Clinical isolates of uncomplicated falciparum malaria from high and low malaria transmission areas show distinct pfcrt and pfmdr1 polymorphisms in western Ethiopia.

Publisher: BioMed Central Country of Publication: England NLM ID: 101139802 Publication Model: Electronic Cited Medium: Internet ISSN: 1475-2875 (Electronic) Linking ISSN: 14752875 NLM ISO Abbreviation: Malar J Subsets: MEDLINE

Original Publication: London : BioMed Central, [2002-

Antimalarials*/pharmacology ; Antimalarials*/therapeutic use ; Malaria, Falciparum*/parasitology ; Malaria*/drug therapy; Humans ; Ethiopia/epidemiology ; Artemether, Lumefantrine Drug Combination/therapeutic use ; Artemether/therapeutic use ; Chloroquine/pharmacology ; Chloroquine/therapeutic use ; Lumefantrine/therapeutic use ; Plasmodium falciparum ; Polymorphism, Single Nucleotide ; Multidrug Resistance-Associated Proteins/genetics ; Protozoan Proteins/genetics ; Protozoan Proteins/therapeutic use ; Drug Resistance/genetics

Background: Pfcrt gene has been associated with chloroquine resistance and the pfmdr1 gene can alter malaria parasite susceptibility to lumefantrine, mefloquine, and chloroquine. In the absence of chloroquine (CQ) and extensive use of artemether-lumefantrine (AL) from 2004 to 2020 to treat uncomplicated falciparum malaria, pfcrt haplotype, and pfmdr1 single nucleotide polymorphisms (SNPs) were determined in two sites of West Ethiopia with a gradient of malaria transmission.
Methods: 230 microscopically confirmed P. falciparum isolates were collected from Assosa (high transmission area) and Gida Ayana (low transmission area) sites, of which 225 of them tested positive by PCR. High-Resolution Melting Assay (HRM) was used to determine the prevalence of pfcrt haplotypes and pfmdr1 SNPs. Furthermore, the pfmdr1 gene copy number (CNV) was determined using real-time PCR. A P-value of less or equal to 0.05 was considered significant.
Results: Of the 225 samples, 95.5%, 94.4%, 86.7%, 91.1%, and 94.2% were successfully genotyped with HRM for pfcrt haplotype, pfmdr1-86, pfmdr1-184, pfmdr1-1042 and pfmdr1-1246, respectively. The mutant pfcrt haplotypes were detected among 33.5% (52/155) and 80% (48/60) of isolates collected from the Assosa and Gida Ayana sites, respectively. Plasmodium falciparum with chloroquine-resistant haplotypes was more prevalent in the Gida Ayana area compared with the Assosa area (COR = 8.4, P = 0.00). Pfmdr1-N86Y wild type and 184F mutations were found in 79.8% (166/208) and 73.4% (146/199) samples, respectively. No single mutation was observed at the pfmdr1-1042 locus; however, 89.6% (190/212) of parasites in West Ethiopia carry the wild-type D1246Y variants. Eight pfmdr1 haplotypes at codons N86Y-Y184F-D1246Y were identified with the dominant NFD 61% (122/200). There was no difference in the distribution of pfmdr1 SNPs, haplotypes, and CNV between the two study sites (P > 0.05).
Conclusion: Plasmodium falciparum with the pfcrt wild-type haplotype was prevalent in high malaria transmission site than in low transmission area. The NFD haplotype was the predominant haplotype of the N86Y-Y184F-D1246Y. A continuous investigation is needed to closely monitor the changes in the pfmdr1 SNPs, which are associated with the selection of parasite populations by ACT.
(© 2023. The Author(s).)

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Keywords: Pfcrt; Pfmdr1; Polymorphisms in a gradient of malaria transmission

0 (Antimalarials)
76634-96-3 (N-formyl-13-dihydrocarminomycin)
0 (Artemether, Lumefantrine Drug Combination)
C7D6T3H22J (Artemether)
886U3H6UFF (Chloroquine)
F38R0JR742 (Lumefantrine)
0 (Multidrug Resistance-Associated Proteins)
0 (Protozoan Proteins)

Date Created: 20230603 Date Completed: 20230605 Latest Revision: 20230606

20231215

PMC10239113

10.1186/s12936-023-04602-6

37270589