In vitro efficacy of standard antimalarial drugs on parasitic isolates from patients with sickle cell disease (SCD) in Abidjan, Côte d'Ivoire
Résumé
Malaria infection triggers off vaso-occlusive attacks in sickle cell patients, leading drastically to death.
Sickle-cell patients use artemisinin-based combination therapies (ACTs) as recommended by the WHO
to treat malaria infections to prevent these crises. The survey of sensitivity of parasites collected from
sickle-cell patients needs is important to be re-specified. Red cells from these patients differ from
others in terms of redox potential and calcium flow. The aim of this study was to assess the in-vitro
efficacy of standard antimalarials used by this fragile population in order to find out a suitable medical
policy for them in Côte d'Ivoire. For this purpose, the standard isotope test for schizont maturation and
the Ring-stage survival assay were used to ascertain the in-vitro sensitivity of 116 Plasmodium
falciparum isolates from sickle cell patients, collected from Abidjan for dihydroartemisinin, chloroquine,
amodiaquine, quinine and luméfantrine. All the isolates exhibited different responses with the different
antimalarials. No cases of in-vitro resistance to Lumefantrine and Quinine were noticed, reappearance
of chloroquine-sensitive and a strong cross activity of chloroquine and dihydroartemisinin were
observed. Indeed, 87 (65.41%) isolates were dihydroartemisinin-sensitive in-vitro whereas 20 (15.04%)
had a resistants after exposure to 700 nM. The majority of clinical isolates non-responding to
dihydroartemisinin were from the sickle cell phenotype HbSS. To sum up, despite the decrease of the
in-vitro sensitivity of dihydroartemisinin on some sickle cell isolates, this molecule is still efficient.
However, it must be actively monitored by the National Malaria Control Programme, particularly for
sickle cell patients where a decrease in sensitivity was observed.
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