Persistence of Markers of Chloroquine Resistance in Plasmodium falciparum in Bangladesh

• Published in: The American journal of tropical medicine and hygiene 2021-01, Vol.104 (1), p.276-282
• Main Authors: Johora, Fatema Tuj, Elahi, Rubayet, Nima, Maisha Khair, Hossain, Mohammad Sharif, Rashid, Humaira, Kibria, Mohammad Golam, Mohon, Abu Naser, Khan, Wasif A, Haque, Rashidul, Alam, Mohammad Shafiul
• Format: Article
• Language: English
• Subjects: Antimalarials - pharmacology; Bangladesh - epidemiology; Chloroquine - pharmacology; Drug Resistance; Erythrocytes; Genetic Markers; Genotype; Humans; Malaria; Malaria, Falciparum - epidemiology; Malaria, Falciparum - parasitology; Membrane Transport Proteins - genetics; Multidrug Resistance-Associated Proteins - genetics; Mutation; Plasmodium falciparum - drug effects; Plasmodium falciparum - genetics; Polymorphism, Genetic; Protozoan Proteins - genetics; Time Factors
• ISSN: 0002-9637; 1476-1645
• DOI: 10.4269/AJTMH.20-0415

The control of malaria, in terms of drug resistance, remains a significant global challenge, with Bangladesh, a malaria-endemic country, being no exception. The aim of this study was to explore antimalarial resistance in Bangladesh by molecular analysis of chloroquine resistance transporter ( ) and multidrug resistance transporter 1 ( ) genetic markers of . . Samples were obtained from uncomplicated malaria patients between 2009 and 2014 from six malaria-endemic districts. Based on parasite transmission intensity, the endemic districts were divided into high-transmission (Chittagong Hill Tracts [CHT]) and low-transmission (non-CHT) regions. Falciparum malaria-positive isolates were genotyped for K76T of the gene, and N86Y and Y184F of the gene: in total, 262 clinical isolates were analyzed. In CHT areas, the prevalence of polymorphisms was 70.6% for 76T, 14.4% for 86Y, and 7.8% for 184F. In non-CHT areas, 76T and 86Y mutations were found in 78.0% and 19.5% of the samples, respectively, whereas no 184F mutations were observed. We compared our data with previous similar molecular observations, which shows a significant decrease in 76T mutation prevalence. No amplification was observed in any of the samples suggesting an unaltered susceptibility to amino alcohol drugs such as mefloquine and lumefantrine. This study provides an updated assessment of the current status of and gene mutations in Bangladesh, and suggests there is persistent high prevalence of markers of resistance to aminoquinoline drugs.