Impact of piperaquine resistance in Plasmodium falciparum on malaria treatment effectiveness in French Guiana: a descriptive epidemiological study
Issued Date
2023-01-01
Resource Type
ISSN
14733099
eISSN
14744457
Scopus ID
2-s2.0-85176413827
Pubmed ID
37858325
Journal Title
The Lancet Infectious Diseases
Rights Holder(s)
SCOPUS
Bibliographic Citation
The Lancet Infectious Diseases (2023)
Suggested Citation
Florimond C., de Laval F., Early A.M., Sauthier S., Lazrek Y., Pelleau S., Monteiro W.M., Agranier M., Taudon N., Morin F., Magris M., Lacerda M.V.G., Viana G.M.R., Herrera S., Adhin M.R., Ferreira M.U., Woodrow C.J., Awab G.R., Cox H., Ade M.P., Mosnier E., Djossou F., Neafsey D.E., Ringwald P., Musset L. Impact of piperaquine resistance in Plasmodium falciparum on malaria treatment effectiveness in French Guiana: a descriptive epidemiological study. The Lancet Infectious Diseases (2023). doi:10.1016/S1473-3099(23)00502-9 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/91115
Title
Impact of piperaquine resistance in Plasmodium falciparum on malaria treatment effectiveness in French Guiana: a descriptive epidemiological study
Author's Affiliation
Mahidol Oxford Tropical Medicine Research Unit
Université Paris Cité
Institut de recherche biomédicale des armées
Sciences Economiques et Sociales de la Santé et Traitement de l'Information Médicale
Anton de Kom Universiteit van Suriname
Centre Hospitalier Andree Rosemon
Instituto de Higiene e Medicina Tropical
Harvard T.H. Chan School of Public Health
Organisation Mondiale de la Santé
IMTSSA Institut de Médecine Tropicale du Service de Santé des Armées
Fiocruz Amazônia
Nuffield Department of Medicine
Universidade de São Paulo
Instituto Evandro Chagas
Universidade do Estado do Amazonas
Broad Institute
Ministry of Public Health
Amazonic Center for Research and Control of Tropical Diseases “Simón Bolívar”
Fundação de Medicina Tropical Dr. Heitor Vieira Dourado
CAUCASECO SCIENTIFIC RESEARCH CENTER
Malaria Vaccine and Drug Development Center
Ministry of Health
Université Paris Cité
Institut de recherche biomédicale des armées
Sciences Economiques et Sociales de la Santé et Traitement de l'Information Médicale
Anton de Kom Universiteit van Suriname
Centre Hospitalier Andree Rosemon
Instituto de Higiene e Medicina Tropical
Harvard T.H. Chan School of Public Health
Organisation Mondiale de la Santé
IMTSSA Institut de Médecine Tropicale du Service de Santé des Armées
Fiocruz Amazônia
Nuffield Department of Medicine
Universidade de São Paulo
Instituto Evandro Chagas
Universidade do Estado do Amazonas
Broad Institute
Ministry of Public Health
Amazonic Center for Research and Control of Tropical Diseases “Simón Bolívar”
Fundação de Medicina Tropical Dr. Heitor Vieira Dourado
CAUCASECO SCIENTIFIC RESEARCH CENTER
Malaria Vaccine and Drug Development Center
Ministry of Health
Other Contributor(s)
Abstract
Background: Plasmodium falciparum is an apicomplexan parasite responsible for lethal cases of malaria. According to WHO recommendations, P falciparum cases are treated with artemisinin-based combination therapy including dihydroartemisinin–piperaquine. However, the emergence of resistant parasites against dihydroartemisinin–piperaquine was reported in southeast Asia in 2008 and, a few years later, suspected in South America. Methods: To characterise resistance emergence, a treatment efficacy study was performed on the reported patients infected with P falciparum and treated with dihydroartemisinin–piperaquine in French Guiana (n=6, 2016–18). Contemporary isolates collected in French Guiana were genotyped for P falciparum chloroquine resistance transporter (pfCRT; n=845) and pfpm2 and pfpm3 copy number (n=231), phenotyped using the in vitro piperaquine survival assay (n=86), and analysed through genomic studies (n=50). Additional samples from five Amazonian countries and one outside the region were genotyped (n=1440). Findings: In field isolates, 40 (47%) of 86 (95% CI 35·9–57·1) were resistant to piperaquine in vitro; these phenotypes were more associated with pfCRTC350R (ie, Cys350Arg) and pfpm2 and pfpm3 amplifications (Dunn test, p<0·001). Those markers were also associated with dihydroartemisinin–piperaquine treatment failure (n=3 [50%] of 6). A high prevalence of piperaquine resistance markers was observed in Suriname in 19 (83%) of 35 isolates and in Guyana in 579 (73%) of 791 isolates. The pfCRTC350R mutation emerged before pfpm2 and pfpm3 amplification in a temporal sequence different from southeast Asia, and in the absence of artemisinin partial resistance, suggesting a geographically distinctive epistatic relationship between these genetic markers. Interpretation: The high prevalence of piperaquine resistance markers in parasite populations of the Guianas, and the risk of associated therapeutic failures calls for caution on dihydroartemisinin–piperaquine use in the region. Furthermore, greater attention should be given to potential differences in genotype to phenotype mapping across genetically distinct parasite populations from different continents. Funding: Pan American Health Organization and WHO, French Ministry for Research, European Commission, Santé publique France, Agence Nationale de la Recherche, Fundação de Amparo à Pesquisa do Estado do Amazonas, Ministry of Health of Brazil, Oswaldo Cruz Foundation, and National Institutes of Health. Translations: For the French and Portuguese translations of the abstract see Supplementary Materials section.