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Clinical Medicine & Research
Volume 4, Number 3 : 175 -179
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© 2006 Marshfield Clinic
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Original Research

Submicroscopic Plasmodium falciparum Infections Before and After Sulfadoxine-Pyrimethamine and Artesunate Association Treatment in Dienga, Southeastern Gabon

Fousseyni S. Touré, PhD, Jérôme Mezui-Me-Ndong, MS, Odile Ouwe-Missi-Oukem-Boyer, PhD, Benjamin Ollomo, PhD, Dominique Mazier, MD, PhD and Sylvie Bisser, MD, PhD

Fousseyni S. Touré, PhD, Centre International de Recherches Médicales de Franceville (CIRMF), BP 769 Franceville, Gabon.
Jérôme Mezui-Me-Ndong, MS, Centre International de Recherches Médicales de Franceville (CIRMF), BP 769 Franceville, Gabon.
Odile Ouwe-Missi-Oukem-Boyer, PhD, Centre International de Recherches Médicales de Franceville (CIRMF), BP 769 Franceville, Gabon.
Benjamin Ollomo, PhD, Centre International de Recherches Médicales de Franceville (CIRMF), BP 769 Franceville, Gabon.
Dominique Mazier, MD, PhD, INSERM U511, Immuno-Biologie Cellulaire et Moléculaire des Infections Parasitaires, Centre Hospitalier Universitaire Pitié-Salpêtrière, 91 Bd de l’Hôpital, 75013 Paris, France.
Sylvie Bisser, MD, PhD, Centre International de Recherches Médicales de Franceville (CIRMF), BP 769 Franceville, Gabon.

Reprint Requests: Fousseyni S. Touré, PhD, Centre International de Recherches Médicales de Franceville (CIRMF), BP 769 Franceville, Gabon. Tel: 00 241 677092; Fax: 00 241 677095; E-mail: fousseyni{at}yahoo.fr

Background: It has been shown that Plasmodium falciparum submicroscopic infections (SMI) can contribute to malaria-associated anemia as well as to cerebral malaria. Polymerase chain reaction (PCR) assays are usually used as an alternative to microscopy in detecting subpatently infected individuals.

Objectives:The main objective of this study was to investigate the occurrence of SMI before and after a suppressive antimalarial treatment in the population of the village of Dienga in Gabon.

Methods: Nested PCR was used to detect SMI and to determine genotypes.

Results:The prevalence rates of SMI were 13.67% (38/278) at day 0 and 8.99% (25/278) at day 14 after sulfadoxine-pyrimethamine-artesunate treatment. Genotype analysis of two polymorphic regions of the merozoite surface protein (MSP)-1 block 2, MSP-2 and a dimorphic region of the erythrocyte binding antigen (EBA-175) revealed that as many as 88% (22/25) of SMI detected after treatment were completely new alleles, indicating either previously sequestered parasites or newly acquired infections.

Conclusion: These results demonstrate the usefulness of sulfadoxine-pyrimethamine-artesunate association treatment in the population of Dienga and confirmed early parasite genotype change after a suppressive antimalarial treatment in endemic areas.

Key Words: Dienga, Gabon • Endemic area • PCR • Prevalence • Submicroscopic Plasmodium falciparum • Sulfadoxine-pyrimethamine-artesunate






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