[Pcr-rflp genotyping of pfcrt and pfmdr1 in plasmodium falciparum isolates from children in Vatomandry, Madagascar]. / Génotypage par pcr-rflp de pfcrt et pfmdr1 sur des isolats de plasmodium falciparum collectés chez des enfants de Vatomandry, Madagascar.

Background: Malaria is a parasitic disease caused by a hematozoan of the genus Plasmodium. Early diagnosis followed by effective treatment is one of the keys to control this disease. In Madagascar, after more than 60 years of use for the treatment of uncomplicated malaria, chloroquine (CQ) was abandoned in favor of artesunate + amodiaquine (ASAQ) combination because of high prevalence of CQ treatment failure. Surveillance based on the assessment of therapeutic efficacy and genetic markers of resistance to antimalarials is therefore essential in order to detect the emergence of potentially resistant parasites as early as possible. In this context, our study aimed to genotype the Plasmodium falciparum chloroquine resistance transporter gene or Pfcrt and Plasmodium falciparum multidrug resistance gene 1 or Pfmdr1 in isolates collected from children in the district of Vatomandry. Methods: A total of 142 P. falciparum isolates collected during active case detection of malaria in children under 15 years old, between February and March of 2016 and 2017 in Vatomandry district, were analyzed. Pfcrt (K76T codon) and Pfmdr1 (N86Y codon) genotyping was carried out by polymerase chain reaction followed by enzymatic digestion (restriction fragment length polymorphism) or PCR-RFLP. Results: The successful rates of amplification of Pfcrt and Pfmdr1 genes were low, around 27% and 39% respectively. The prevalence of isolates carrying the mutant Pfcrt K76T codon and the mutant Pfmdr1 N86Y codon was 2.6% [95% confidence interval (95% CI): 0.1 - 15.0%] and 36% [95% CI: 23.7 - 49.7%] respectively. Conclusion: Despite the limited number of samples analyzed, our study highlighted the circulation of isolates carrying both the mutant Pfcrt K76T and Pfmdr1 N86Y alleles. Although the prevalence of mutations in Pfcrt and Pfmdr1 genes that we observed was low, other studies should be carried out in order to follow the evolution of these markers in time and space. The use of more sensitive methods will better characterize P. falciparum strains circulating in Madagascar. Artesunate-amodiaquine is used as a first-line treatment for uncomplicated malaria in the country; it is also crucial to monitor the other codons, i.e. 184 and 1246 of the Pfmdr1 gene, implicated in the resistance of P. falciparum to amodiaquine in Africa.

DNA recovery from used malaria RDT to detect Plasmodium species and to assess Plasmodium falciparum genetic diversity: a pilot study in Madagascar.

BACKGROUND: Rapid diagnostic tests (RDT) are widely used for malaria diagnosis in Madagascar, where Plasmodium falciparum is the predominant species. Molecular diagnosis is essential for malaria surveillance, but requires additional blood samples for DNA extraction. Used RDTs is an attractive alternative that can be used as a source of DNA. Plasmodium falciparum genetic diversity and multiplicity of infection, usually determined by the genotyping of polymorphic regions of merozoite surface proteins 1 and 2 genes (msp1, msp2), and the repeated region RII of the glutamate-rich protein gene (glurp) have been associated with malaria transmission levels and subsequently with the impact of the deployed control strategies. Thus, the study aims to use RDT as DNA source to detect Plasmodium species, to characterize Plasmodium falciparum genetic diversity and determine the multiplicity of infection. METHODS: A pilot study was conducted in two sites with different epidemiological patterns: Ankazomborona (low transmission area) and Matanga (high transmission area). On May 2018, used RDT (SD BIOLINE Malaria Ag P.f/Pan, 05FK63) were collected as DNA source. Plasmodium DNA was extracted by simple elution with nuclease free water. Nested-PCR were performed to confirm Plasmodium species and to analyse P. falciparum msp1, msp2 and glurp genes polymorphisms. RESULTS: Amongst the 170 obtained samples (N = 74 from Ankazomborona and N = 96 from Matanga), Plasmodium positivity rate was 23.5% (40/170) [95% CI 17.5-30.8%] by nested-PCR with 92.2% (37/40) positive to P. falciparum, 5% (2/40) to Plasmodium vivax and 2.5% (1/40) to P. falciparum/P. vivax mixed infection. Results showed high polymorphisms in P. falciparum msp1, msp2 and glurp genes. Multiple infection rate was 28.6% [95% CI 12.2-52.3%]. The mean of MOI was 1.79 ± 0.74. CONCLUSION: This pilot study highlighted that malaria diagnosis and molecular analysis are possible by using used malaria RDT. A large-scale study needs to be conducted to assess more comprehensively malaria parasites transmission levels and provide new data for guiding the implementation of local strategies for malaria control and elimination. Trial registration Retrospectively registered.

