital laboratories had the highest percentage (72.3 %, Kappa=0.51) of accurate species identification. Study participants that had participated in malaria microscopy and quality assurance trainings were significantly better at quantifying parasite densities (P<0.001). CONCLUSION The accuracy of parasite identification and quantification differed strongly between participants and expert microscopists. Therefore, regular competency assessment and training for malaria microscopists should be mandatory to assure proper diagnosis and management of malaria in Ethiopia.
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Affiliation(s)
- Abnet Abebe
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia,*
| | - Meseret Belayneh
- Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Habtamu Asrat
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | | | | | - Adino Desale
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Getnet Hailu
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | | | | | | | - Ebise Abose
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | | | - Abeba G Tsadik
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Adisu Kebede
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Gonfa Ayana
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Kassu Desta
- Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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