Temporal Changes in Prevalence of Molecular Markers Mediating Antimalarial Drug Resistance in a High Malaria Transmission Setting in Uganda
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Date
2014
Journal Title
Journal ISSN
Volume Title
Publisher
The American journal of tropical medicine and hygiene
Abstract
Standard therapy for malaria in Uganda changed from chloroquine to chloroquine + sulfadoxine-pyrimethamine
in 2000, and artemether-lumefantrine in 2004, although implementation of each change was slow. Plasmodium falciparum
genetic polymorphisms are associated with alterations in drug sensitivity. We followed the prevalence of drug resistancemediating
P. falciparum polymorphisms in 982 samples from Tororo, a region of high transmission intensity, collected from
three successive treatment trials conducted during 2003–2012, excluding samples with known recent prior treatment.
Considering transporter mutations, prevalence of the mutant pfcrt 76T, pfmdr1 86Y, and pfmdr1 1246Y alleles decreased
over time. Considering antifolate mutations, the prevalence of pfdhfr 51I, 59R, and 108N, and pfdhps 437G and 540E were
consistently high; pfdhfr 164L and pfdhps 581G were uncommon, but most prevalent during 2008–2010. Our data suggest
sequential selective pressures as different treatments were implemented, and they highlight the importance of genetic
surveillance as treatment policies change over time.
Description
Keywords
malaria, Antimalarial Drug Resistance, High Malaria Transmission
Citation
Mbogo, G. W., Nankoberanyi, S., Tukwasibwe, S., Baliraine, F. N., Nsobya, S. L., Conrad, M. D., ... & Rosenthal, P. J. (2014). Temporal changes in prevalence of molecular markers mediating antimalarial drug resistance in a high malaria transmission setting in Uganda. The American journal of tropical medicine and hygiene, 91(1), 54.