Caracterização epidemiológica e sensibilidade a antimaláricos tradicionais de isolados de Plasmodium spp. de Porto Velho, Amazônia ocidental, Brasil
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Sep 10, 2022
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Objetivo: Descrever o perfil epidemiológico dos pacientes infectados com malária em Porto Velho e a suscetibilidade do Plasmodium spp. a diferentes classes de medicamentos usados nos métodos de tratamento atuais. Métodos: 708 pacientes infectados com malária foram atendidos no Centro de Medicina Tropical de Porto Velho, onde responderam a questionários epidemiológicos padronizados. Mapas foram construídos usando informações do local de residência de 199 pacientes infectados. No ensaio de quimiossensibilidade, a concentração inibitória (CI50) de diidroartemisinina, cloroquina, mefloquina e lumefantrina foi avaliada pelo ensaio de maturação de esquizonte. Resultados: Maior prevalência de infecção por Plasmodium spp. entre homens, jovens, com episódios recorrentes de malária e moradores de área urbana. A espécie mais prevalente foi P. vivax seguida por P. falciparum. Quanto ao tratamento, observou-se que P. falciparum demonstrou resistência apenas à cloroquina (CQ) com mediana de IC50 (MD de CI50) = 119,8 nM, enquanto P. vivax demonstrou sensibilidade a todas as drogas (MD de CI50 < 10; 100; 30 ; e 150 nM para diidroartemisinina, CQ, mefloquina e lumefantrina, respectivamente). Conclusão: Este estudo contribui na compreensão da doença pelos órgãos públicos de saúde do município, na literatura e vigilância sobre quimiossensibilidade ao Plasmodium e para os processos decisórios dos gestores municipais.
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MedeirosD. S. S. de, FerreiraA. dos S., AlmeidaM. L., RossiN. R. D. L. P., BarbosaR. A. P., SantosA. P. A. dos, AguiarA. C. C., TadaM. S., PereiraD. B., & TelesC. B. G. (2022). Caracterização epidemiológica e sensibilidade a antimaláricos tradicionais de isolados de Plasmodium spp. de Porto Velho, Amazônia ocidental, Brasil. Revista Eletrônica Acervo Saúde, 15(9), e10745. https://doi.org/10.25248/reas.e10745.2022
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Referências
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12. DAHER A, et al. Efficacy and safety of artemisinin-based combination therapy and chloroquine with concomitant primaquine to treat Plasmodium vivax malaria in Brazil: an open label randomized clinical trial. Malaria Journal, 2018; 17: 1-11.
13. FERREIRA MU, CASTRO MC. Challenges for malaria elimination in Brazil. Malaria Journal, 2016; 15: 1-18.
14. GIL LHS, et al. Seasonal distribution of malaria vectors (Diptera: Culicidae) in rural localities of Porto Velho, Rondônia, brazilian amazon. Revista do Instituto de Medicina Tropical de São Paulo, 2015; 57: 263-267.
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19. LI J, et al. Ex vivo susceptibilities of Plasmodium vivax isolates from the China-Myanmar border to antimalarial drugs and association with polymorphisms in Pvmdr1 and Pvcrt-o genes. PLOS Neglected Tropical Diseases, 2020; 14: e0008255.
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24. OLIVEIRA-FERREIRA J, et al. Malaria in Brazil: an overview. Malaria Journal, 2010; 9: 1-15.
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26. PORTO VELHO. Secretaria Municipal de Saúde. Plano municipal de saúde de Porto Velho. 2018. Available from: https://semusa.portovelho.ro.gov.br/uploads/arquivos/2018/05/23266/1543936466pms-versao-oficial-pdf.pdf. Acessed on: 1 december 2021.
27. PRADINES B, et al. Prevalence of in vitro resistance to eleven standard or new antimalarial drugs among Plasmodium falciparum isolates from Pointe-Noire, Republic of the Congo. Journal of Clinical Microbiology, 2006; 44: 2404-2408.
28. PRATT-RICCIO LR, et al. Use of a colorimetric (DELI) test for the evaluation of chemoresistance of Plasmodium falciparum and Plasmodium vivax to commonly used anti-plasmodial drugs in the Brazilian Amazon. Malaria Journal, 2013; 12: 1-8.
29. SANTANA-FILHO FS, et al. Chloroquine-resistant Plasmodium vivax, Brazilian Amazon. Emerging Infectious Diseases, 2007; 13: 1125-1126.
