Molecular Analysis Demonstrates High Prevalence of Chloroquine Resistance but No Evidence of Artemisinin Resistance in Plasmodium Falciparum in the Chittagong Hill Tracts of Bangladesh

Overview

Journal Malar J

Publisher Biomed Central

Specialty Tropical Medicine

Date 2017 Aug 16

PMID 28806961

Citations 4

Authors

Mohammad Shafiul Alam

Benedikt Ley

Maisha Khair Nima

Fatema Tuj Johora

Mohammad Enayet Hossain

Kamala Thriemer

Sarah Auburn

Jutta Marfurt

Ric N Price

Wasif A Khan

Affiliations

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Abstract

Background: Artemisinin resistance is present in the Greater Mekong region and poses a significant threat for current anti-malarial treatment guidelines in Bangladesh. The aim of this molecular study was to assess the current status of drug resistance in the Chittagong Hill Tracts of Bangladesh near the Myanmar border.

Methods: Samples were obtained from patients enrolled into a Clinical Trial (NCT02389374) conducted in Alikadam, Bandarban between August 2014 and January 2015. Plasmodium falciparum infections were confirmed by PCR and all P. falciparum positive isolates genotyped for the pfcrt K76T and pfmdr1 N86Y markers. The propeller region of the kelch 13 (k13) gene was sequenced from isolates from patients with delayed parasite clearance.

Results: In total, 130 P. falciparum isolates were available for analysis. The pfcrt mutation K76T, associated with chloroquine resistance was found in 81.5% (106/130) of cases and the pfmdr1 mutation N86Y in 13.9% (18/130) cases. No single nucleotide polymorphisms were observed in the k13 propeller region.

Conclusion: This study provides molecular evidence for the ongoing presence of chloroquine resistant P. falciparum in Bangladesh, but no evidence of mutations in the k13 propeller domain associated with artemisinin resistance. Monitoring for artemisinin susceptibility in Bangladesh is needed to ensure early detection and containment emerging anti-malarial resistance.

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Assessment of Plasmodium falciparum Artemisinin Resistance Independent of Polymorphisms and with Escalating Malaria in Bangladesh.

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Decreased prevalence of the Plasmodium falciparum Pfcrt K76T and Pfmdr1 and N86Y mutations post-chloroquine treatment withdrawal in Katete District, Eastern Zambia.

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