Distribution of mutations associated with antifolate and chloroquine resistance among imported Plasmodium vivax in the State of Qatar

Devendra Bansal, Anushree Acharya, Praveen K. Bharti, Mohamed H. Abdelraheem, Ashraf Elmalik, Salem Abosalah, Fahmi Y. Khan, Mohamed ElKhalifa, Hargobinder Kaur, Pradyumna K. Mohapatra, Rakesh Sehgal, Mohammed A. Idris, Jagadish Mahanta, Neeru Singh, Hamza A. Babiker, Ali A. Sultan

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)1797-1803
Number of pages7
JournalAmerican Journal of Tropical Medicine and Hygiene
Volume97
Issue number6
DOIs
Publication statusPublished - Jan 1 2017

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Qatar
Folic Acid Antagonists
Plasmodium vivax
Chloroquine
Mutation
Vivax Malaria
Genes
Dihydropteroate Synthase
Alleles
Primaquine
Tetrahydrofolate Dehydrogenase
Drug Monitoring
Genetic Polymorphisms
Therapeutics
Drug Resistance
General Hospitals
Haplotypes
Malaria
Single Nucleotide Polymorphism
Parasites

ASJC Scopus subject areas

  • Parasitology
  • Infectious Diseases
  • Virology

Cite this

Distribution of mutations associated with antifolate and chloroquine resistance among imported Plasmodium vivax in the State of Qatar. / Bansal, Devendra; Acharya, Anushree; Bharti, Praveen K.; Abdelraheem, Mohamed H.; Elmalik, Ashraf; Abosalah, Salem; Khan, Fahmi Y.; ElKhalifa, Mohamed; Kaur, Hargobinder; Mohapatra, Pradyumna K.; Sehgal, Rakesh; Idris, Mohammed A.; Mahanta, Jagadish; Singh, Neeru; Babiker, Hamza A.; Sultan, Ali A.

In: American Journal of Tropical Medicine and Hygiene, Vol. 97, No. 6, 01.01.2017, p. 1797-1803.

Research output: Contribution to journalArticle

Bansal, D, Acharya, A, Bharti, PK, Abdelraheem, MH, Elmalik, A, Abosalah, S, Khan, FY, ElKhalifa, M, Kaur, H, Mohapatra, PK, Sehgal, R, Idris, MA, Mahanta, J, Singh, N, Babiker, HA & Sultan, AA 2017, 'Distribution of mutations associated with antifolate and chloroquine resistance among imported Plasmodium vivax in the State of Qatar', American Journal of Tropical Medicine and Hygiene, vol. 97, no. 6, pp. 1797-1803. https://doi.org/10.4269/ajtmh.17-0436
Bansal, Devendra ; Acharya, Anushree ; Bharti, Praveen K. ; Abdelraheem, Mohamed H. ; Elmalik, Ashraf ; Abosalah, Salem ; Khan, Fahmi Y. ; ElKhalifa, Mohamed ; Kaur, Hargobinder ; Mohapatra, Pradyumna K. ; Sehgal, Rakesh ; Idris, Mohammed A. ; Mahanta, Jagadish ; Singh, Neeru ; Babiker, Hamza A. ; Sultan, Ali A. / Distribution of mutations associated with antifolate and chloroquine resistance among imported Plasmodium vivax in the State of Qatar. In: American Journal of Tropical Medicine and Hygiene. 2017 ; Vol. 97, No. 6. pp. 1797-1803.
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abstract = "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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AU - Acharya, Anushree

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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

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AU - Babiker, Hamza A.

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