Title : Detection of single nucleotide polymorphisms as biomarker of benzimidazole resistance in hookworms among HIV-positive and HIV-negative patients in Plateau State, Nigeria
Abstract:
Statement of Problem: Parasite control programs that rely on mass drug administration (MDA) over prolonged periods using the same antihelmintic drugs would exert selection pressure on hookworm populations and favour the development of drug resistance. Benzimidazole resistance in hookworms is characterized by occurrence of single nucleotide polymorphisms (SNPs) due to amino acid substitutions on β-tubulin isotype-1 gene. This cross-sectional study was conducted to determine the prevalence of hookworm infection and to detect benzimidazole resistance-associated SNPs in hookworms among HIV-positive and HIV-negative patients in Plateau State Nigeria.
Methodology and Theoritical Orientation: A total of 526 individuals were enrolled after consenting to participate in the study. Stool samples were collected and analysed for hookworm eggs using wet mount and formol-ether concentration techniques. Specimens confirmed to be hookworm-positive by microscopy were further subjected to molecular analyses on Real-Time qPCR. Moreover, a well-structured questionnaire was administered to each participant to obtain information on their biodata.
Findings: An overall hookworm prevalence of 6.46% (34/526); HIV-positive patients accounting for 3.62% (11/526), while HIV-negative patients had 10.36% (23/526). Out of the 34 samples positive by microscopy for hookworms, 16 were confirmed to be Necator americanus on qPCR. However, 5 out of the 16 samples were from HIV-positive patients, while 11 were from HIV-negative patients. Single nucleotide polymorphisms (SNP) were detected at codons 167 and 200 of N. americanus from two different samples. Occurrence of these SNPs were found only among HIV-negative patients.
Conclusion: The detection of SNPs indicates that boimarkers associated with benzimidazole resistance are in circulation in hookworms in Plateau State, Nigeria. The presence of SNPs within the population carries an unknown potential to impact the effectiveness and sustainability of use of benzimidazoles for the control of hookworm infections.
