A snapshot of the prevalence of dihydropteroate synthase-431V mutation and other sulfadoxine-pyrimethamine resistance markers in Plasmodium falciparum isolates in Nigeria

Abstract Background Malaria is a major public health issue with substantial risks among vulnerable populations. Currently, the World Health Organization (WHO) recommends SP-IPTp in the second and third trimesters. However, the efficacy of SP-IPTp is threatened by the emergence of sulfadoxine-pyrimet...

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Main Authors: Adebanjo J. Adegbola, Omotade A. Ijarotimi, Akaninyene E. Ubom, Bukola A. Adesoji, Olajide E. Babalola, Emma F. Hocke, Helle Hansson, Andria Mousa, Oluseye O. Bolaji, Michael Alifrangis, Cally Roper
Format: Article
Language:English
Published: BMC 2023-03-01
Series:Malaria Journal
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Online Access:https://doi.org/10.1186/s12936-023-04487-5
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author Adebanjo J. Adegbola
Omotade A. Ijarotimi
Akaninyene E. Ubom
Bukola A. Adesoji
Olajide E. Babalola
Emma F. Hocke
Helle Hansson
Andria Mousa
Oluseye O. Bolaji
Michael Alifrangis
Cally Roper
author_facet Adebanjo J. Adegbola
Omotade A. Ijarotimi
Akaninyene E. Ubom
Bukola A. Adesoji
Olajide E. Babalola
Emma F. Hocke
Helle Hansson
Andria Mousa
Oluseye O. Bolaji
Michael Alifrangis
Cally Roper
author_sort Adebanjo J. Adegbola
collection DOAJ
description Abstract Background Malaria is a major public health issue with substantial risks among vulnerable populations. Currently, the World Health Organization (WHO) recommends SP-IPTp in the second and third trimesters. However, the efficacy of SP-IPTp is threatened by the emergence of sulfadoxine-pyrimethamine resistant malaria parasites due to single nucleotide polymorphisms in the Plasmodium falciparum dihydrofolate reductase and dihydropteroate synthetase genes. This study aimed to assess the current prevalence of Pfdhfr/Pfdhps mutations in P. falciparum isolates collected from individuals residing in Ile-Ife, Nigeria, and also present maps of the prevalence of Pfdhps 431V and 581G within Nigeria and surrounding countries. Methods Between October 2020 and April 2021, samples were collected as dried blood spots among 188 participants who showed malaria positivity with a histidine-rich-protein-based rapid diagnostic test (RDT). Nested PCR assays were used to confirm falciparum in the samples with RDT positivity, and to amplify fragments of the Pfdhfr/Pfdhps genes followed by targeted amplicon sequencing. Published data since 2007 on the prevalence of the Pfdhps genotypes in Nigeria and the neighbouring countries were used to produce maps to show the distribution of the mutant genotypes. Results Only 74 and 61 samples were successfully amplified for the Pfdhfr and Pfdhps genes, respectively. At codons resulting in N51I, C59R, and S108N, Pfdhfr carried mutant alleles of 97.3% (72/74), 97.3% (72/74) and 98.6% (73/74), respectively. The Pfdhps gene carried mutations at codons resulting in amino acid changes at 431–436-437–540-581–613; I431V [45.9%, (28/61)], A581G [31.1% (19/61)] and A613S [49.2% (30/61)]. Constructed haplotypes were mainly the triple Pfdhfr mutant 51I-59R-108N (95.9%), and the most common haplotypes observed for the Pfdhps gene were the ISGKAA (32.8%), ISGKGS (8.2%), VAGKAA (14.8%), VAGKAS (9.8%) and VAGKGS (14.8%). In the context of the previously published data, a high prevalence of 431V/581G mutations was found in the study population. It seems quite evident that the Pfdhps 431V, 581G and 613S often co-occur as Pfdhps-VAGKGS haplotype. Conclusion This study showed that the prevalence of VAGKGS haplotype seems to be increasing in prevalence. If this is similar in effect to the emergence of 581G in East Africa, the efficacy of SP-IPTp in the presence of these novel Pfdhps mutants should be re-assessed.
