Source of drug resistant Plasmodium falciparum in a potential malaria elimination site in Saudi Arabia

Hissa M. Al-Farsi, Zainab S. Al-Hashami, Saad M. Bin Dajem, Adel Ali H Al-Sheikh, Ahmed Al-Qahtani, Albano Beja-Pereira, Mohamed A. Idris, Hamza A. Babiker

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

A major challenge to the success of malaria control program in Saudi Arabia is the high influx of expatriates and holy visitors from malaria endemic countries. In the present study we examined whether drug resistant parasite genotypes reported in Jazan region, southwest of Saudi Arabia are imported or developed locally. We examined 178 Plasmodium falciparum isolates for alleles of dihydropteroate synthase (dhps) and dihydrofolate reductase (dhfr), associated with Sulfadoxine-Pyrimethamine (SP) resistance, and three microsatellites flanking each gene. In addition, we examined a neutral polymorphic gene (Pfg377). We compared the dhfr and dhps haplotypes in Jazan, using network analysis, to an existing similar data set of 94 P. falciparum isolates from eastern Sudan. In Jazan, double mutant dhfr allele (51I, 108N) occurred with a prevalence of 33%. The vast majority (99%) of dhps were wild-type alleles. The mean expected heterozygosity (He) of microsatellites around mutant dhfr alleles (He=0.312; n=60) was lower (P≤0.05) than that around the wild-type allele (He=0.834; n=116). Also, the mutant dhfr isolates showed high He for dhps (He=0.80) and the non-drug resistance locus Pfg377 (He=0.63) indicative of selection for mutant dhfr only. The predominant double mutant dhfr haplotype in Jazan (73%), was prevalent among P. falciparum in east Africa. Network analysis suggests the mutant haplotype of dhfr gene was possibly introduced into Jazan from East Africa. The absence of mutations in dhps as well as triple mutant dhfr haplotype associated with SP failure support the current use of SP as a partner with artesunate as a first line therapy in Saudi Arabia. However, the close relationship between the major mutant dhfr haplotype in Sudan and Saudi Arabia, favour the hypothesis of recent migration as a source of the major resistant dhfr lineage. Thus, regular monitoring of the dhfr and dhps haplotypes is of high priority to guard possible importation of high level SP resistant lineages.

Original languageEnglish
Pages (from-to)1253-1259
Number of pages7
JournalInfection, Genetics and Evolution
Volume12
Issue number6
DOIs
Publication statusPublished - Aug 2012

Fingerprint

dihydrofolate reductase
Tetrahydrofolate Dehydrogenase
Saudi Arabia
malaria
Plasmodium falciparum
Malaria
drug
heterozygosity
drugs
allele
sulfadoxine
Pharmaceutical Preparations
pyrimethamine
Haplotypes
mutants
haplotypes
Alleles
alleles
network analysis
gene

Keywords

  • Evolutionary origin
  • Plasmodium falciparum
  • Pyrimethamine-sulfadoxine resistance
  • Saudi Arabia

ASJC Scopus subject areas

  • Ecology, Evolution, Behavior and Systematics
  • Genetics
  • Molecular Biology
  • Microbiology
  • Infectious Diseases
  • Microbiology (medical)

Cite this

Al-Farsi, H. M., Al-Hashami, Z. S., Bin Dajem, S. M., Al-Sheikh, A. A. H., Al-Qahtani, A., Beja-Pereira, A., ... Babiker, H. A. (2012). Source of drug resistant Plasmodium falciparum in a potential malaria elimination site in Saudi Arabia. Infection, Genetics and Evolution, 12(6), 1253-1259. https://doi.org/10.1016/j.meegid.2012.03.011

Source of drug resistant Plasmodium falciparum in a potential malaria elimination site in Saudi Arabia. / Al-Farsi, Hissa M.; Al-Hashami, Zainab S.; Bin Dajem, Saad M.; Al-Sheikh, Adel Ali H; Al-Qahtani, Ahmed; Beja-Pereira, Albano; Idris, Mohamed A.; Babiker, Hamza A.

In: Infection, Genetics and Evolution, Vol. 12, No. 6, 08.2012, p. 1253-1259.

Research output: Contribution to journalArticle

Al-Farsi HM, Al-Hashami ZS, Bin Dajem SM, Al-Sheikh AAH, Al-Qahtani A, Beja-Pereira A et al. Source of drug resistant Plasmodium falciparum in a potential malaria elimination site in Saudi Arabia. Infection, Genetics and Evolution. 2012 Aug;12(6):1253-1259. https://doi.org/10.1016/j.meegid.2012.03.011
Al-Farsi, Hissa M. ; Al-Hashami, Zainab S. ; Bin Dajem, Saad M. ; Al-Sheikh, Adel Ali H ; Al-Qahtani, Ahmed ; Beja-Pereira, Albano ; Idris, Mohamed A. ; Babiker, Hamza A. / Source of drug resistant Plasmodium falciparum in a potential malaria elimination site in Saudi Arabia. In: Infection, Genetics and Evolution. 2012 ; Vol. 12, No. 6. pp. 1253-1259.
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