The spread of resistance to antimalarials is a major public health problem worldwide and especially in sub-Saharan Africa where the highest morbidity and mortality rates are found with a critical scarcity of data on r...The spread of resistance to antimalarials is a major public health problem worldwide and especially in sub-Saharan Africa where the highest morbidity and mortality rates are found with a critical scarcity of data on resistance. The objective of this review is to describe the mutations in the pfdhfr, pfdhps and k13 genes associated with resistance to artemisinin and Sulfadoxine-Pyrimethamine reported in West Africa during the decade 2007 to 2017 followed by a meta-analysis of their prevalence. A bibliographic search on the MEDLINE, PubMed, EMBASE and Sciences Direct databases made it possible to find 405 scientific papers relating to resistance to artemisinin and to Sulfadoxine-Pyrimethamine during the period 2007-2017. The analysis has concerned 217 scientific articles after the elimination of duplicates with 57 articles included in this review after the examination of titles and abstracts. The results of the present review show that the dhfr and dhps mutants are widespread in sub-Saharan Africa. Although, Kelch 13 mutants from Southeast Asia associated with artemisinin resistance are still absent in West Africa, studies have reported the presence of synonymous or non-K13 mutations correlated with a delay in parasite clearance in Burkina Faso (2.26%), Senegal (5.5%) and Togo (1.8%). The increased prevalence of dhfr and dhps mutants in West Africa could jeopardize its use for intermittent preventive treatment in the near future. Despite the absence of strains resistant to artemisinin-based combination therapy in the West African region, increased surveillance is necessary to prevent the rapid occurrence of possible resistance, especially in the context of synonymous or non-K13 mutations correlated with a delay in parasitic clearance.展开更多
文摘The spread of resistance to antimalarials is a major public health problem worldwide and especially in sub-Saharan Africa where the highest morbidity and mortality rates are found with a critical scarcity of data on resistance. The objective of this review is to describe the mutations in the pfdhfr, pfdhps and k13 genes associated with resistance to artemisinin and Sulfadoxine-Pyrimethamine reported in West Africa during the decade 2007 to 2017 followed by a meta-analysis of their prevalence. A bibliographic search on the MEDLINE, PubMed, EMBASE and Sciences Direct databases made it possible to find 405 scientific papers relating to resistance to artemisinin and to Sulfadoxine-Pyrimethamine during the period 2007-2017. The analysis has concerned 217 scientific articles after the elimination of duplicates with 57 articles included in this review after the examination of titles and abstracts. The results of the present review show that the dhfr and dhps mutants are widespread in sub-Saharan Africa. Although, Kelch 13 mutants from Southeast Asia associated with artemisinin resistance are still absent in West Africa, studies have reported the presence of synonymous or non-K13 mutations correlated with a delay in parasite clearance in Burkina Faso (2.26%), Senegal (5.5%) and Togo (1.8%). The increased prevalence of dhfr and dhps mutants in West Africa could jeopardize its use for intermittent preventive treatment in the near future. Despite the absence of strains resistant to artemisinin-based combination therapy in the West African region, increased surveillance is necessary to prevent the rapid occurrence of possible resistance, especially in the context of synonymous or non-K13 mutations correlated with a delay in parasitic clearance.
