Distribution pattern of amino acid mutations in chloroquine and antifolate drug resistance associated genes in complicated and uncomplicated Plasmodium vivax isolates from Chandigarh, North India

BMC Infectious Diseases

Rakesh Sehgal¹  Hargobinder Kaur¹  Ali A. Sultan²  Devendra Bansal³  Archit Kumar⁴  Praveen K. Bharti⁵  Pradyumna K. Mohapatra⁶  Jagadish Mahanta⁶ 

[1] Department of Medical Parasitology, Postgraduate Institute of Medical Education and Research, Chandigarh, India;Department of Microbiology and Immunology, Weill Cornell Medicine – Qatar, Cornell University, Qatar Foundation, Education City, Doha, Qatar;Department of Microbiology and Immunology, Weill Cornell Medicine – Qatar, Cornell University, Qatar Foundation, Education City, Doha, Qatar;Present address: Ministry of Public Health, Doha, Qatar;Department of Virology, Postgraduate Institute of Medical Education and Research, Chandigarh, India;National Institute for Research in Tribal Health, Indian Council of Medical Research, Nagpur Road, Garha, Jabalpur, Madhya Pradesh, India;Regional Medical Research Centre, NE, Indian Council of Medical Research, Post Box no.105, Dibrugarh, Assam, India;

关键词: Plasmodium vivax;    Complicated malaria;    Antimalarial drug resistance;    North India;   

DOI  :  10.1186/s12879-020-05397-6

来源: Springer

【 摘 要 】

BackgroundThe increasing antimalarial drug resistance is a significant hindrance to malaria control and elimination programs. For the last six decades, chloroquine (CQ) plus pyrimethamine remains the first-line treatment for P. vivax malaria. Regions where both P. falciparum and P. vivax co-exist, P. vivax is exposed to antifolate drugs due to either misdiagnosis or improper treatment that causes selective drug pressure to evolve. Therefore, the present study aims to estimate antimalarial drug resistance among the complicated and uncomplicated P. vivax patients.MethodsA total of 143 P. vivax malaria positive patients were enrolled in this study, and DNA was isolated from their blood samples. Pvcrt-o, Pvmdr-1, Pvdhps, and Pvdhfr genes were PCRs amplified, and drug resistance-associated gene mutations were analyzed. Statistical analysis of the drug resistance genes and population diversity was performed using MEGA vs. 7.0.21 and DnaSP v software.ResultsAmong the CQ resistance marker gene Pvcrt-o, the prevalence of K10 insertion was 17.5% (7/40) and 9.5% (7/73) of complicated and uncomplicated P vivax group isolates respectively. In Pvmdr-1, double mutant haplotype (M958/L1076) was found in 99% of the clinical isolates. Among the pyrimethamine resistance-associated gene Pvdhfr, the double mutant haplotype I13P33F57R58T61N117I173 was detected in 23% (11/48) in complicated and 20% (17/85) in uncomplicated group isolates. In the sulphadoxine resistance-associated Pvdhps gene, limited polymorphism was observed with the presence of a single mutant (D459A) among 16 and 5% of the clinical isolates in the complicated and uncomplicated group respectively.ConclusionThe study presents the situations of polymorphism in the antimalarial drug resistance-associated genes and emphasizes the need for regular surveillance. It is imperative for the development of suitable antimalarial drug policy in India.

【 授权许可】

CC BY