Abstract
Malaria remains a major public health issue in Nigeria, and Nigeria is one of the main sources of imported malaria in China. Antimalarial drug resistance is a significant obstacle to the control and prevention of malaria globally. The molecular markers associated with antimalarial drug resistance can provide early warnings about the emergence of resistance. The prevalence of antimalarial drug resistant genes and mutants, including PfK13, Pfcrt, Pfmdr1, Pfdhfr, and Pfdhps, was evaluated among the imported Plasmodium falciparum isolates from Nigeria in Henan, China, from 2012 to 2019. Among the 167 imported P. falciparum isolates, the wild-type frequency of PfK13, Pfcrt, Pfmdr1, Pfdhfr, and Pfdhps was 98.7, 63.9, 34.8, 3.1, and 3.1%, respectively. The mutation of PfK13 was rare, with just two nonsynonymous (S693F and Q613H) and two synonymous mutations (C469C and G496G) identified from four isolates. The prevalence of Pfcrt mutation at codon 74–76 decreased year-by-year, while the prevalence of pfmdr1 86Y also decreased significantly with time. The prevalence of Pfdhfr and Pfdhps mutants was high. Combined mutations of Pfdhfr and Pfdhps had a high prevalence of the quadruple mutant I51R59N108-G437 (39.0%), followed by the octal mutant I51R59N108-V431A436G437G581S613 (17.0%). These molecular findings update the known data on antimalarial drug-resistance genes and provide supplemental information for Nigeria.
Highlights
Malaria incidence and mortality have substantially reduced since 2010, and an increasing number of countries are moving toward malaria elimination
Malaria remains the major public problem in sub-Saharan Africa, and Nigeria had the greatest burden of global malaria cases (27%) and malaria deaths (23%) worldwide in 2019 (WHO, 2020)
The 850 bp fragments of the Kelch 13 (K13)-propeller domain were successfully sequenced from 157 samples among 167 P. falciparum isolates
Summary
Malaria incidence and mortality have substantially reduced since 2010, and an increasing number of countries are moving toward malaria elimination. In 2016, the World Health Organization (WHO) identified 21 countries that had the potential to eliminate malaria by 2020, including China (WHO, 2018). Antimalarial Drug-Resistance Genes From Nigerian Isolates (Liu et al, 2014), while in 2017, no indigenous malaria cases were reported in China for the first time (Zhang et al, 2018). The emergence of antimalarial drug resistance increases the burden of malaria, and is one of the recurring challenges in the global fight against malaria. Monitoring antimalarial drug efficacy is necessary to provide information for treatment policies, as well as to mitigate the impact of resistance and prevent its spread. Therapeutic efficacy studies (TESs) and integrated drug efficacy surveillance (iDES) are common and reliable measures to obtain data on treatment efficacy, and the molecular markers associated with parasite resistance can provide supplemental information for TESs and iDES
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