Characterization of Klebsiella pneumoniae isolated from patients suspected of pulmonary or bubonic plague during the Madagascar epidemic in 2017.

Klebsiella pneumoniae can lead to a wide range of diseases including pneumonia, bloodstream and urinary tract infections. During a short period of a pulmonary plague epidemic in October 2017 in Madagascar, 12 K. pneumoniae isolates were identified in ten sputum and two buboes aspirate samples. These isolates were from 12 patients suspected of plague, without epidemiological relationships, but were negative for Yersinia pestis in culture. Data were collected from the plague national surveillance system. The isolates were characterized by antimicrobial susceptibility testing and whole-genome sequencing. Real-time PCR was performed to confirm the presence of K. pneumoniae DNA in buboes. All isolates were identified as K. pneumoniae sensu stricto. Five isolates were extended-spectrum ß-lactamases producers; eleven different sequence types were identified. Five isolates belonged to known hypervirulent sequence types. Our results demonstrate community-acquired pneumonia caused by K. pneumoniae isolates in patients suspected of plague stressing the importance of bed-side differential diagnosis.

Phytochemical Composition, Antibacterial Activity, and Antioxidant Properties of the Artocarpus altilis Fruits to Promote Their Consumption in the Comoros Islands as Potential Health-Promoting Food or a Source of Bioactive Molecules for the Food Industry.

The present study aimed to evaluate the health-promoting potential of breadfruit (Artocarpus altilis (Parkinson) Fosberg, Moraceae family), a traditional Comorian food, considering the sample variability according to geographic localisation. Moreover, the main aims of this research were also to promote its consumption in the Comoros Islands as potential health-promoting food and evaluate it as a source of bioactive molecules for the food industry thanks to its antioxidant and antibacterial properties. Investigations on biologically active substances were carried out on the extracts obtained from breadfruit flours from five regions of Grande Comore (Ngazidja), the main island in Comoros. Phytochemical screening revealed the presence of tannins and polyphenols, flavonoids, leucoanthocyanins, steroids, and triterpenes. The considered secondary metabolites were phenolic compounds, vitamin C, monoterpenes, and organic acids. The contents of total phenolic compounds (mgGAE/100 g of dry weight-DW) in the extracts ranged from 29.69 ± 1.40 (breadfruit from Mbadjini-ExMBA) to 96.14 ± 2.07 (breadfruit from Itsandra-ExITS). These compounds included flavanols, flavonols, cinnamic acid and benzoic acid derivatives, and tannins which were detected at different levels in the different extracts. Chlorogenic acid presented the highest levels between 26.57 ± 0.31 mg/100 g DW (ExMIT) and 43.80 ± 5.43 mg/100 g DW (ExMBA). Quercetin was by far the most quantitatively important flavonol with levels ranging from 14.68 ± 0.19 mg/100 g DW (ExMIT) to 29.60 ± 0.28 mg/100 g DW (ExITS). The extracts were also rich in organic acids and monoterpenes. Quinic acid with contents ranging from 77.25 ± 6.04 mg/100 g DW (ExMBA) to 658.56 ± 0.25 mg/100 g DW of ExHAM was the most important organic acid in all the breadfruit extracts, while limonene was quantitatively the main monoterpene with contents between 85.86 ± 0.23 mg/100 g DW (ExMIT) and 565.45 ± 0.24 mg/100 g DW (ExITS). The antibacterial activity of the extracts was evaluated on twelve pathogens including six Gram (+) bacteria and six Gram (-) bacteria. By the solid medium disc method, except for Escherichia coli and Pseudomonas aeruginosa, all the bacteria were sensitive to one or more extracts. Inhibitory Halo Diameters (IHDs) ranged from 8 mm to 16 mm. Salmonella enterica, Clostridium perfringens, and Vibrio fischeri were the most sensitive with IHD > 14 mm for ExITS. By the liquid microdilution method, MICs ranged from 3.12 mg/mL to 50 mg/mL and varied depending on the extract. Bacillus megaterium was the most sensitive with MICs ≤ 12.5 mg/mL. Pseudomonas aeruginosa, Shigella flexneri, and Vibrio fischeri were the least sensitive with all MICs ≥ 12.5 mg/mL. ExHAM was most effective with a MIC of 3.12 mg/mL on Staphylococcus aureus and 6.25 mg/mL on Salmonella enterica. The antioxidant power of the extracts was evaluated by the FRAP method. The activity ranged from 5.44 ± 0.35 (ExMBA) to 14.83 ± 0.11 mmol Fe2+/kg DW (ExHAM). Breadfruit from different regions of Comoros contained different classes of secondary metabolites well known for their important pharmacological properties. The results of this study on phenolics, monoterpenes, and organic acids have provided new data on these fruits. The obtained results showed that breadfruit from the biggest island of the Union of Comoros also presented antimicrobial and antioxidant properties, even if some differences in effectiveness existed between fruits from different regions.

