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Prevalence of mutations associated with antimalarial drugs in Plasmodium falciparum isolates prior to the introduction of sulphadoxine-pyrimethamine as first-line treatment in Iran.

Zakeri S, Afsharpad M, Raeisi A, Djadid ND - Malar. J. (2007)

Bottom Line: The prevalence of pfdhps 437G mutation was 17% (Chabahar) and 33% (Sarbaz) isolates. 20.4% of samples presented the pfdhfr 108N, 59R with pfdhps 437G mutations.The frequency of allele pfcrt 76T was 98%, while 41.4% (Chabahar) and 27.7% (Sarbaz) isolates carried pfmdr1 86Y allele.Eight distinct haplotypes were identified in all 206 samples, while the most prevalent haplotype was T76/N86/N51R59N108/A437 among both study areas.

View Article: PubMed Central - HTML - PubMed

Affiliation: Malaria and Vector Research Group (MVRG), Biotechnology Research Center, Institut Pasteur of Iran, Pasteur Avenue, PO BOX 1316943551, Tehran, Iran. zakeris@yahoo.com

ABSTRACT

Background: This work was carried out to assess the patterns and prevalence of resistance to chloroquine (CQ) and sulphadoxine-pyrimethamine (SP) in Iran.

Methods: The prevalence of pfcrt K76T, pfmdr1 N86Y, pfdhfr N51I, C59R, S108N/T and I164L and codons S436F/A, A437G, K540E, A581E, and A613S/T in pfdhps genes were genotyped by PCR/RFLP methods in 206 Plasmodium falciparum isolates from Chabahar and Sarbaz districts in Sistan and Baluchistan province, Iran, during 2003-2005.

Results: All P. falciparum isolates carried the 108N, while 98.5% parasite isolates carried the 59R mutation. 98.5% of patients carried both 108N and 59R. The prevalence of pfdhps 437G mutation was 17% (Chabahar) and 33% (Sarbaz) isolates. 20.4% of samples presented the pfdhfr 108N, 59R with pfdhps 437G mutations. The frequency of allele pfcrt 76T was 98%, while 41.4% (Chabahar) and 27.7% (Sarbaz) isolates carried pfmdr1 86Y allele. Eight distinct haplotypes were identified in all 206 samples, while the most prevalent haplotype was T76/N86/N51R59N108/A437 among both study areas.

Conclusion: Finding the fixed level of CQ resistance polymorphisms (pfcrt 76T) suggests that CQ must be withdrawn from the current treatment strategy in Iran, while SP may remain the treatment of choice for uncomplicated malaria.

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Related in: MedlinePlus

Map of Iran indicating the location of the study area in Chabahar and Sarbaz districts situated in the south-eastern corner of Baluchistan Province, from where the P. falciparum isolates were collected. S&B: Sistan and Baluchistan province, Ch: Chabahar, P: Pishin
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Figure 1: Map of Iran indicating the location of the study area in Chabahar and Sarbaz districts situated in the south-eastern corner of Baluchistan Province, from where the P. falciparum isolates were collected. S&B: Sistan and Baluchistan province, Ch: Chabahar, P: Pishin

Mentions: Chabahar and Sarbaz districts in Sistan and Baluchistan province in south-eastern part of Iran have been selected as study areas. Both areas are malaria endemic and the patients have access to antimalarial drugs through local health centers. In Chabahar district samples were collected from Chabahar, Nowbandiyan and Dargas health centers, however, in Sarbaz district most of the samples were collected from Pishin health center (5 Km far from border line with Pakistan), where, there is a lot of population movement to Pakistan and vice versa (Figure 1). In these regions, malaria transmission is year-round with two peaks, the first in May to August with P. vivax as the predominant species and the second peak from October to November, when both P. falciparum and P. vivax infections are generally equally recorded. 206 blood samples were collected from P. falciparum-infected patients, aged from 1 to >60 years old with Iranian, Afghani and Pakistani nationals from Chabahar (n = 152) and Sarbaz (n = 54) districts in Sistan and Baluchistan during 2003 to October 2005.


