ABSTRACT
Objective To assess the occurrence and pattern of Toll-like receptor 4 (TLR4) co-segregated genotypes among children with Plasmodium falciparum malaria in Nigeria. Methods In this case-control study, a total of 79 Plasmodium falciparum infected children aged 2–7 years and 105 age-matched uninfected controls of Yoruba descents in Lagos were studied. The extracted DNA samples were used for TLR4 genotyping at codons 299 (Asp > Gly) and 399 (Thr > Ile) by PCR-restriction fragment length polymorphism. Malaria infection was diagnosed by blood smear microscopy and infected children were stratified into asymptomatic, uncomplicated and severe malaria sub-groups. Malnutrition was determined by measuring the mid upper arm circumference and anemia was defined as hemoglobin 0.05) in frequency between infected and non-infected children. However, low and high occurrences of the TLR4 Asp299Asp/Thr399Thr and Asp299Gly/Thr399Thr genotypes were observed in the severe malaria subgroup. Conclusions This study reveals a protective role for TLR4 Asp299Gly/Thr399Ile and Asp299Asp/Thr399Thr genotypes against severe malaria in Nigerian children.
ABSTRACT
To assess N51I, C59R and S108N polymorphisms of dihydrofolate reductase [dhfr] and A437G and K540E of dihydropteroate synthase [dhps] genes of P. falciparum isolates recovered from pregnant women with asymptomatic malaria in a coastal setting in Nigeria. A total of 107 consenting and consecutively enrolled pregnant women [mean age +/- standard deviation, 26.6 +/- 4.5 years] attending antenatal care at the Iru/Victoria Island Primary Health Centre, Lagos, were screened for peripheral malaria by microscopy, by a histidine-rich protein-2-based rapid diagnostic test [RDT]] and by polymerase chain reaction [PCR] using finger-pricked and dot blood samples. DNA was extracted from the blood and used for dhfr and dhps gene polymorphism analyses by PCR and restriction fragment length polymorphism. The sociodemographic and parasite data obtained were analysed. Of the 107 patients, 34 [31.8%], 46 [43%] and 40 [37.4%] were found to be P. falciparum infected using microscopy, RDT and corrected RDT-PCR, respectively [p < 0.05]. The prevalence of P. falciparum isolates with mutant and mixed genotypes of dhfr at codons 51, 59 and 108 was 70, 75 and 80%, respectively, and the triple mutation in the homozygous form was 35%. The prevalence of the homozygous quintuple dhfr plus dhps mutant was 5%, while that of the P. falciparum isolates with mutant or mixed genotypes of dhps at codons 437 and 540 was 37.5 and 22.5%, respectively. This study revealed the emergence of the K540E mutation among the parasite population in Lagos. However, it supports the implementation of the intermittent preventive treatment of malaria during pregnancy with sulphadoxine-pyrimeth-amine with continuous effectiveness monitoring in the Study area