Biology subjects

Kabanywanyi, A. M.

Publications and source records attributed to Kabanywanyi, A. M..

4 recordsLinked to original sources

bioRxiv2021

P. falciparum K13 mutations present varying degrees of artemisinin resistance and reduced fitness in African parasites

The emergence of artemisinin (ART) resistance in Plasmodium falciparum parasites, driven by K13 mutations, has led to widespread antimalarial treatment failure in Southeast Asia. In Africa, our genotyping of 3,299 isolates confirms the emergence of the K13 R561H variant in Rwanda and reveals the continuing dominance of wild-type K13 across 11 countries. We show that this mutation, along with M579I and C580Y, confers varying degrees of in vitro ART resistance in African parasites. C580Y and M579I cause substantial fitness costs, which may counter-select against their dissemination in high-transmission settings. We also define the impact of multiple K13 mutations on ART resistance and fitness in multiple Southeast Asian strains. ART susceptibility is unaltered upon editing point mutations in ferrodoxin or mdr2, earlier resistance markers. These data point to the lack of an evident biological barrier to mutant K13 mediating ART resistance in Africa, while identifying their detrimental impact on parasite growth.

physiology↗

bioRxiv2021

Plasmodium falciparum K13 mutations in Africa and Asia present varying degrees of artemisinin resistance and an elevated fitness cost in African parasites

The emergence of artemisinin (ART) resistance in Plasmodium falciparum parasites has led to increasing rates of treatment failure with first-line ART-based combination therapies (ACTs) in Southeast Asia. In this region, select mutations in K13 can result in delayed parasite clearance rates in vivo and enhanced survival in the ring-stage survival assay (RSA) in vitro. Our genotyping of 3,299 P. falciparum isolates across 11 sub-Saharan countries reveals the continuing dominance of wild-type K13 and confirms the emergence of a K13 R561H variant in Rwanda. Using gene editing, we provide definitive evidence that this mutation, along with M579I and C580Y, can confer variable degrees of in vitro ART resistance in African P. falciparum strains. C580Y and M579I were both associated with substantial fitness costs in African parasites, which may counter-select against their dissemination in high-transmission settings. We also report the impact of multiple K13 mutations, including the predominant variant C580Y, on RSA survival rates and fitness in multiple Southeast Asian strains. No change in ART susceptibility was observed upon editing point mutations in ferrodoxin or mdr2, earlier associated with ART resistance in Southeast Asia. These data point to the lack of an evident biological barrier to mutant K13 mediating ART resistance in Africa, while identifying their detrimental impact on parasite growth.

microbiology↗

bioRxiv2020

Describing the current status of Plasmodium falciparum population structure and drug resistance within mainland Tanzania using molecular inversion probes

High-throughput Plasmodium genomic data is increasingly useful in assessing prevalence of clinically important mutations and malaria transmission patterns. Understanding parasite diversity is important for identification of specific human or parasite populations that can be targeted by control programs, and to monitor the spread of mutations associated with drug resistance. An up-to-date understanding of regional parasite population dynamics is also critical to monitor the impact of control efforts. However, this data is largely absent from high-burden nations in Africa, and to date, no such analysis has been conducted for malaria parasites in Tanzania country-wide. To this end, over 1,000 P. falciparum clinical isolates were collected in 2017 from 13 sites in seven administrative regions across Tanzania, and parasites were genotyped at 1,800 variable positions genome-wide using molecular inversion probes. Population structure was detectable among Tanzanian P. falciparum parasites, roughly separating parasites from the northern and southern districts and identifying genetically admixed populations in the north. Isolates from geographically close districts were more likely to be genetically related compared to parasites sampled from more distant districts. Known drug resistance mutations were seen at increased frequency in northern districts, and additional variants with undetermined significance for antimalarial resistance also varied by geography. Malaria Indicator Survey (2017) data corresponded with genetic findings, including average region-level complexity-of-infection and malaria prevalence estimates. The parasite populations identified here provide important information on extant spatial patterns of genetic diversity of Tanzanian parasites, to which future surveys of genetic relatedness can be compared. SIGNIFICANCEDocumenting dynamics of malaria parasite genomics in high-transmission settings at scale in sub-Saharan Africa is critical for policy and decision making to support ongoing malaria elimination initiatives. Using molecular inversion probes, we genotyped over 1,000 Tanzanian Plasmodium falciparum samples collected country-wide in 2017 at hundreds of variable polymorphic positions across the genome. Frequencies of known drug resistance mutations were higher in northern districts of the country compared to the south. Results also showed a distinct isolation-by-distance pattern (whereby increasing geographic distance was correlated with decreasing genetic relatedness), as well as signals of higher genetic sharing between several southern districts. These results provide, for the first time, a picture of current within-country diversity of Tanzanian P. falciparum populations.