Pyrrolizidine-Derived Alkaloids: Highly Toxic Components in the Seeds of Crotalaria cleomifolia Used in Popular Beverages in Madagascar.

Seeds of Crotalaria cleomifolia (Fabaceae) are consumed in Madagascar in preparation of popular beverages. The investigation of extracts from the seeds of this species revealed the presence of high amounts of alkaloids from which two pyrrolizidine-derived alkaloids were isolated. One of them was fully characterized by spectroscopic and spectrometric methods, which was found to be usaramine. Owing to the high toxicity of these alkaloids, issuing a strong warning among populations consuming the seeds of Crotalaria cleomifolia must be considered.

Genetic diversity of Plasmodium falciparum populations in three malaria transmission settings in Madagascar.

BACKGROUND: Assessment of the genetic diversity of Plasmodium falciparum parasites from various malaria transmission settings could help to define tailored local strategies for malaria control and elimination. Such assessments are currently scarce in Madagascar. The study presented here aimed to bridge this gap by investigating the genetic diversity of P. falciparum populations in three epidemiological strata (Equatorial, Tropical and Fringes) in Madagascar. METHODS: Two-hundred and sixty-six P. falciparum isolates were obtained from patients with uncomplicated malaria enrolled in clinical drug efficacy studies conducted at health centres in Tsaratanana (Equatorial stratum), Antanimbary (Tropical stratum) and Anjoma Ramartina (Fringes) in 2013 and 2016. Parasite DNA was extracted from blood samples collected before anti-malarial treatment. Plasmodium species were identified by nested PCR targeting the 18 S rRNA gene. The genetic profiles of P. falciparum parasites were defined by allele-specific nested PCR on the polymorphic regions of the msp-1 and msp-2 genes. RESULTS: Fifty-eight alleles were detected in the P. falciparum samples tested: 18 alleles for msp-1 and 40 for msp-2. K1 (62.9%, 139/221) and FC27 (69.5%, 114/164) were the principal msp-1 and msp-2 allele families detected, although the proportions of the msp-1 and msp-2 alleles varied significantly between sites. Polyclonal infections were more frequent at sites in the Equatorial stratum (69.8%) than at sites in the Tropical stratum (60.5%) or Fringes (58.1%). Population genetics analyses showed that genetic diversity was similar between sites and that parasite flow within sites was limited. CONCLUSIONS: This study provides recent information about the genetic diversity of P. falciparum populations in three transmission strata in Madagascar, and valuable baseline data for further evaluation of the impact of the control measures implemented in Madagascar.

Physicochemical and microbiological characteristics of kitoza, a traditional salted/dried/smoked meat product of Madagascar.

Kitoza samples collected from producers in Madagascar were analyzed for their physicochemical and microbial properties. Lactic acid bacteria and coagulase-negative staphylococci were the two codominant populations with average counts of 6-7 log cfu/g. Good hygienic practices were sometimes lacking but samples were not contaminated with Salmonella, Clostridium perfringens, and Bacillus cereus and only once with Listeria monocytogenes. Staphylococcus aureus was found occasionally with higher counts in salted/dried products than in salted/smoked products. Moisture, protein, fat, and salt contents varied considerably and were on average 41.5, 43.5, 14.3, and 3.3 g/100 g, respectively, and water activity was 0.893 on average. Smoked kitoza showed higher moisture content compared to dried kitoza. Most of the smoked kitoza had a water activity higher than 0.9 which is not in accordance with their storage at ambient temperatures. Benzo(a)pyrene content was above 2 µg/kg in 11 out of 30 smoked samples (17 ± 16.5 µg/kg on average).

Staphylococcal ecosystem of kitoza, a traditional malagasy meat product.

