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Efficacité thérapeutique de l’association artésunateamodiaquine et polymorphisme des gènes dihydrofolate réductase, dihydroptéroate synthétase et kelch 13 propeller à Pala (République du Tchad)

Abstract : Malaria remains one of the most important public health challenges in the world. Consequences are dramatic in pregnant women as in children under 5 years. Ministry of Public Health of Chad recommends artemisinin-based combination therapies as first line treatment in uncomplicated falciparum malaria. Sulfadoxine-Pyrimethamine is the main drug for intermittent preventive treatment (IPT) in pregnant women and seasonal chemeprophyxis in infants in combination with amodiquine. The main objective of this work was to evaluate firstly the therapeutic efficacy of artesunate-amodiaquine (ASAQ) during uncomplicated malaria P. falciparum in Pala and secondly to determine the prevalence of molecular markers resistance of P. falciparum to Sulfadoxine-Pyrimethamine (SP) and artemisinin. The study was conducted from November to December 2015 in children under 59 months. 28-day WHO protocol was used. A total of 58 children were included in the clinical trial, and 51 among this population completed the study up to 28 days. Results showed a good efficacy and tolerability of ASAQ in the study population. Only one case of treatment failure at D28 has been reported. After PCR correction, ACPR was 100%. Molecular markers of SP, after the sequence analysis, results showed more wild alleles than mutants. Triple mutant dhfr and the double mutant dhps were observed in respectively, 3.3% and 6.7% isolates. Quadruple mutant was relatively small (3.3%). quintuple mutant was not reported. K13-propeller gene, no mutations (synonymous, not synonymous) were observed.
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Mahamat Souleymane Issa. Efficacité thérapeutique de l’association artésunateamodiaquine et polymorphisme des gènes dihydrofolate réductase, dihydroptéroate synthétase et kelch 13 propeller à Pala (République du Tchad). Parasitologie. Université Félix Houphouët-Boigny (Abidjan, Côte d'Ivoire), 2018. Français. ⟨tel-02387676⟩

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