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Population genetics of Trypanosoma brucei gambiense in sleeping sickness patients with treatment failures in the focus of Mbuji-Mayi, Democratic Republic of the Congo.
- Source :
-
Infection, genetics and evolution : journal of molecular epidemiology and evolutionary genetics in infectious diseases [Infect Genet Evol] 2015 Mar; Vol. 30, pp. 128-133. Date of Electronic Publication: 2014 Dec 20. - Publication Year :
- 2015
-
Abstract
- Human African trypanosomiasis (HAT) in the Democratic Republic of the Congo (DRC) is caused by the protozoan Trypanosoma brucei gambiense. Until recently, all patients in the second or neurological stage of the disease were treated with melarsoprol. At the end of the past and the beginning of the present century, alarmingly high relapse rates in patients treated with melarsoprol were reported in isolated HAT foci. In the Mbuji-Mayi focus of DRC, a particular mutation that confers cross resistance for pentamidine and melarsoprol was recently found for all strains studied. Nevertheless, treatment successfully cured a significant proportion of patients. To check for the existence of other possible genetic factors of the parasites, we genotyped trypanosomes isolated from patients before and after treatment (relapsing patients) with eight microsatellite markers. We found no evidence of any genetic correlation between parasite genotype and treatment outcome and we concluded that relapse or cure probably depend more on patients' factors such as disease progression, nutritional or immunological status or co-infections with other pathogens. The existence of a melarsoprol and pentamidine resistance associated mutation at such high rates highlights an increasing problem, even for other drugs, especially those using the same transporters as melarsoprol and pentamidine.<br /> (Copyright © 2014 Elsevier B.V. All rights reserved.)
- Subjects :
- Animals
Antiprotozoal Agents pharmacology
Antiprotozoal Agents therapeutic use
Democratic Republic of the Congo epidemiology
Disease Models, Animal
Genetics, Population
Humans
Mice
Phylogeny
Treatment Failure
Trypanosomiasis, African epidemiology
Drug Resistance genetics
Trypanosoma brucei gambiense classification
Trypanosoma brucei gambiense drug effects
Trypanosoma brucei gambiense genetics
Trypanosomiasis, African drug therapy
Trypanosomiasis, African parasitology
Subjects
Details
- Language :
- English
- ISSN :
- 1567-7257
- Volume :
- 30
- Database :
- MEDLINE
- Journal :
- Infection, genetics and evolution : journal of molecular epidemiology and evolutionary genetics in infectious diseases
- Publication Type :
- Academic Journal
- Accession number :
- 25535944
- Full Text :
- https://doi.org/10.1016/j.meegid.2014.12.017