Monitoring the resistance of Plasmodium falciparum to artemisinin: Evaluation of k13-propeller gene alleles in Bobo-Dioulasso, Burkina Faso

Abstract

The recent onset of artemisinin-resistant phenotype has raised new concerns about malaria treatment, threatening all efforts to control and eliminate the disease. Evaluation of alleles of the k13-propeller gene remains of paramount importance in monitoring the efficacy of artemisinin-based therapeutic combinations (ATC) in countries like Burkina Faso using of ATC. The biological samples from this study were collected from July to December 2012 in patients randomized 1:1 to receive Artemether-Lumefantrine (AL) or
Artesunate-Amodiaquine (AS-AQ) for the treatment of uncomplicated malaria in the urban health centers of Colsama and Sakaby at Bobo-Dioulasso. For all participants, blood drops were collected on filter paper on days 0, 1, 2, 3, 7, 14, 21, 28 and on any other day the participant felt sick. For parasites collected on day 0
prior to the treatment of participants at inclusion, we assessed the prevalence of mutations at the k13-propeller gene. A total of 228 participants were included in the nested PCR molecular analysis and
sequencing. At D28, PCR unadjusted therapeutic efficacy was 97.27 % for AS-AQ versus 86.48 % for AL while PCR adjusted therapeutic efficacy was 98.18% for AS-AQ and 89.19 % for AL. We founded baseline
prevalence of 2.26 % (5/221) of synonymous mutations in the k13-propeller gene precisely C469C, Y493Y, G496G and V589V. The results of this study demonstrated the absence of mutations on K13-propeller gene associated with artemisinin resistance in Southeast Asia suggesting therefore that ATCs remain efficacious in the treatment of uncomplicated malaria in Bobo-Dioulasso.