30. SCHLOSSER AR, et al. Recurrence of Falciparum Malaria under Coartem Treatment in the City of Mâncio Lima, Acre, Brazil: A Retrospective Study. Asian Journal of Research in Infectious Diseases, 2020; 4: 1-10.
31. SIMOES LS, et al. Fatores associados às recidivas de malária causada por Plasmodium vivax no Município de Porto Velho, Rondônia, Brasil. Cadernos em Saúde Pública, 2014; 30: 1403-17.
32. SOUZA PF, et al. Spatial spread of malaria and economic frontier expansion in the Brazilian Amazon. PLoS One, 2019; 14: e0217615.
33. TAKLA M, JEEVARATNAM K. Chloroquine, hydroxychloroquine, and COVID-19: Systematic review and narrative synthesis of efficacy and safety. Saudi Pharmaceutical Journal, 2020; 28: 1760-1776.
34. VILLALOBOS-SALCEDO JM, et al. In-vivo sensitivity of Plasmodium vivax isolates from Rondônia (western Amazon region, Brazil) to regimens including chloroquine and primaquine. Annals of Tropical Medicine and Parasitology, 2000; 94: 749-758.
35. WORLD HEALTH ORGANIZATION (WHO). World malaria report 2019. World Health Organization. Geneva: WHO, 2019; 232 p.
2. ALEXANDRE MA, et al. Severe Plasmodium vivax malaria, Brazilian Amazon. Emerging Infectious Diseases, 2010; 16: 1611-1614.
3. ANGELO JR, et al. The role of spatial mobility in malaria transmission in the Brazilian Amazon: The case of Porto Velho municipality, Rondônia, Brazil (2010-2012). PLoS One, 2017; 12: e0172330.
4. ARAÚJO MS, et al. Natural Plasmodium infection in monkeys in the state of Rondônia (Brazilian Western Amazon). Malaria Journal, 2013; 12: 1-8.
5. ASHLEY EA, et al. Malaria. The Lancet, 2018; 391: 1608-1621.
6. BRASIL. Ministério da Saúde. Secretaria de Vigilância em Saúde. Guia de tratamento da malária no Brasil - Departamento de Imunização e Doenças Transmissíveis. 2a edição. Brasília: MS; 2021: 84 p.
7. BRASIL. Ministério da Saúde. Sistema de informação e vigilância epidemiológica em malária – SIVEP. Malária – Brasil. Public data. Avaliable from: http://200.214.130.44/sivep_malaria/. Acessed on: 1 december 2021.
8. BRAZILIAN INSTITUTE OF GEOGRAPHY AND STATISTICS. Porto Velho. 2020. Available from: https://www.ibge.gov.br/cidades-e-estados/ro/porto-velho.html. Acessed on: 1 december 2021.
9. CHAORATTANAKAWEE S, et al. Measuring ex vivo drug susceptibility in Plasmodium vivax isolates from Cambodia. Malaria Jorunal, 2017; 16: 1-13.
10. CHEHUAN YF, et al. In vitro chloroquine resistance for Plasmodium vivax isolates from the Western Brazilian Amazon. Malaria Journal, 2013 ;12: 1-5.
11. COCHRANE TT, COCHRANE TA. Diversity of the land resources in the Amazonian State of Rondônia, Brazil. Acta Amazonica, 2006; 36: 91-101.
12. DAHER A, et al. Efficacy and safety of artemisinin-based combination therapy and chloroquine with concomitant primaquine to treat Plasmodium vivax malaria in Brazil: an open label randomized clinical trial. Malaria Journal, 2018; 17: 1-11.
13. FERREIRA MU, CASTRO MC. Challenges for malaria elimination in Brazil. Malaria Journal, 2016; 15: 1-18.
14. GIL LHS, et al. Seasonal distribution of malaria vectors (Diptera: Culicidae) in rural localities of Porto Velho, Rondônia, brazilian amazon. Revista do Instituto de Medicina Tropical de São Paulo, 2015; 57: 263-267.
15. HALLAL PC. SOS Brazil: science under attack. The Lancet, 2021; 397: 373-374.
16. INSTITUTE OF MEDICINE. Committee on the Economics of Antimalarial Drugs. Saving Lives, Buying Time: Economics of Malaria Drugs in an Age of Resistance. Arrow KJ, Panosian C, Gelband H, editors. Washington (DC): National Academies Press (US); 2004.
