Prevalence of pfmdr1, pfcrt, pfdhfr and pfdhps mutations associated with drug resistance, in Luanda, Angola

<p>Abstract</p> <p>Background</p> <p>Malaria is the infectious disease causing the highest morbidity and mortality in Angola and due to widespread chloroquine (CQ) resistance, the country has recently changed its first-line treatment recommendations for uncomplicated malaria, from CQ to artemisinin combination therapies (ACT) in adults, and sulphadoxine/pyrimethamine (S/P) in pregnant women. Loss of SP sensitivity is, however, progressing rapidly in Africa and, in this study, were investigated a number of molecular markers associated to CQ and S/P.</p> <p>Methods</p> <p>Blood samples were collected from 245 children with uncomplicated malaria, admitted at the Pediatric Hospital Dr. David Bernardino (HPDB), Angola, and the occurrence of mutations in <it>Plasmodium falciparum </it>was investigated in the <it>pfmdr1 </it>(N86Y) and <it>pfcrt </it>(K76T) genes, associated with CQ resistance, as well as in <it>pfdhfr </it>(C59R) and <it>pfdhps </it>(K540E), conferring SP resistance.</p> <p>Results</p> <p>The frequencies of <it>pfmdr1 </it>mutations in codon 86 were 28.6% N, 61.3% Y and 10.1% mixed infections (NY). The frequency of <it>pfcrt </it>mutations in codon 76 were 93.9% K, 5.7% T and 0.4% mixed infections (KT). For <it>pfdhfr </it>the results were in codon 59, 60.6% C, 20.6% R and 18.8% mixed infections (CR). Concerning <it>pfdhps</it>, 6.3% of the isolates were bearers of the mutation 540E and 5.4% mixed infections (K540E).</p> <p>Conclusion</p> <p>The results of this epidemiologic study showed high presence of CQ resistance markers while for SP a much lower prevalence was detected for the markers under study.</p

TREATMENT OF URBAN CUTANEOUS LEISHMANIASIS IN IRAN WITH CYCLOGUANIL PAMOATE

One hundred one cases of urban cutaneous leishmaniasis from Mashad and Teh ran were placed under treatment with either one or two sim ultaneous standa rd doses of cycloguanil parnoate. Out of 101 patients, 96 were followed until the 120th day; 31 (31 per cent ) recovered with in 60 days, ?3 (&apos;3 per cent) recovered utter between 60 and I70 days, and 42 (42 per cent) did not respond. A higher recovery rate was o bserved in subjects who received two simultaneous doses of the drug (38 per cent cithin 60 days), Recovery ra te was also higher in the patients from Tehran who were children aged 7 to 12 yea rs, However, our results indicate that Carnolar is less effective than pentavalent an imonial (Glucantime). The side-effects of the drug were tenderness (83 per cent), induration (27 per cent) fever (6 per cent) and abscess (2 per cent). No changes in complete blood count were observed. The incidence of adverse drug reactions was higher when two simultaneous doses were given

COMPARISON OF IMMUNOFLUORESCENCE AND, ELISA IN THE DETECTION OF MALARIAL ANTIBODIES IN SOUTHERN IRAN

In order to compare the enzyme-linked immunosorbent assay (ELISA) and indirect fluorescent antibody technique (IFAT) in detection of malarial antibodies, 652 sera samples collected in the Health Survey Project (1975) in a random sampling method from about 10% or residents of selected villages in Bandar Abbas and Minab areas of Southern Iran, were tested with the above two serological methods. In microscopical examination of blood films malaria parasite (P. vivax) was found in 12 cases. Malarial antibodies were detected with Aotus P. falciparum and P. vivax malaria antigens in titers &amp;#8805; 40 in 2"4.3% find 34.9% respectively. The ELISA values with Aotus, P. falcifJCIrum antigen in 15.6% were more than 0.2 In general, the IF AT showed a considerably higher positively rate than the ELISA. The result of both types of serological assay indicated a progressive incoming of positivity rate and antibody level with the age. In the present study malaria antibody was not detected by ELISA. In some P. vivax parasitologlcally proved cases; perhaps due to the using of heterologus P. falciparum antigen. The use of mixed polyvalent P. falciparum and P. fieldi malaria antigens was more efficient in detecting highest titres of malaria antiboies

Molecular Monitoring of Plasmodium vivax Infection afterRadical Treatment in Southeastern Iran

Background: The aim was to evaluate the relapse risk of vivax malaria in patients who received radical treatment in Hormozgan Province, a malarious area located on southeast of Iran. Methods: A total of 95 symptomatic vivax malaria infected patients were enrolled in urban health centers of Bandar- Abbas, Minab, Bandar-Jask and Bashagard districts of Hormozgan Province, southeast of Iran from January 2008 to March 2009 for consideration as a case- series study. DNA was extracted from parasite infected whole blood samples. A polymorphic region of Plasmodium vivax merozoite surface protein 1 (pvMSP1) was selected and a PCR method was employed for all the samples to amplify the specific variable gene fragment. The obtained fragments in primary and secondary samples were sequenced. Both nucleotide and amino acid sequences of the samples were investigated for returned patients. Results: 3.2% of the patients experienced a second attack between 83-199 days after the initial episode of infection. Alignment of nucleotide and their deduced amino acid sequences between pair sequences of primary and secondary isolates revealed 8 and 6 dissimilarities respectively for the first case, and 9 and 7 dissimilarities for the second case. Although microscopical examination of recurrent thick blood smear of the third patient confirmed new P. vivax  infection, the venous blood sample was accidentally missed. Sequencing results of primary and returned isolates 1P, 1S, 2P, 2S and 3P in this study showed an identity with BP13, T117, BP13, TC28 and Chesson genotypes respectively. Conclusion: The returned (secondary) isolates may account to be for the sake of reinfection

Evaluation of Sensitivity of Plasmodium vivax to Chloroquine

&quot;nBackground: To monitor the current response of P. vivax to chloroquine in South and Southeast Iran.&quot;nMethods: The study was undertaken from August 2004 until August 2005 at the Bandar- Abbas, Iranshahr, Nikshahr and Chabahar districts. A total of 195 patients out of 225 parasitologically positive P. vivax cases completed the study .The patients were given a standard 3- day regimen of chloroquine and followed-up clinically and parasitologically accord&amp;shy;ing to the world Health Organization guideline with some modifications. Results of study were addressed as mean of parasite clearance time (MPCT). &quot;nResults: The patients responded to the regimen of chloroquine within 24-120 hours. The MPCTs of P. vivax for Ban&amp;shy;dar- Abbas, Iranshahr, Nikshahr and Chabahar districts were 63.05(&amp;plusmn;15.37), 56(&amp;plusmn; 21.7), 70.92 (&amp;plusmn;6.51) and 58(&amp;plusmn;14) hours, respectively and for the whole study area (South and South East of Iran) was 63.50(&amp;plusmn;15.84) hours. The results of the whole studied areas indicate that difference of MPCT between male and female patients is marginally significant (P=0.05).&quot;nConclusion: Although, parasite clearance time for a number of cases occurred within 96 and 120 hours, no P. vivax para&amp;shy;sites had reappeared in considered patients after day five within 28 days follow- up, reflecting that chloroquine is still an efficacious drug for the treatment of vivax malaria in the studied districts. Higher MPCT in Nikshahr district than the other districts indicating this could be an early sign for reduced susceptibility of the parasite to the drug