• Multiple origins and regional dispersal of resistant dhps in African Plasmodium falciparum malaria.

      Pearce, Richard J; Pota, Hirva; Evehe, Marie-Solange B; Bâ, El-Hadj; Mombo-Ngoma, Ghyslain; Malisa, Allen L; Ord, Rosalynn; Inojosa, Walter; Matondo, Alexandre; Diallo, Diadier A; Mbacham, Wilfred; van den Broek, Ingrid V; Swarthout, Todd D; Getachew, Asefaw; Dejene, Seyoum; Grobusch, Martin P; Njie, Fanta; Dunyo, Samuel; Kweku, Margaret; Owusu-Agyei, Seth; Chandramohan, Daniel; Bonnet, Maryline; Guthmann, Jean-Paul; Clarke, Sian; Barnes, Karen I; Streat, Elizabeth; Katokele, Stark T; Uusiku, Petrina; Agboghoroma, Chris O; Elegba, Olufunmilayo Y; Cissé, Badara; A-Elbasit, Ishraga E; Giha, Hayder A; Kachur, S Patrick; Lynch, Caroline; Rwakimari, John B; Chanda, Pascalina; Hawela, Moonga; Sharp, Brian; Naidoo, Inbarani; Roper, Cally; London School of Hygiene & Tropical Medicine, Department of Infectious Tropical Diseases, London, UK. (2009-04-14)
      BACKGROUND: Although the molecular basis of resistance to a number of common antimalarial drugs is well known, a geographic description of the emergence and dispersal of resistance mutations across Africa has not been attempted. To that end we have characterised the evolutionary origins of antifolate resistance mutations in the dihydropteroate synthase (dhps) gene and mapped their contemporary distribution. METHODS AND FINDINGS: We used microsatellite polymorphism flanking the dhps gene to determine which resistance alleles shared common ancestry and found five major lineages each of which had a unique geographical distribution. The extent to which allelic lineages were shared among 20 African Plasmodium falciparum populations revealed five major geographical groupings. Resistance lineages were common to all sites within these regions. The most marked differentiation was between east and west African P. falciparum, in which resistance alleles were not only of different ancestry but also carried different resistance mutations. CONCLUSIONS: Resistant dhps has emerged independently in multiple sites in Africa during the past 10-20 years. Our data show the molecular basis of resistance differs between east and west Africa, which is likely to translate into differing antifolate sensitivity. We have also demonstrated that the dispersal patterns of resistance lineages give unique insights into recent parasite migration patterns.
    • Short Report: Association Between Chloroquine and Amodiaquine Resistance and Allelic Variation in the Plasmodium Falciparum Multiple Drug Resistance 1 Gene and the Chloroquine Resistance Transporter Gene in Isolates from the Upper Nile in Southern Sudan.

      Ochong, E; van den Broek, I; Keus, K; Nzila, A; Kenya Medical Research Institute, Wellcome Trust Collaborative Program, Médecins sans Frontières-Holland, South Sudan Section, Nairobi, Kenya. (Published by: American Society of Tropical Medicine and Hygiene, 2003-08)
      Amodiaquine, a 4-aminoquinoline compound, is being considered as an alternative to chloroquine and pyrimethamine/sulfadoxine where resistance in Plasmodium falciparum to both drugs has been selected. Although amodiaquine is more potent than chloroquine, its effectiveness is reduced in areas where chloroquine resistance is high. We report an association of the P. falciparum chloroquine resistance transporter (pfcrt) gene and the P. falciparum multiple drug resistance 1 (pfmdr1) gene, two chloroquine resistance markers, with chloroquine and amodiaquine efficacy in vivo in southern Sudan. The data show that the allele of the pfcrt gene with a lysine to threonine change at codon 76 is strongly associated with both chloroquine and amodiaquine resistance. No such association was observed with the pfmdr1 gene.