Monitoring Plasmodium falciparum Drug Resistance Markers in Pregnant Women Attending Antenatal Clinics in Senegal
1 Service of Parasitology-Mycology, UFR Santé Thiès, Thies BP A967, Senegal; (S.K.); (F.B.S.); (A.S.); (J.-L.A.N.)
2 Service of Parasitology-Mycology, Cheikh Anta Diop University, Dakar BP 5005, Senegal; (I.A.M.); (A.C.L.); (B.F.)
3 Disease Control and Elimination,Medical Research council Unit The Gambia at London School of Hygiene and Tropical Medicine, Atlantic Road, Fajara, P.O. Box 273 Banjul, The Gambia; (M.A.O.); (A.A.-N.)
4 Special Programme for Research & Training in Tropical Diseases (TDR), World Health Organization WHO—TDR, Geneva, Switzerland; (C.M.)
5 Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK; (PM.); (A.A.-N.)
* Corresponding author: or ; Tel.: +221-773800832/+221-775885087
* Author to whom correspondence should be addressed.
Received: 29 Jun 2024 / Accepted: 3 Oct 2024 / Published: 31 Oct 2024
Abstract
Background: Malaria control in Senegal relies on antimalarial drugs like sulfadoxine–pyrimethamine (SP) for treatment and chemoprevention. Monitoring drug resistance markers is vital to ensure these interventions’ effectiveness. This study assessed the prevalence of SP resistance markers among pregnant women attending antenatal clinics in Senegal in 2019. Methods: Cross-sectional surveys were conducted during the high-transmission period of 2019 among pregnant women in low- and high-transmission areas. After obtaining consent, three dry blood spots on Whatman paper were collected. Samples were analyzed by real-time Polymerase Chain Reaction (RT-PCR) to detect the Plasmodium falciparum VarATS gene. Positive samples were genotyped by High-Resolution Melting for mutations in the dihydrofolate reductase and dihydropteroate synthase genes. Results: Six hundred samples positive for P. falciparum were analyzed. The population was predominantly young and resided in high-transmission areas. Key resistance mutations were detected at the following rates: PfdhfrII164L (11.7%), PfdhpsS436A (14.8%), PfdhpsA437G (19.0%), PfdhpsA581G (15.2%) and PfdhpsA613S (15.5%). The PfdhpsK540E mutation was not detected. The prevalence of these mutations was significantly higher in high-transmission areas. No significant differences in resistance markers were observed based on SP intake or gravidity. Conclusions: The low frequencies of SP resistance markers and the absence of the Pfdhps K540E mutation suggest that SP remains effective for malaria chemoprevention in Senegal. However, regular surveillance is crucial to monitor and contain any potential resistance of P. falciparum to SP and to track the evolution and spread of resistant parasites within malaria control areas. Surveys in antenatal clinics could be a good strategy for monitoring at low cost the emergence of resistance to SP.
Keywords: malaria; sulfadoxine–pyrimethamine; resistance markers; pregnant women; Senegal
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CITE
Diouf, M.P.; Oboh, M.A.; Manga, I.A.; Kande, S.; Lo, A.C.; Sall, F.B.; Seck, A.; Faye, B.; Merle, C.S.; Amambua-Ngwa, A.; Miligan, P.; Ndiaye, J.-L. Monitoring Plasmodium falciparum Drug Resistance Markers in Pregnant Women Attending Antenatal Clinics in Senegal. ajpme 2024, 2, 13.
Diouf MP, Oboh MA, Manga IA, Kande S, Lo AC, Sall FB, Seck A, Faye B, Merle CS, Amambua-Ngwa A, Miligan P, Ndiaye J-L. Monitoring Plasmodium falciparum Drug Resistance Markers in Pregnant Women Attending Antenatal Clinics in Senegal. African Journal of Parasitology, Mycology and Entomology. 2024; 2(2):13.
Diouf, Marie Pierre; Oboh, Mary Aigbiremo; Manga, Isaac Akhénaton; Kande, Safiétou; Lo, Aminata Colle; Sall, Fatimata Bintou; Seck, Amadou; Faye, Babacar; Merle, Corinne Simone; Amambua-Ngwa, Alfred; Miligan, Paul; Ndiaye, Jean-Louis Abdourahim. 2024. "Monitoring Plasmodium falciparum Drug Resistance Markers in Pregnant Women Attending Antenatal Clinics in Senegal." ajpme 2, no. 2: 13.
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