Distribution of Plasmodium vivaxpvdhfr and pvdhps alleles and their association with sulfadoxine–pyrimethamine treatment outcomes in Indonesia

Malaria Journal

Research

Sekar Tuti¹  Rita M. Dewi¹  Robert W. Sauerwein²  Neil F. Lobo³  Wajio Sumarto⁴  Sylvia S. Marantina⁴  Ismail E. Rozi⁴  Rodiah Nababan⁴  Puji B. S. Asih⁴  Din Syafruddin⁵  Ahmad S. Taufik⁶ 

[1] Department of Biomedicine and Pharmacology, National Institute for Health Research and Development, Jakarta, Indonesia;Department of Medical Microbiology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands;Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN, USA;Eijkman Institute for Molecular Biology, Jalan Diponegoro 69, 10430, Jakarta, Indonesia;Eijkman Institute for Molecular Biology, Jalan Diponegoro 69, 10430, Jakarta, Indonesia;Department of Parasitology, Faculty of Medicine, Hasanuddin University, Makasar, Indonesia;Immunobiology Laboratory, School of Medicine, University of Mataram, Mataram, Indonesia;

关键词: Drug resistance;    Sulfadoxine–pyrimethamine (SP);    Molecular markers;    Plasmodium vivax;    Indonesia;   

DOI  :  10.1186/s12936-015-0903-0

 received in 2015-06-29, accepted in 2015-09-12,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundSympatric existence of Plasmodium falciparum and Plasmodium vivax, and the practice of malaria treatment without microscopic confirmation suggest that the accidental treatment of vivax malaria with sulfadoxine–pyrimethamine (SP) is common.MethodsIn this study, the frequency distribution of alleles associated with SP resistance were analysed among the P. vivax infections from malariometric surveys and its association with SP treatment failure in clinical studies in Indonesia. The dhfr and dhps alleles were detected using PCR–RFLP method.ResultsAnalysis of 159 P. vivax isolates from malariometric surveys and 69 samples from in vivo SP efficacy study revealed various the existence of various alleles of the pvdhfr and pfdhps genes including 57L/I, 58R, 61M, and 117N/T. Allele 13L of the dhfr gene and 553G of the dhps gene were not detected in any isolates examined in both studies. In the dhfr gene, tandem repeat type-A was the major tandem repeat observed in any isolates analysed. In the dhps gene, only the 383G allele was observed. Isolates carrying double, triple and quadruple mutants of dhfr gene were found in Lampung, Purworejo, Sumba, and Papua. Although this study revealed a wide distribution of dhfr and dhps alleles among the P. vivax isolates across a broad geographic regions in Indonesia, impact on SP efficacy was not observed in Sumba.ConclusionWith proper malaria diagnosis, SP may still be used as a rational anti-malarial drug either as a single prescription or in combination with artemisinin.

【 授权许可】

CC BY   
© Asih et al. 2015