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, T. M E A-Elgadir, Gehad E. ElGhazali, Margaret J. Mackinnon, Hamza A. Babiker

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27 Citations (Scopus)


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 languageEnglish
Pages (from-to)181-187
Number of pages7
JournalActa Tropica
Issue number2
Publication statusPublished - Feb 2006



  • Mutation
  • pfcrt
  • pfmdr1
  • Resistance
  • Severe malaria
  • Virulence

ASJC Scopus subject areas

  • Parasitology
  • Infectious Diseases

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