TY - JOUR
T1 - Distribution of mutations associated with antifolate and chloroquine resistance among imported Plasmodium vivax in the State of Qatar
AU - Bansal, Devendra
AU - Acharya, Anushree
AU - Bharti, Praveen K.
AU - Abdelraheem, Mohamed H.
AU - Elmalik, Ashraf
AU - Abosalah, Salem
AU - Khan, Fahmi Y.
AU - ElKhalifa, Mohamed
AU - Kaur, Hargobinder
AU - Mohapatra, Pradyumna K.
AU - Sehgal, Rakesh
AU - Idris, Mohammed A.
AU - Mahanta, Jagadish
AU - Singh, Neeru
AU - Babiker, Hamza A.
AU - Sultan, Ali A.
N1 - Funding Information:
Financial support: This publication was made possible by NPRP grant [NPRP-5-098-3-021] from the Qatar National Research Fund (a member of Qatar Foundation). The findings achieved herein are solely the responsibility of the author[s].
Funding Information:
1Department of Microbiology and Immunology, Weill Cornell Medicine - Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar; 2National Institute for Research in Tribal Health, Indian Council of Medical Research, Jabalpur, India; 3Department of Microbiology and Immunology, Faculty of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman; 4Department of Emergency Medicine, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar; 5Department of Medicine, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar; 6Department of Laboratory Medicine and Pathology, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar; 7Department of Parasitology, Postgraduate Institute of Medical Education and Research, Chandigarh, India; 8Regional Medical Research Centre, NE, Indian Council of Medical Research, Dibrugarh, India; 9Department of Biochemistry, Faculty of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
Publisher Copyright:
© 2017 by The American Society of Tropical Medicine and Hygiene.
PY - 2017
Y1 - 2017
N2 - Plasmodium vivax is the most prevalent parasite worldwide, escalating by spread of drug resistance. Currently, in Qatar, chloroquine (CQ) plus primaquine are recommended for the treatment of P. vivax malaria. The present study examined the prevalence of mutations in dihydrofolate reductase (dhfr), dihydropteroate synthase (dhps) genes and CQ resistance transporter (crt-o) genes, associated with sulphadoxine-pyrimethamine (SP) and chloroquine resistance, among imported P. vivax cases in Qatar. Blood samples were collected from patients positive for P. vivax and seeking medical treatment at Hamad General Hospital, Doha, during 2013-2016. The Sanger sequencing method was performed to examine the single nucleotide polymorphisms in Pvdhfr, Pvdhps, and Pvcrt-o genes. Of 314 examined P. vivax isolates, 247 (78.7%), 294 (93.6%) and 261 (83.1%) were successfully amplified and sequenced for Pvdhfr, Pvdhps, and Pvcrt-o, respectively. Overall, 53.8% (N = 133) carried mutant alleles (58R/117N) in Pvdhfr, whereas 77.2% (N = 227) and 90% (N = 235) isolates possessed wild type allele in Pvdhps and Pvcrt-o genes, respectively. In addition, a total of eleven distinct haplotypes were detected in Pvdhfr/Pvdhps genes. Interestingly, K10 insertion in the Pvcrt-o gene was observed only in patients originating from the Indian subcontinent. The results suggested that CQremains an acceptable treatment regimen but further clinical data are required to assess the effectiveness of CQ and SP in Qatar to support the current national treatment guidelines. In addition, limited distribution of genetic polymorphisms associated with CQ and SP resistance observed in imported P. vivax infections, necessitates regular monitoring of drug resistant P. vivax malaria in Qatar.
AB - Plasmodium vivax is the most prevalent parasite worldwide, escalating by spread of drug resistance. Currently, in Qatar, chloroquine (CQ) plus primaquine are recommended for the treatment of P. vivax malaria. The present study examined the prevalence of mutations in dihydrofolate reductase (dhfr), dihydropteroate synthase (dhps) genes and CQ resistance transporter (crt-o) genes, associated with sulphadoxine-pyrimethamine (SP) and chloroquine resistance, among imported P. vivax cases in Qatar. Blood samples were collected from patients positive for P. vivax and seeking medical treatment at Hamad General Hospital, Doha, during 2013-2016. The Sanger sequencing method was performed to examine the single nucleotide polymorphisms in Pvdhfr, Pvdhps, and Pvcrt-o genes. Of 314 examined P. vivax isolates, 247 (78.7%), 294 (93.6%) and 261 (83.1%) were successfully amplified and sequenced for Pvdhfr, Pvdhps, and Pvcrt-o, respectively. Overall, 53.8% (N = 133) carried mutant alleles (58R/117N) in Pvdhfr, whereas 77.2% (N = 227) and 90% (N = 235) isolates possessed wild type allele in Pvdhps and Pvcrt-o genes, respectively. In addition, a total of eleven distinct haplotypes were detected in Pvdhfr/Pvdhps genes. Interestingly, K10 insertion in the Pvcrt-o gene was observed only in patients originating from the Indian subcontinent. The results suggested that CQremains an acceptable treatment regimen but further clinical data are required to assess the effectiveness of CQ and SP in Qatar to support the current national treatment guidelines. In addition, limited distribution of genetic polymorphisms associated with CQ and SP resistance observed in imported P. vivax infections, necessitates regular monitoring of drug resistant P. vivax malaria in Qatar.
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U2 - 10.4269/ajtmh.17-0436
DO - 10.4269/ajtmh.17-0436
M3 - Article
C2 - 29016333
AN - SCOPUS:85037036051
SN - 0002-9637
VL - 97
SP - 1797
EP - 1803
JO - American Journal of Tropical Medicine and Hygiene
JF - American Journal of Tropical Medicine and Hygiene
IS - 6
ER -