Sub-microscopic Plasmodium falciparum parasitaemia, dihydropteroate synthase (dhps) resistance mutations to sulfadoxine–pyrimethamine, transmission intensity and risk of malaria infection in pregnancy in Mount Cameroon Region
Abstract Background Plasmodium falciparum resistance to intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp-SP) continues to spread throughout sub-Saharan Africa. This study assessed the occurrence of microscopic and sub-microscopic P. falciparum parasitaemia, dihydropteroate synt...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-03-01
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| Series: | Malaria Journal |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12936-023-04485-7 |
| _version_ | 1797865514837475328 |
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| author | Harry F. Mbacham Diange M Mosume Tobias O. Apinjoh Vincent N. Ntui Marcel N. Moyeh Laken N. Kalaji Godlove B. Wepnje Stephen M Ghogomu Jodie A Dionne Alan T.N. Tita Eric A. Achidi Judith K. Anchang-Kimbi |
| author_facet | Harry F. Mbacham Diange M Mosume Tobias O. Apinjoh Vincent N. Ntui Marcel N. Moyeh Laken N. Kalaji Godlove B. Wepnje Stephen M Ghogomu Jodie A Dionne Alan T.N. Tita Eric A. Achidi Judith K. Anchang-Kimbi |
| author_sort | Harry F. Mbacham |
| collection | DOAJ |
| description | Abstract Background Plasmodium falciparum resistance to intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp-SP) continues to spread throughout sub-Saharan Africa. This study assessed the occurrence of microscopic and sub-microscopic P. falciparum parasitaemia, dihydropteroate synthase mutations associated with resistance to SP and maternal anaemia in the Mount Cameroon area. Methods Consenting pregnant women living in semi-rural and semi-urban/urbanized settings were enrolled in this cross-sectional study. Socio-demographic, antenatal and clinical data were documented. Microscopic and sub-microscopic parasitaemia were diagnosed using peripheral blood microscopy and nested polymerase chain reaction (PCR) respectively. The dhps mutations were genotyped by restriction fragment length polymorphism analysis. The presence of A437G, K540E, and A581G was considered a marker for high-level resistance. Haemoglobin levels and anaemia status were determined. Results Among the women, the prevalence of microscopic and sub-microscopic P. falciparum infection were 7.7% (67/874) and 18.6% (93/500) respectively. Predictors of microscopic infection were younger age (< 21 years) (AOR = 2.89; 95% CI 1.29–6.46) and semi-rural settings (AOR = 2.27; 95% CI 1.31–3.96). Determinants of sub-microscopic infection were the rainy season (AOR, 3.01; 95% CI 1.77–5.13), primigravidity (AOR = 0.45; 95% CI 0.21–0.94) and regular ITN usage (AOR = 0.49; 95% CI 0.27–0.90). Of the145 P. falciparum isolates genotyped, 66.9% (97) carried mutations associated with resistance to SP; 33.8% (49), 0%, 52.4% (76) and 19.3% (28) for A437G, K540E, A581G and A437G + A581G respectively. The A581G mutation was associated with ≥ 3 SP doses evident only among sub-microscopic parasitaemia (P = 0.027) and multigravidae (P = 0.009). Women with microscopic infection were more likely from semi-rural settings (AOR = 7.09; 95% CI 2.59–19.42), to report history of fever (AOR = 2.6; 95% CI 1.07–6.31), to harbour parasites with double resistant mutations (AOR = 6.65; 95% CI 1.85–23.96) and were less likely to have received 2 SP doses (AOR = 0.29; 95% CI 1.07–6.31). Microscopic infection decreased Hb levels more than sub-microscopic infection. Conclusion The occurrence of sub-microscopic P. falciparum parasites resistant to SP and intense malaria transmission poses persistent risk of malaria infection during pregnancy in the area. ITN usage and monitoring spread of resistance are critical. |
| first_indexed | 2024-04-09T23:09:18Z |
| format | Article |
| id | doaj.art-0406446ade9445a99df85c19286a6111 |
| institution | Directory Open Access Journal |
| issn | 1475-2875 |
| language | English |
| last_indexed | 2024-04-09T23:09:18Z |
| publishDate | 2023-03-01 |
| publisher | BMC |
| record_format | Article |
| series | Malaria Journal |
| spelling | doaj.art-0406446ade9445a99df85c19286a61112023-03-22T10:28:59ZengBMCMalaria Journal1475-28752023-03-0122111610.1186/s12936-023-04485-7Sub-microscopic Plasmodium falciparum parasitaemia, dihydropteroate synthase (dhps) resistance mutations to sulfadoxine–pyrimethamine, transmission intensity and risk of malaria infection in pregnancy in Mount Cameroon RegionHarry F. Mbacham0Diange M Mosume1Tobias O. Apinjoh2Vincent N. Ntui3Marcel N. Moyeh4Laken N. Kalaji5Godlove B. Wepnje6Stephen M Ghogomu7Jodie A Dionne8Alan T.N. Tita9Eric A. Achidi10Judith K. Anchang-Kimbi11Department of Animal Biology and Conservation, University of BueaDepartment of Animal Biology and Conservation, University of BueaDepartment of Biochemistry and Molecular Biology, University of BueaDepartment of Biochemistry and Molecular Biology, University of BueaDepartment of Biochemistry and Molecular Biology, University of BueaDepartment of Animal Biology and Conservation, University of BueaDepartment of Animal Biology and Conservation, University