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
Open Access
- 15 September 2020
- journal article
- research article
- Published by Springer Science and Business Media LLC in BMC Infectious Diseases
- Vol. 20 (1), 1-9
- https://doi.org/10.1186/s12879-020-05397-6
Abstract
The 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. A 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. Among 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. The 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.Keywords
Funding Information
- Qatar National Research Fund (NPRP 5 - 098 - 3 – 021)
This publication has 43 references indexed in Scilit:
- Prevalence and patterns of antifolate and chloroquine drug resistance markers in Plasmodium vivax across PakistanMalaria Journal, 2013
- Plasmodium vivax associated severe malaria complications among children in some malaria endemic areas of EthiopiaBMC Public Health, 2013
- A new high-throughput method for simultaneous detection of drug resistance associated mutations in Plasmodium vivax dhfr, dhps and mdr1 genesMalaria Journal, 2011
- Molecular epidemiology of Plasmodium vivax anti-folate resistance in IndiaMalaria Journal, 2011
- Some Lessons for the Future from the Global Malaria Eradication Programme (1955–1969)PLoS Medicine, 2011
- Plasmodium vivaxResistance to Chloroquine in Madagascar: Clinical Efficacy and Polymorphisms inpvmdr1andpvcrt-oGenesAntimicrobial Agents and Chemotherapy, 2008
- Determinants of In Vitro Drug Susceptibility Testing of Plasmodium vivaxAntimicrobial Agents and Chemotherapy, 2008
- Chloroquine Resistant Plasmodium vivax: In Vitro Characterisation and Association with Molecular PolymorphismsPLOS ONE, 2007
- Similar Trends of Pyrimethamine Resistance-Associated Mutations in Plasmodium vivax and P. falciparumAntimicrobial Agents and Chemotherapy, 2007
- The pathogenic basis of malariaNature, 2002