PFCRT and DHFR-TS Sequences for Monitoring Drug Resistance in Adzopé Area of Côte d’Ivoire After the Withdrawal of Chloroquine and Pyrimethamine

Abstract

Purpose: Drug resistance is probably the greatest challenge to most malaria-control programmes. The goal of this study was to evaluate polymorphisms in parasite resistance gene markers, pfcft and dhfr, from falciparum malaria isolates collected in Adzopé City, Côte d'Ivoire in 2007. Methods: Blood samples were collected in filter paper from 72 children infected with Plasmodium falciparum living in Adzopé area. Plasmodium falciparum DNA was extracted and nested PCRs were performed using specific primers of pfcrt and dhfr-ts. During the study, chloroquine and sulphadoxinepyrimethamine (which previously were the first-and second-line treatments, respectively, for malaria in Côte d'Ivoire) were not given to the enrolled children, having been withdrawn in 2004. Results: The results revealed the presence of the mutant-type pfcrt and dhfr-ts in 51 (62.2 %) and 29 (35.4 %) samples, respectively. The mutant-type pfcrt alleles consisted of four single mutations (Met74/Asn75/Thr76) and 47 triple mutations (Ile74/Glu75/Thr76). However, the frequency distribution of mutations in dhfr-ts was 35.4 % for dhfr-Asn108, 17 % for dhfr-Ile51 and 21 % for dhfr-Arg59. Conclusion: The results of this study show high presence of chloroquine (CQ) resistance markers while for sulphadoxine-pyrimethamine (SP), a much lower prevalence was detected for the markers under study. Chloroquine remains an inadequate drug for malaria therapy in the study region. Furthermore, in spite of the official withdrawal of CQ and SP in favour of the arteminisin-based combinations (ACTs), it appears the population of this area continues to use the drugs via self-medication. ; Tel: +225-22 50 35 60 Ouattara et al Trop J Pharm Res, December 2010; 9(6): 566

Towards a re-emergence of chloroquine sensitivity in Côte d’Ivoire?

“…These results contrasted those obtained (for the Thr-76 mutation) in 2006 (65%) in Yopougon, Abidjan [ 8 ], in 2005 (100% and 95%) in Bonoua and Samo respectively [ 10 ] and in 2010 (62%) in Adzopé [ 9 ]. However, the data are in accordance with Gharbi et al [ 23 ] who, after modelling chloroquine resistance in Côte d’Ivoire from the Thr-76 allele with samples from travelers returning to Côte d’Ivoire reported a decrease in prevalence from 63 to 37% of Thr-76 allele.…”

“…In Côte d’Ivoire, the prevalence of CQ-resistant parasites that used to be very low in 1987 with only three confirmed cases of chloroquine resistance (CQR) appeared to have increased [ 8 , 9 ]. Indeed, high prevalence of the K76T mutation, a key mutation associated with Plasmodium falciparum resistance to CQ, have been reported in Yopougon in Abidjan (65%), Bonoua (100%), Samo (95%) and Adzopé (62%) [ 10 ].…”

Molecular analysis of markers associated with chloroquine and sulfadoxine/pyrimethamine resistance in Plasmodium falciparum malaria parasites from southeastern Côte-d'Ivoire by the time of Artemisinin-based Combination Therapy adoption in 2005

“…26 , 34 , 35 In contrast, the higher rate of NCSI in both sites (50% in Bonoua and 38.7% in Samo) compared to IRN I (32.6% in Bonoua and 19.4% in Samo), suggests that pyrimethamine was likely still clinically effective by the time of SP withdrawal, but this may certainly have changed in the subsequent 7 years. Fortunately, in a recent paper, 36 Ouattara reported a lower prevalence of 35% of IRN I in Adzopé in 2007, located inland 108 km from Abidjan. Spatiotemporal studies would confirm whether the prevalence of this key mutation, along with SP pressure, decreases as one samples further inland.…”

Polymorphism of pfcrt K76T and pfatpase6 S769N in Malaria Patients at Teluk Bintuni Regency, Papua, Indonesia

“…8, [10][11][12] The used of artemisinin combination therapy (ACT) as the first line therapy of anti-malarial drugs has been done as an effort to overcome CQ resistance. 13 Assessment toward P. falciparum drug resistance will help to provide clinical data that could be useful in choosing effective drugs.…”