Prevalence of Plasmodium Falciparum Mutations Associated With Antimalarial Drug Resistance During an Epidemic in Kuna Yala, Panama, Central America

Abstract

A molecular epidemiology study was conducted to determine the distribution of antimalarial drug resistance alleles among field isolates of Plasmodium falciparum. Samples were obtained during an epidemic affecting Kuna Amerindians in Panama. A high prevalence of mutations associated with chloroquine, pyrimethamine, and sulfadoxine was observed. Genotype analysis of msp2 revealed a low genetic diversity of P. falciparum parasites circulating in the studied area. The public health implications of these findings for the Central American region are discussed.

Molecular Analysis of Chloroquine and Sulfadoxine-Pyrimethamine Resistance-Associated Alleles in Plasmodium falciparum Isolates from Nicaragua

“…With such low levels of transmission, most of the Nicaraguan population will lack immunity to Plasmodium infection, making the region more prone to malaria epidemics after introduction of drug-resistant parasites, similar to what was seen in Panama in 2003. 3 Therefore, if reports of CQ or SP therapeutic resistance or failure emerge, they must be addressed rapidly and aggressively to avoid selection and spread of highly resistant parasite pocket populations as described in other settings. 32 Molecular surveillance continues to be a valuable tool for monitoring the emergence and spread of drug-resistant parasite isolates worldwide.…”

“…5,6 Notably, it was the K76T polymorphism that was associated with treatment failure in Panama. 3 The pfcrt alleles SVMNT and CVMNT are found in South America; SVMNT is the most common. 7 The CVMET genotype is found in Colombia.…”

“…However, there have been epidemics of P. falciparum malaria in Panama, east of the Panama Canal, where molecular markers of resistance to CQ and SP were detected. 3 Polymorphisms in positions 72, 74, 75, and 76 of the P. falciparum CQ resistance transporter ( pfcrt) gene have been associated with reduced parasite susceptibility to CQ. 4 Therefore, pfcrt alleles are often described by their amino acid sequence at positions 72-76.…”

Determinación de la resistencia a insecticidas organofosforados, carbamatos y piretroides en tres poblaciones de Anopheles albimanus (Diptera: Culicidae) de Panamá

“…Los patrones de transmisión en esta región, responden principalmente a factores económicos, socioculturales y de movimientos de población, unidos a los factores biológicos y ecológicos determinantes en la historia de la enfermedad (19 (20).…”

Artesunate + amodiaquine versus artemether-lumefantrine for the treatment of uncomplicated Plasmodium falciparum malaria in the Colombian Pacific region: a noninferiority trial

“…Reports of in vitro and in vivo P. falciparum resistance to chloroquine (CQ) in South America, including the Colombian Pacific region, have been published [8][9][10] . Due to the increasing worldwide CQ resistance reports, the most current antimalarial treatment recommended by WHO is combination therapy with two or more blood schizonticidal drugs.…”