Contributors: Mère et enfant en milieu tropical : pathogènes, système de santé et transition épidémiologique (MERIT - UMR_D 216); Institut de Recherche pour le Développement (IRD)-Université Paris Descartes - Paris 5 (UPD5); PRES Sorbonne Paris Cité; Faculté de Pharmacie de Paris - Université Paris Descartes (UPD5 Pharmacie); Université Paris Descartes - Paris 5 (UPD5); Noguchi Memorial Institute for Medical Research Accra, Ghana (NMIMR); Université du Ghana = University of Ghana; Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE); Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR48; Institut des sciences biologiques - CNRS Biologie (INSB-CNRS)-Institut des sciences biologiques - CNRS Biologie (INSB-CNRS)-Centre National de la Recherche Scientifique (CNRS); Laboratoire de Recherche sur le Paludisme Yaoundé, Cameroon; Organisation de Coordination pour la lutte contre les Endémies en Afrique Centrale; Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques et émergentes (TransVIHMI); Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I (UY1)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Université Cheikh Anta Diop de Dakar Sénégal (UCAD); Prévention du Sida au Cameroun Yaoundé, Cameroon; Institut de Recherches Médicales et d’Études des Plantes Médicinales Yaoundé, Cameroon (IMPM); This work was supported by the French Agence Nationale de la Recherche (ANR, Programme Blanc 2011, SVSE3, PRIMAL) and the French Ministry of Research (Programme PAL+).
نبذة مختصرة : International audience ; Background: Chloroquine had been used extensively during the last five decades in Cameroon. Its decreasing clinical effectiveness, supported by high proportions of clinical isolates carrying the mutant pfcrt haplotype (CVIET), led the health authorities to resort to amodiaquine monotherapy in 2002 and artemisinin-based combination therapy (ACT) in 2004 (artesunate-amodiaquine, with artemether-lumefantrine as an alternative since 2006) as the first-line treatment of uncomplicated malaria. The aim of the present study was to investigate whether the withdrawal of chloroquine was associated with a reduction in pfcrt mutant parasite population and reemergence of chloroquinesensitive parasites in southeastern Cameroon between 2003 and 2012.Methods: The frequency of pfcrt haplotypes at positions 72-76 in Plasmodium falciparum isolates collected from individuals in 2003 and 2012 in southeastern Cameroon was determined by sequence specific oligonucleotide probes-enzyme linked immunosorbent assay (SSOP-ELISA). Results: The proportions of parasites carrying the mutant haplotype CVIET and the wild-type CVMNK were 53.0 and 28.0% in 2003, respectively. The proportion of the mutant haplotype in samples collected 9 years later decreased to 25.3% whereas the proportion of parasites carrying the wild-type CVMNK haplotype was 53.7%.Conclusions: Even though the proportion of chloroquine-sensitive parasites seems to be increasing in southeastern Cameroon, a reintroduction of chloroquine cannot be recommended at present in Cameroon. The current national anti-malarial drug policy should be implemented and reinforced to combat drug-resistant malaria.
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