Author:
Schunk Mirjam,Kumma Wondimagegn P,Miranda Isabel Barreto,Osman Maha E,Roewer Susanne,Alano Abraham,Löscher Thomas,Bienzle Ulrich,Mockenhaupt Frank P
Abstract
Abstract
Background
In Ethiopia, malaria is caused by both Plasmodium falciparum and Plasmodium vivax. Drug resistance of P. falciparum to sulfadoxine-pyrimethamine (SP) and chloroquine (CQ) is frequent and intense in some areas.
Methods
In 100 patients with uncomplicated malaria from Dilla, southern Ethiopia, P. falciparum dhfr and dhps mutations as well as P. vivax dhfr polymorphisms associated with resistance to SP and P. falciparum pfcrt and pfmdr1 mutations conferring CQ resistance were assessed.
Results
P. falciparum and P. vivax were observed in 69% and 31% of the patients, respectively. Pfdhfr triple mutations and pfdhfr/pfdhps quintuple mutations occurred in 87% and 86% of P. falciparum isolates, respectively. Pfcrt T76 was seen in all and pfmdr1 Y86 in 81% of P. falciparum. The P. vivax dhfr core mutations N117 and R58 were present in 94% and 74%, respectively.
Conclusion
These data point to an extraordinarily high frequency of drug-resistance mutations in both P. falciparum and P. vivax in southern Ethiopia, and strongly support that both SP and CQ are inadequate drugs for this region.
Publisher
Springer Science and Business Media LLC
Subject
Infectious Diseases,Parasitology
Reference28 articles.
1. Abeku TA, van Oortmarssen GJ, Borsboom G, de Vlas SJ, Habbema J: Spatial and temporal variations of malaria epidemic risk in Ethiopia: factors involved and implications. Acta Trop. 2003, 87: 331-340. 10.1016/S0001-706X(03)00123-2.
2. RBM Baseline survey in selected districts in Ethiopia. Report 2001. Ministry of Health, Addis Ababa, Ethiopia.
3. Das P: Ethiopia faces severe malaria epidemic. Lancet. 2003, 362: 2071-10.1016/S0140-6736(03)15150-1.
4. Jima D, Tesfaye G, Medhin A, Kebede A, Argaw D, Babaniyi O: Efficacy of sulfadoxine-pyrimethamine for the treatment of uncomplicated falciparum malaria in Ethiopia. East Afr Med J. 2005, 82: 391-395.
5. Assessment of the therapeutic efficacy of antimalarial drugs in Ethiopia. Ministry of Health, Addis Ababa, Ethiopia.