Prevalence of sulfadoxine–pyrimethamine resistance-associated mutations in dhfr and dhps genes of Plasmodium falciparum three years after SP withdrawal in Bahir Dar, Northwest Ethiopia

•We assessed mutations in dhfr and dhps genes for SP resistance in P. falciparum.•Initial mutations of dhfr and dhps genes maintained after 3 years of SP withdrawal.•Decline in the triple dhfr and quintuple (dhfr/dhps) mutations were observed.•We report potential re-emergence of SP sensitivity in P....

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Bibliographic Details
Published in:Acta tropica 2013-12, Vol.128 (3), p.636-641
Main Authors: Hailemeskel, Elifaged, Kassa, Moges, Taddesse, Gemechu, Mohammed, Hussien, Woyessa, Adugna, Tasew, Geremew, Sleshi, Markos, Kebede, Amha, Petros, Beyene
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Antiprotozoal Agents - pharmacology
Bahir Dar
blood
Child
Child, Preschool
codons
Dihydrofolate reductase
Dihydropteroate synthase
Dihydropteroate Synthase - genetics
DNA, Protozoan - genetics
Drug Combinations
Drug Resistance
drugs
Ethiopia - epidemiology
Female
genes
haplotypes
Humans
Infant
Infant, Newborn
malaria
Malaria, Falciparum - epidemiology
Malaria, Falciparum - parasitology
Male
Middle Aged
monitoring
mutants
mutation
Mutation, Missense
Nucleic Acid Hybridization
P. falciparum
parasites
patients
Plasmodium falciparum
Plasmodium falciparum - drug effects
Plasmodium falciparum - genetics
Plasmodium falciparum - isolation & purification
Polymerase Chain Reaction
Prevalence
Pyrimethamine - pharmacology
Sulfadoxine - pharmacology
Sulfadoxine–pyrimethamine
Tetrahydrofolate Dehydrogenase - genetics
Young Adult
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Summary:•We assessed mutations in dhfr and dhps genes for SP resistance in P. falciparum.•Initial mutations of dhfr and dhps genes maintained after 3 years of SP withdrawal.•Decline in the triple dhfr and quintuple (dhfr/dhps) mutations were observed.•We report potential re-emergence of SP sensitivity in P. falciparum at Bahir Dar. Ethiopia changed the first-line anti-malarial drug for uncomplicated Plasmodium falciparum malaria from sulfadoxine–pyrimethamine (SP) to Coartem® in 2004 following nation-wide assessment of the efficacy of both drugs in 2003. This study was conducted to assess the prevalence of sulfadoxine–pyrimethamine resistance-associated mutations in dhfr and dhps genes of P. falciparum three years after SP withdrawal in Bahir Dar, Northwest Ethiopia. A total of 165 blood spot samples were collected from patients infected with P. falciparum in Bahir Dar Health Center in 2005 (n=78) and 2008 (n=87) using Whatman (3M) filter papers. The three dhfr codons (dhfr108, dhfr 51 and dhfr 59) and the two dhps codons (dhfr 437 and 540) which are believed to determine SP resistance were detected by using nested PCR-based dot blot-hybridization technique. In dhfr, only the dhfr59Arg mutant-type showed statistically significant reduction from 80.3% in 2005 to 56.4% in 2008 (p
ISSN:0001-706X
1873-6254
DOI:10.1016/j.actatropica.2013.09.010