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spelling doaj.art-57dcc0a36950423ca53c83c38ae04cef2023-03-22T10:28:46ZengBMCMalaria Journal1475-28752023-03-0122111210.1186/s12936-023-04487-5A snapshot of the prevalence of dihydropteroate synthase-431V mutation and other sulfadoxine-pyrimethamine resistance markers in Plasmodium falciparum isolates in NigeriaAdebanjo J. Adegbola0Omotade A. Ijarotimi1Akaninyene E. Ubom2Bukola A. Adesoji3Olajide E. Babalola4Emma F. Hocke5Helle Hansson6Andria Mousa7Oluseye O. Bolaji8Michael Alifrangis9Cally Roper10Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Obafemi Awolowo UniversityDepartment of Obstetrics, Gynaecology and Perinatology, Faculty of Clinical Sciences, College of Health Sciences, Obafemi Awolowo UniversityDepartment of Obstetrics, Gynaecology and Perinatology, Obafemi Awolowo University Teaching Hospitals ComplexDepartment of Nursing Services, Obafemi Awolowo University Teaching Hospitals ComplexState Specialist HospitalDepartment of Immunology and Microbiology, Centre for Medical Parasitology, University of CopenhagenDepartment of Immunology and Microbiology, Centre for Medical Parasitology, University of CopenhagenDepartment of Infection Biology, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical MedicineDepartment of Pharmaceutical Chemistry, Faculty of Pharmacy, Obafemi Awolowo UniversityDepartment of Immunology and Microbiology, Centre for Medical Parasitology, University of CopenhagenDepartment of Infection Biology, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical MedicineAbstract Background Malaria is a major public health issue with substantial risks among vulnerable populations. Currently, the World Health Organization (WHO) recommends SP-IPTp in the second and third trimesters. However, the efficacy of SP-IPTp is threatened by the emergence of sulfadoxine-pyrimethamine resistant malaria parasites due to single nucleotide polymorphisms in the Plasmodium falciparum dihydrofolate reductase and dihydropteroate synthetase genes. This study aimed to assess the current prevalence of Pfdhfr/Pfdhps mutations in P. falciparum isolates collected from individuals residing in Ile-Ife, Nigeria, and also present maps of the prevalence of Pfdhps 431V and 581G within Nigeria and surrounding countries. Methods Between October 2020 and April 2021, samples were collected as dried blood spots among 188 participants who showed malaria positivity with a histidine-rich-protein-based rapid diagnostic test (RDT). Nested PCR assays were used to confirm falciparum in the samples with RDT positivity, and to amplify fragments of the Pfdhfr/Pfdhps genes followed by targeted amplicon sequencing. Published data since 2007 on the prevalence of the Pfdhps genotypes in Nigeria and the neighbouring countries were used to produce maps to show the distribution of the mutant genotypes. Results Only 74 and 61 samples were successfully amplified for the Pfdhfr and Pfdhps genes, respectively. At codons resulting in N51I, C59R, and S108N, Pfdhfr carried mutant alleles of 97.3% (72/74), 97.3% (72/74) and 98.6% (73/74), respectively. The Pfdhps gene carried mutations at codons resulting in amino acid changes at 431–436-437–540-581–613; I431V [45.9%, (28/61)], A581G [31.1% (19/61)] and A613S [49.2% (30/61)]. Constructed haplotypes were mainly the triple Pfdhfr mutant 51I-59R-108N (95.9%), and the most common haplotypes observed for the Pfdhps gene were the ISGKAA (32.8%), ISGKGS (8.2%), VAGKAA (14.8%), VAGKAS (9.8%) and VAGKGS (14.8%). In the context of the previously published data, a high prevalence of 431V/581G mutations was found in the study population. It seems quite evident that the Pfdhps 431V, 581G and 613S often co-occur as Pfdhps-VAGKGS haplotype. Conclusion This study showed that the prevalence of VAGKGS haplotype seems to be increasing in prevalence. If this is similar in effect to the emergence of 581G in East Africa, the efficacy of SP-IPTp in the presence of these novel Pfdhps mutants should be re-assessed.https://doi.org/10.1186/s12936-023-04487-5SP resistanceMolecular markerDihydropteroateDihydrofolateMalariaPregnancy
spellingShingle Adebanjo J. Adegbola
Omotade A. Ijarotimi
Akaninyene E. Ubom
Bukola A. Adesoji
Olajide E. Babalola
Emma F. Hocke
Helle Hansson
Andria Mousa
Oluseye O. Bolaji
Michael Alifrangis
Cally Roper
A snapshot of the prevalence of dihydropteroate synthase-431V mutation and other sulfadoxine-pyrimethamine resistance markers in Plasmodium falciparum isolates in Nigeria
Malaria Journal
SP resistance
Molecular marker
Dihydropteroate
Dihydrofolate
Malaria
Pregnancy
title A snapshot of the prevalence of dihydropteroate synthase-431V mutation and other sulfadoxine-pyrimethamine resistance markers in Plasmodium falciparum isolates in Nigeria
title_full A snapshot of the prevalence of dihydropteroate synthase-431V mutation and other sulfadoxine-pyrimethamine resistance markers in Plasmodium falciparum isolates in Nigeria
title_fullStr A snapshot of the prevalence of dihydropteroate synthase-431V mutation and other sulfadoxine-pyrimethamine resistance markers in Plasmodium falciparum isolates in Nigeria
title_full_unstemmed A snapshot of the prevalence of dihydropteroate synthase-431V mutation and other sulfadoxine-pyrimethamine resistance markers in Plasmodium falciparum isolates in Nigeria
title_short A snapshot of the prevalence of dihydropteroate synthase-431V mutation and other sulfadoxine-pyrimethamine resistance markers in Plasmodium falciparum isolates in Nigeria
title_sort snapshot of the prevalence of dihydropteroate synthase 431v mutation and other sulfadoxine pyrimethamine resistance markers in plasmodium falciparum isolates in nigeria
topic SP resistance
Molecular marker
Dihydropteroate
Dihydrofolate
Malaria
Pregnancy
url https://doi.org/10.1186/s12936-023-04487-5
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