Prevalence of mutation and phenotypic expression associated with sulfadoxine-pyrimethamine resistance in Plasmodium falciparum and Plasmodium vivax

Abstract

therapeutic efficacy of sulfadoxine-pyrimethamine (sP), which is commonly used to treat falciparum malaria, was assessed in isolates of Plasmodium falciparum (Welch, 1897) and Plasmodium vivax (grassi et Feletti, 1890) of Aligarh, Uttar Pradesh, North india and taif, saudi Arabia during 2011-2012. Both the species showed mutations in dihydrofolate reductase (DHFr) enzyme as they have common biochemical drug targets. Mutation rate for pfdhfr was higher compared to pvdhfr because the drug was mainly given to treat falciparum malaria. since both the species coexist, P. vivax was also exposed to sP due to faulty species diagnosis or medication without specific diagnosis. low level of mutations against sP in P. falciparum of saudi isolates indicates that the sP combination is still effective for the treatment of falciparum malaria. since sP is used as first-line of treatment because of high level of resistance against chloroquine (cQ), it may result in spread of higher level of mutations resulting in drug resistance and treatment failure in near future. therefore, to avoid further higher mutations in the parasite, use of better treatment regimens such as artesunate combination therapy must be introduced against sP combination.

Polymorphisms in Plasmodium vivax antifolate resistance markers in Afghanistan between 2007 and 2017

“…These findings agree with previously published reports showing low prevalence (less than 5%) of triple and quadruple mutant pvdhfr and pvdhps haplotypes in P. vivax parasite populations from Iran, Pakistan and India (Table 2 ) [ 21 , 22 , 26 – 31 , 36 – 39 ]. In the wider study region, it was observed that the pyrimethamine resistance marker at position 117 in pvdhfr arose first and was followed by the subsequent mutation in positions 117 and 58, conferring increasing levels of resistance as report earlier [ 23 , 26 – 31 ].…”

Keeping the momentum: suggestions for treatment policy updates in the final push to eliminate malaria in India

“…India also has high prevalence of double mutations (57%) in P. falciparum dihydrofolate reductase (Pfdhfr) followed by triple (16%; C50R-N51I-S108N; N51I-C59R-S108N, N51I-S108N-I164L, C59R-S108N-I164L; quadruple (10%) (N51I-C59R-S108N-I164L), quadruple (10%; (N51I-C59R-S108N-I164L) and single (7%; A16V, C50R, N51I, C59R, S108N, I164L). Double mutations (C50R-N51I, N51I-C59R, N51I-S108N) have been detected in the Northeastern states, Chhattisgarh, Jharkhand, Odisha, West Bengal and Uttar Pradesh [11][12][13][14][15][16][17]. Even quintuple (three mutations in dhfr (N51I-C59R-S108N) and two mutations in dhps (A437G-K540E) and sextuple resistance (three mutations in dhfr (IRN) and three mutations in dhps (A437G-K540E-A581G) mutations have been reported from the Northeastern states and a few areas in West Bengal between 2006 and 2013 [18].…”