Kitoza is a traditional meat product from Madagascar manufactured with strips of pork or beef. The process includes a first step of salting and mixing with spices followed by sun-drying or smoking step. As salting and drying select coagulase-negative staphylococci (CNS), our aim was to identify the CNS species in kitoza with the objective in the future of developing indigenous starters. Microbial analyses revealed that the only pathogenic bacterium enumerated was Staphylococcus aureus, which was found in 54% of the samples. The level of Enterobacteriaceae revealed a rather good hygienic quality of these products. CNS were confirmed in all the samples at high levels ranging from 5 to 7logcfu/g. Identification of CNS species in a large collection of 829 isolates revealed 9 identified species, 7 for beef and 8 for pork kitoza. There were significant difference in the distribution of CNS species according to the type of meat and the process. Staphylococcus saprophyticus was the dominant species for sun-dried or smoked beef and sun-dried pork kitoza (73-75%), while for smoked pork kitoza Staphylococcus equorum (26%), S. saprophyticus (23%), Staphylococcus succinus (23%) and Staphylococcus epidermidis (17%) co-dominated. Some CNS could be used as indigenous starters in particular to compete against S. aureus.

Chemical composition of the pods of Albizia polyphylla.

In this study, we report for the first time the presence of alkaloids belonging to ß-carboline type in the pods of the endemic Albizia polyphylla from Madagascar. Three major alkaloids were isolated and structurally identified as: 1-methyl-ß-carboline, (+)-(R)-1-methyl-1,2,3,4-tetrahydro-ß-carboline and (-)-(S)-1,2-dimethyl-1,2,3,4-tetrahydro-ß-carboline.

Marked toxicity of Albizia bernieri extracts on embryo-larval development in the medaka fish (Oryzias latipes).

Previous phytochemical studies have shown that the plants of the Albizia genus (Fabaceae) contain bioactive saponins, lignans, spermine alkaloids, flavonoids, glycosides phenols and pyridoxine derivatives. Their extracts sometimes display medical properties, but can have also toxic effects. The purpose of our study was to determine the in vivo toxicity of Albizia bernieri seeds in the experimental model of the medaka fish embryo, which is recommended for use in toxicity studies. Our results show clearly that incubating the embryos or larvae of the medaka fish in a medium containing A. bernieri extracts caused a dose-dependent reduction in embryo or larvae survival. Embryos exposed to an extract of A. bernieri displayed cerebral lesions, such as cell lysis and the emergence of lysosomes in the glial tissue. We conclude that when comparing with data obtained with different plant extracts tested on medaka development in our laboratory, A. bernieri displays an unusually high toxicity. Focussing on the cerebral target as well as the fish behaviour could bring more specific informations.

Clerodane and 19-norclerodane diterpenoids from the tubers of Dioscorea antaly.

Two clerodane diterpenoids, antadiosbulbins A and B and two 19-norclerodane diterpenes, 8-epidiosbulbins E and G along with the known diosbulbin E as well as nine known phenolics including five phenanthrenes and stilbenes and four flavonoids were isolated from the ethyl acetate soluble part of the methanolic extract of the tubers of Dioscorea antaly, a yam endemic to Madagascar. Structures were determined by analysis of the spectral data, mainly 2D-NMR and mass spectrometry.

Effects of Madagascar yam extracts, Dioscorea antaly, on embryo-larval development of medaka fish, Oryzias latipes.

The yams edible starchy tubers, are of cultural, economic and nutritional importance in tropical and subtropical regions. The present study concerns the analysis at different levels of Dioscorea antaly toxicity to medaka embryo-larval development. The incubation of medaka fish embryos in a medium containing Dioscorea antaly extract resulted in a dose dependent reduction in survival rate. Survival rates were reduced up to 100% with extract concentrations of 4mg mL(-1). The LD(50) was estimated to be 0.86mg mL(-1)Dioscorea antaly. Anatomopathological studies did not show any caustic effects, irritation to mouth, throat or intestinal tract in surviving embryos but rather an inflammatory reaction in the liver. The data presented in this paper thus extends the use of medaka embryos as a valuable model to analyze the effects of food toxins.

Effects of Rhodocodon madagascariensis extracts on embryo-larval development of medaka fish, Oryzias latipes.

Rhodocodon madagascariensis, also named Urginea mascarenensis, is a malagasy plant belonging to the Hyacinthaceae family. As for the other members of the endemic malagasy genus Rhodocodon, the chemical and toxicological properties of this species have not yet been studied. The present study concerns the analysis of the toxicity of R. madagascariensis to medaka embryo-larval development. The incubation of medaka fish embryos or larvae in a medium containing R. madagascariensis extract resulted in a dose dependent reduction in development of embryos leading to lethality and a drastic reduction in survival rate of exposed larvae. Survival rates were reduced up to 100% with an extract concentration of 4 mg mL(-1). The LD(50) was estimated to be 1 mg mL(-1). Anatomopathological studies did show some neuro-embryonal modifications in the encephalic region. The data presented in this paper thus extends the use of medaka embryos as a valuable model to detect and analyse the effects of plant toxins.