of BueaDepartment of Biochemistry and Molecular Biology, University of BueaDepartment of Medicine, University of Alabama at BirminghamDepartment of Obstetrics and Gynecology, University of Alabama at BirminghamDepartment of Biochemistry and Molecular Biology, University of BueaDepartment of Animal Biology and Conservation, University of BueaAbstract Background Plasmodium falciparum resistance to intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp-SP) continues to spread throughout sub-Saharan Africa. This study assessed the occurrence of microscopic and sub-microscopic P. falciparum parasitaemia, dihydropteroate synthase mutations associated with resistance to SP and maternal anaemia in the Mount Cameroon area. Methods Consenting pregnant women living in semi-rural and semi-urban/urbanized settings were enrolled in this cross-sectional study. Socio-demographic, antenatal and clinical data were documented. Microscopic and sub-microscopic parasitaemia were diagnosed using peripheral blood microscopy and nested polymerase chain reaction (PCR) respectively. The dhps mutations were genotyped by restriction fragment length polymorphism analysis. The presence of A437G, K540E, and A581G was considered a marker for high-level resistance. Haemoglobin levels and anaemia status were determined. Results Among the women, the prevalence of microscopic and sub-microscopic P. falciparum infection were 7.7% (67/874) and 18.6% (93/500) respectively. Predictors of microscopic infection were younger age (< 21 years) (AOR = 2.89; 95% CI 1.29–6.46) and semi-rural settings (AOR = 2.27; 95% CI 1.31–3.96). Determinants of sub-microscopic infection were the rainy season (AOR, 3.01; 95% CI 1.77–5.13), primigravidity (AOR = 0.45; 95% CI 0.21–0.94) and regular ITN usage (AOR = 0.49; 95% CI 0.27–0.90). Of the145 P. falciparum isolates genotyped, 66.9% (97) carried mutations associated with resistance to SP; 33.8% (49), 0%, 52.4% (76) and 19.3% (28) for A437G, K540E, A581G and A437G + A581G respectively. The A581G mutation was associated with ≥ 3 SP doses evident only among sub-microscopic parasitaemia (P = 0.027) and multigravidae (P = 0.009). Women with microscopic infection were more likely from semi-rural settings (AOR = 7.09; 95% CI 2.59–19.42), to report history of fever (AOR = 2.6; 95% CI 1.07–6.31), to harbour parasites with double resistant mutations (AOR = 6.65; 95% CI 1.85–23.96) and were less likely to have received 2 SP doses (AOR = 0.29; 95% CI 1.07–6.31). Microscopic infection decreased Hb levels more than sub-microscopic infection. Conclusion The occurrence of sub-microscopic P. falciparum parasites resistant to SP and intense malaria transmission poses persistent risk of malaria infection during pregnancy in the area. ITN usage and monitoring spread of resistance are critical.https://doi.org/10.1186/s12936-023-04485-7PregnancyIPTp-SPP. falciparumSub-microscopic parasitaemiaDhps resistant mutationsCameroon |
| spellingShingle | Harry F. Mbacham Diange M Mosume Tobias O. Apinjoh Vincent N. Ntui Marcel N. Moyeh Laken N. Kalaji Godlove B. Wepnje Stephen M Ghogomu Jodie A Dionne Alan T.N. Tita Eric A. Achidi Judith K. Anchang-Kimbi Sub-microscopic Plasmodium falciparum parasitaemia, dihydropteroate synthase (dhps) resistance mutations to sulfadoxine–pyrimethamine, transmission intensity and risk of malaria infection in pregnancy in Mount Cameroon Region Malaria Journal Pregnancy IPTp-SP P. falciparum Sub-microscopic parasitaemia Dhps resistant mutations Cameroon |
| title | Sub-microscopic Plasmodium falciparum parasitaemia, dihydropteroate synthase (dhps) resistance mutations to sulfadoxine–pyrimethamine, transmission intensity and risk of malaria infection in pregnancy in Mount Cameroon Region |
| title_full | Sub-microscopic Plasmodium falciparum parasitaemia, dihydropteroate synthase (dhps) resistance mutations to sulfadoxine–pyrimethamine, transmission intensity and risk of malaria infection in pregnancy in Mount Cameroon Region |
| title_fullStr | Sub-microscopic Plasmodium falciparum parasitaemia, dihydropteroate synthase (dhps) resistance mutations to sulfadoxine–pyrimethamine, transmission intensity and risk of malaria infection in pregnancy in Mount Cameroon Region |
| title_full_unstemmed | Sub-microscopic Plasmodium falciparum parasitaemia, dihydropteroate synthase (dhps) resistance mutations to sulfadoxine–pyrimethamine, transmission intensity and risk of malaria infection in pregnancy in Mount Cameroon Region |
| title_short | Sub-microscopic Plasmodium falciparum parasitaemia, dihydropteroate synthase (dhps) resistance mutations to sulfadoxine–pyrimethamine, transmission intensity and risk of malaria infection in pregnancy in Mount Cameroon Region |
| title_sort | sub microscopic plasmodium falciparum parasitaemia dihydropteroate synthase dhps resistance mutations to sulfadoxine pyrimethamine transmission intensity and risk of malaria infection in pregnancy in mount cameroon region |
| topic | Pregnancy IPTp-SP P. falciparum Sub-microscopic parasitaemia Dhps resistant mutations Cameroon |
| url | https://doi.org/10.1186/s12936-023-04485-7 |
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