genomics↗

bioRxiv2019

Comparative palatability of orally disintegrating tablets (ODTs) of Praziquantel (L-PZQ and Rac-PZQ) versus current PZQ tablet in African children: a randomized, single-blind, crossover study

BackgroundPraziquantel (PZQ) is currently the only recommended drug for infection and disease caused by the species of schistosome infecting humans; however, the current tablet formulation is not suitable for preschool age children mainly due to its bitterness and the size of the tablet. We assessed the palatability of two new orally disintegrating tablet (ODT) formulations of PZQ.\n\nMethodsThis randomized, single-blind, crossover, swill-and-spit palatability study (NCT02315352) was carried out at a single school in Tanzania in children aged 6-11 years old, irrespective of schistosomiasis infection. Children were stratified according to age group (6-8 years or 9-11 years) and gender, then randomized to receive each formulation in a pre-specified sequence. Over 2 days, the children assessed the palatability of levo-Praziquantel (L-PZQ) ODT 150 mg and Racemate Praziquantel (Rac-PZQ) ODT 150 mg disintegrated in the mouth without water on the first day, and L-PZQ and Rac-PZQ dispersed in water and the currently available PZQ 600 mg formulation (PZQ-Cesol(R)) crushed and dispersed in water on the second day. The palatability of each formulation was rated using a 100 mm visual analogue scale (VAS) incorporating a 5-point hedonic scale, immediately after spitting out the test product (VASt=0 primary outcome) and after 2-5 minutes (VASt=2-5).\n\nFindingsIn total, 48 children took part in the assessment. Overall, there was no reported difference in the VASt=0 between the two ODT formulations (p=0.106) without water. Higher VASt=0 and VASt=2-5 scores were reported for L-PZQ ODT compared with Rac-PZQ ODT in older children (p=0.046 and p=0.026, respectively). The VASt=0 and VASt=2-5 were higher for both ODT formulations compared with the current formulation (p<0.001 for both time points). No serious adverse events were reported.\n\nInterpretationThe new paediatric-friendly formulations dispersed in water were both found to be more palatable than the existing formulation of PZQ. There may be gender and age effects on the assessment of palatability.\n\nFundingThis study was funded by Merck KGaA, Darmstadt, Germany and the Global Health Innovative Technology (GHIT) Fund (Grant nos. 2013-212).\n\nAuthor summarySchistosomiasis or Bilharzia is among top debilitating parasitic diseases in endemic developing countries. It presents in two forms of either urinary or intestinal form. The diseases mode of transmission is waterborne through contact with infested water. The main group being affected in developing countries are women and children due to their frequent contact with water. WHO introduced mass drug administration program whereby drugs are distributed in endemic communities to cut off the transmission of NTDs schistosomiasis included.\n\nPraziquantel is the sole drug for treatment of all forms of Schistosomiasis currently and it has still been proven to be highly efficacious. Preventive chemotherapy program of WHO uses the same drug as a prophylactic tool to control the disease.\n\nThe biggest challenge for this drug is its availability as a 600mg tablet with a slightly bigger size and unpleasant taste, especially for younger children. This makes uneasy administering the correct dosage of drug to school children while making preschoolers totally neglected.\n\nThis study was done as swill and spit exercise (drug was not ingested) to assess the new orally disintegrating isomers of Praziquantel, L-PZQ and Rac-PZQ which have been prepared as a 150mg tablet and improved taste as compared to the existing Praziquantel formulation. Findings from 48 African children showed that both new formulations are more palatable to younger children as compared to the existing Praziquantel formulation.\n\nThese results provide evidence for further evaluation of the clinical efficacy and tolerability of the newer formulations towards the introduction of paediatric friendly Praziquantel tablets for Schistosomiasis treatment.

epidemiology↗