Persistence of Markers of Chloroquine Resistance in Plasmodium falciparum in Bangladesh

Johora, Fatema Tuj; Elahi, Rubayet; Nima, Maisha Khair; Hossain, Mohammad Sharif; Rashid, Humaira; Kibria, Mohammad Golam; Mohon, Abu Naser; Khan, Wasif Ali; Haque, Rashidul; Alam, Mohammad Shafiul

doi:10.4269/ajtmh.20-0415

Cited by 2 publications

(1 citation statement)

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“…In countries like Ethiopia where CQ drug pressure persists for the treatment of vivax malaria, high frequency of the mutant allele is being reported from Yemen [ 31 ], Malaysia [ 22 ], Nigeria [ 32 ], India [ 33 ], Bangladesh [ 34 ] and Angola [ 35 ]. Conversely, progressive decrease in 76T allele and recovery of K76 allele were documented particularly in sub-Saharan African countries such as Malawi [ 16 ] Tanzania [ 36 ], Kenya [ 37 ] and Uganda [ 38 ], where AL is being implemented.…”

Section: Discussionmentioning

confidence: 99%

High prevalence of Pfcrt 76T and Pfmdr1 N86 genotypes in malaria infected patients attending health facilities in East Shewa zone, Oromia Regional State, Ethiopia

Hassen

Alemayehu

Dinka

et al. 2022

Malar J

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Background Plasmodium falciparum resistance to series of anti-malarial drugs is a major challenge in efforts to control and/or eliminate malaria globally. In 1998, following the widespread of chloroquine (CQ) resistant P. falciparum, Ethiopia switched from CQ to sulfadoxine–pyrimethamine (SP) and subsequently in 2004 from SP to artemether–lumefantrine (AL) for the treatment of uncomplicated falciparum malaria. Data on the prevalence of CQ resistance markers after more than two decades of its removal is important to map the selection pressure behind the targets codons of interest. The present study was conducted to determine the prevalence of mutations in Pfcrt K76T and Pfmdr1 N86Y codons among malaria-infected patients from Adama, Olenchiti and Metehara sites of East Shewa zone, Oromia Regional State, Ethiopia. Methods Finger-prick whole blood samples were collected on 3MM Whatman ® filter papers from a total of 121 microscopically confirmed P. falciparum infected patients. Extraction of parasite DNA was done by Chelex-100 method from dried blood spot (DBS). Genomic DNA template was used to amplify Pfcrt K76T and Pfmdr1 N86Y codons by nested PCR. Nested PCR products were subjected to Artherobacter protophormiae-I (APoI) restriction enzyme digestion to determine mutations at codons 76 and 86 of Pfcrt and Pfmdr1 genes, respectively. Results Of 83 P. falciparum isolates successfully genotyped for Pfcrt K76T, 91.6% carried the mutant genotypes (76T). The prevalence of Pfcrt 76T was 95.7%, 92.5% and 84.5% in Adama, Metehara and Olenchiti, respectively. The prevalence of Pfcrt 76T mutations in three of the study sites showed no statistical significance difference (χ2 = 1.895; P = 0.388). On the other hand, of the 80 P. falciparum samples successfully amplified for Pfmdr1, all carried the wild-type genotypes (Pfmdr1 N86). Conclusion Although CQ officially has been ceased for the treatment of falciparum malaria for more than two decades in Ethiopia, greater proportions of P. falciparum clinical isolates circulating in the study areas carry the mutant 76T genotypes indicating the presence of indirect CQ pressure in the country. However, the return of Pfmdr1 N86 wild-type allele may be favoured by the use of AL for the treatment of uncomplicated falciparum malaria.

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