17. KATSURAGAWA TH, et al. The Dynamics of transmission and spatial distribution of malaria in riverside areas of Porto Velho, Rondônia, in the Amazon region of Brazil. PLoS One, 2010; 5: e9245.
18. LANÇA EF, et al. Risk factors and characterization of Plasmodium vivax-associated admissions to pediatric intensive care units in the Brazilian Amazon. PLoS One, 2012; 7: e35406.
19. LI J, et al. Ex vivo susceptibilities of Plasmodium vivax isolates from the China-Myanmar border to antimalarial drugs and association with polymorphisms in Pvmdr1 and Pvcrt-o genes. PLOS Neglected Tropical Diseases, 2020; 14: e0008255.
20. LU F, et al. Return of chloroquine sensitivity to Africa? Surveillance of African Plasmodium falciparum chloroquine resistance through malaria imported to China. Parasites and Vectors, 2017; 10: 1-9.
21. MARFURT J, et al. Ex vivo activity of histone deacetylase inhibitors against multidrug-resistant clinical isolates of Plasmodium falciparum and P. vivax. Antimicrobial Agents and Chemotherapy, 2011; 55: 961-966.
22. MATHIEU LC, et al. Local emergence in Amazonia of Plasmodium falciparum k13 C580Y mutants associated with in vitro artemisinin resistance. Elife, 2020; 12: e51015.
23. MEO SA, et al. Efficacy of chloroquine and hydroxychloroquine in the treatment of COVID-19. European Review for Medical and Pharmacological Sciences, 2020; 24: 4539-4547.
24. OLIVEIRA-FERREIRA J, et al. Malaria in Brazil: an overview. Malaria Journal, 2010; 9: 1-15.
25. PEREIRA D, et al. Safety, efficacy and pharmacokinetic evaluations of a new coated chloroquine tablet in a single-arm open-label non-comparative trial in Brazil: a step towards a user-friendly malaria vivax treatment. Malaria Journal, 2016; 15: 1-10.
26. PORTO VELHO. Secretaria Municipal de Saúde. Plano municipal de saúde de Porto Velho. 2018. Available from: https://semusa.portovelho.ro.gov.br/uploads/arquivos/2018/05/23266/1543936466pms-versao-oficial-pdf.pdf. Acessed on: 1 december 2021.
27. PRADINES B, et al. Prevalence of in vitro resistance to eleven standard or new antimalarial drugs among Plasmodium falciparum isolates from Pointe-Noire, Republic of the Congo. Journal of Clinical Microbiology, 2006; 44: 2404-2408.
28. PRATT-RICCIO LR, et al. Use of a colorimetric (DELI) test for the evaluation of chemoresistance of Plasmodium falciparum and Plasmodium vivax to commonly used anti-plasmodial drugs in the Brazilian Amazon. Malaria Journal, 2013; 12: 1-8.
29. SANTANA-FILHO FS, et al. Chloroquine-resistant Plasmodium vivax, Brazilian Amazon. Emerging Infectious Diseases, 2007; 13: 1125-1126.
30. SCHLOSSER AR, et al. Recurrence of Falciparum Malaria under Coartem Treatment in the City of Mâncio Lima, Acre, Brazil: A Retrospective Study. Asian Journal of Research in Infectious Diseases, 2020; 4: 1-10.
31. SIMOES LS, et al. Fatores associados às recidivas de malária causada por Plasmodium vivax no Município de Porto Velho, Rondônia, Brasil. Cadernos em Saúde Pública, 2014; 30: 1403-17.
32. SOUZA PF, et al. Spatial spread of malaria and economic frontier expansion in the Brazilian Amazon. PLoS One, 2019; 14: e0217615.
33. TAKLA M, JEEVARATNAM K. Chloroquine, hydroxychloroquine, and COVID-19: Systematic review and narrative synthesis of efficacy and safety. Saudi Pharmaceutical Journal, 2020; 28: 1760-1776.
34. VILLALOBOS-SALCEDO JM, et al. In-vivo sensitivity of Plasmodium vivax isolates from Rondônia (western Amazon region, Brazil) to regimens including chloroquine and primaquine. Annals of Tropical Medicine and Parasitology, 2000; 94: 749-758.
35. WORLD HEALTH ORGANIZATION (WHO). World malaria report 2019. World Health Organization. Geneva: WHO, 2019; 232 p.