Drug resistance-virulence relationship in Plasmodium falciparum causing severe malaria in an area of seasonal and unstable transmission

Hayder A. Giha; Mustafa I. Elbashir; Ishraga E. A-Elbasit; Thoraya M.E. A-Elgadir; Gehad E. ElGhazali; Margaret J. Mackinnon; Hamza A. Babiker

doi:10.1016/j.actatropica.2005.10.004

Drug resistance-virulence relationship in Plasmodium falciparum causing severe malaria in an area of seasonal and unstable transmission

Hayder A. Giha^*, Mustafa I. Elbashir, Ishraga E. A-Elbasit, Thoraya M.E. A-Elgadir, Gehad E. ElGhazali, Margaret J. Mackinnon, Hamza A. Babiker

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

30 Citations (Scopus)

Abstract

The pathogenesis of severe Plasmodium falciparum malaria is still obscure, but is believed to be multi-factorial, and among the important factors are intrinsic parasite-properties. Here we investigated the association between clinical manifestation of P. falciparum malaria (an indicator of virulence) and two parasite properties - drug resistance and gametocyte production. Among 996 P. falciparum infections detected in the out-patient clinic of Gedarif Hospital in eastern Sudan, there was no significant association between the incidence of severe versus mild disease and the presence of resistant alleles at the chloroquine-resistance transporter locus (pfcrt-T76) and the multi-drug-resistance locus (pfmdr1-Y86). However, among severe cases, there was a significantly lower prevalence of parasites carrying resistant alleles among patients that died versus survived. There was a trend towards a higher gametocyte rate among severe malaria patients compared with uncomplicated malaria cases. These results are discussed in relation to the fitness of drug resistant parasites.

Original language	English
Pages (from-to)	181-187
Number of pages	7
Journal	Acta Tropica
Volume	97
Issue number	2
DOIs	https://doi.org/10.1016/j.actatropica.2005.10.004
Publication status	Published - Feb 2006
Externally published	Yes

Keywords

Mutation
Resistance
Severe malaria
Virulence
pfcrt
pfmdr1

ASJC Scopus subject areas

Parasitology
veterinary (miscalleneous)
Insect Science
Infectious Diseases

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.actatropica.2005.10.004

Cite this

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title = "Drug resistance-virulence relationship in Plasmodium falciparum causing severe malaria in an area of seasonal and unstable transmission",

abstract = "The pathogenesis of severe Plasmodium falciparum malaria is still obscure, but is believed to be multi-factorial, and among the important factors are intrinsic parasite-properties. Here we investigated the association between clinical manifestation of P. falciparum malaria (an indicator of virulence) and two parasite properties - drug resistance and gametocyte production. Among 996 P. falciparum infections detected in the out-patient clinic of Gedarif Hospital in eastern Sudan, there was no significant association between the incidence of severe versus mild disease and the presence of resistant alleles at the chloroquine-resistance transporter locus (pfcrt-T76) and the multi-drug-resistance locus (pfmdr1-Y86). However, among severe cases, there was a significantly lower prevalence of parasites carrying resistant alleles among patients that died versus survived. There was a trend towards a higher gametocyte rate among severe malaria patients compared with uncomplicated malaria cases. These results are discussed in relation to the fitness of drug resistant parasites.",

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author = "Giha, {Hayder A.} and Elbashir, {Mustafa I.} and A-Elbasit, {Ishraga E.} and A-Elgadir, {Thoraya M.E.} and ElGhazali, {Gehad E.} and Mackinnon, {Margaret J.} and Babiker, {Hamza A.}",

note = "Funding Information: We would like to thank the patients and their families who willingly agreed to participate in this study. We also want to extend our gratitude to include the staff and authorities in Gedarif Hospital, and our field team. Hayder Giha received a training fellowship from the International Agency of Atomic Energy (IAEA), and this investigation received financial support from the Medical Research Council, UK and the UNDP/World Bank/WHO Special Program for Research and Training in Tropical Diseases (TDR) and the Multilateral Initiative on Malaria in Africa (MIM), project ID A00003. ",

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AU - Giha, Hayder A.

AU - Elbashir, Mustafa I.

AU - A-Elbasit, Ishraga E.

AU - A-Elgadir, Thoraya M.E.

AU - ElGhazali, Gehad E.

AU - Mackinnon, Margaret J.

AU - Babiker, Hamza A.

N1 - Funding Information: We would like to thank the patients and their families who willingly agreed to participate in this study. We also want to extend our gratitude to include the staff and authorities in Gedarif Hospital, and our field team. Hayder Giha received a training fellowship from the International Agency of Atomic Energy (IAEA), and this investigation received financial support from the Medical Research Council, UK and the UNDP/World Bank/WHO Special Program for Research and Training in Tropical Diseases (TDR) and the Multilateral Initiative on Malaria in Africa (MIM), project ID A00003.

PY - 2006/2

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N2 - The pathogenesis of severe Plasmodium falciparum malaria is still obscure, but is believed to be multi-factorial, and among the important factors are intrinsic parasite-properties. Here we investigated the association between clinical manifestation of P. falciparum malaria (an indicator of virulence) and two parasite properties - drug resistance and gametocyte production. Among 996 P. falciparum infections detected in the out-patient clinic of Gedarif Hospital in eastern Sudan, there was no significant association between the incidence of severe versus mild disease and the presence of resistant alleles at the chloroquine-resistance transporter locus (pfcrt-T76) and the multi-drug-resistance locus (pfmdr1-Y86). However, among severe cases, there was a significantly lower prevalence of parasites carrying resistant alleles among patients that died versus survived. There was a trend towards a higher gametocyte rate among severe malaria patients compared with uncomplicated malaria cases. These results are discussed in relation to the fitness of drug resistant parasites.

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KW - Mutation

KW - Resistance

KW - Severe malaria

KW - Virulence

KW - pfcrt

KW - pfmdr1

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Drug resistance-virulence relationship in Plasmodium falciparum causing severe malaria in an area of seasonal and unstable transmission

Abstract

Keywords

ASJC Scopus subject areas

UN SDGs

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