Prevalence of mutations associated with antimalarial drugs in Plasmodium falciparum isolates prior to the introduction of sulphadoxine-pyrimethamine as first-line treatment in Iran.

Zakeri S, Afsharpad M, Raeisi A, Djadid ND - Malar. J. (2007)

Map of Iran indicating the location of the study area in Chabahar and Sarbaz districts situated in the south-eastern corner of Baluchistan Province, from where the P. falciparum isolates were collected. S&B: Sistan and Baluchistan province, Ch: Chabahar, P: Pishin
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2214731&req=5

Figure 1: Map of Iran indicating the location of the study area in Chabahar and Sarbaz districts situated in the south-eastern corner of Baluchistan Province, from where the P. falciparum isolates were collected. S&B: Sistan and Baluchistan province, Ch: Chabahar, P: Pishin
Mentions: Chabahar and Sarbaz districts in Sistan and Baluchistan province in south-eastern part of Iran have been selected as study areas. Both areas are malaria endemic and the patients have access to antimalarial drugs through local health centers. In Chabahar district samples were collected from Chabahar, Nowbandiyan and Dargas health centers, however, in Sarbaz district most of the samples were collected from Pishin health center (5 Km far from border line with Pakistan), where, there is a lot of population movement to Pakistan and vice versa (Figure 1). In these regions, malaria transmission is year-round with two peaks, the first in May to August with P. vivax as the predominant species and the second peak from October to November, when both P. falciparum and P. vivax infections are generally equally recorded. 206 blood samples were collected from P. falciparum-infected patients, aged from 1 to >60 years old with Iranian, Afghani and Pakistani nationals from Chabahar (n = 152) and Sarbaz (n = 54) districts in Sistan and Baluchistan during 2003 to October 2005.

Bottom Line: The prevalence of pfdhps 437G mutation was 17% (Chabahar) and 33% (Sarbaz) isolates. 20.4% of samples presented the pfdhfr 108N, 59R with pfdhps 437G mutations.The frequency of allele pfcrt 76T was 98%, while 41.4% (Chabahar) and 27.7% (Sarbaz) isolates carried pfmdr1 86Y allele.Eight distinct haplotypes were identified in all 206 samples, while the most prevalent haplotype was T76/N86/N51R59N108/A437 among both study areas.

View Article: PubMed Central - HTML - PubMed

Affiliation: Malaria and Vector Research Group (MVRG), Biotechnology Research Center, Institut Pasteur of Iran, Pasteur Avenue, PO BOX 1316943551, Tehran, Iran. zakeris@yahoo.com

ABSTRACT

Background: This work was carried out to assess the patterns and prevalence of resistance to chloroquine (CQ) and sulphadoxine-pyrimethamine (SP) in Iran.

Methods: The prevalence of pfcrt K76T, pfmdr1 N86Y, pfdhfr N51I, C59R, S108N/T and I164L and codons S436F/A, A437G, K540E, A581E, and A613S/T in pfdhps genes were genotyped by PCR/RFLP methods in 206 Plasmodium falciparum isolates from Chabahar and Sarbaz districts in Sistan and Baluchistan province, Iran, during 2003-2005.

Results: All P. falciparum isolates carried the 108N, while 98.5% parasite isolates carried the 59R mutation. 98.5% of patients carried both 108N and 59R. The prevalence of pfdhps 437G mutation was 17% (Chabahar) and 33% (Sarbaz) isolates. 20.4% of samples presented the pfdhfr 108N, 59R with pfdhps 437G mutations. The frequency of allele pfcrt 76T was 98%, while 41.4% (Chabahar) and 27.7% (Sarbaz) isolates carried pfmdr1 86Y allele. Eight distinct haplotypes were identified in all 206 samples, while the most prevalent haplotype was T76/N86/N51R59N108/A437 among both study areas.

Conclusion: Finding the fixed level of CQ resistance polymorphisms (pfcrt 76T) suggests that CQ must be withdrawn from the current treatment strategy in Iran, while SP may remain the treatment of choice for uncomplicated malaria.

Show MeSH
Related in: MedlinePlus