Monitoring antimalarial drug-resistance markers in Somalia

Abstract

The use of an effective antimalarial drug is the cornerstone of malaria control. However, the development and spread of resistant <i>Plasmodium falciparum</i> strains have placed the global eradication of malaria in serious jeopardy. Molecular marker analysis constitutes the hallmark of the monitoring of <i>Plasmodium</i> drug-resistance. This study included 96 <i>P. falciparum</i> PCR-positive samples from southern Somalia. The <i>P. falciparum chloroquine resistance transporter</i> gene had high frequencies of K76T, A220S, Q271E, N326S, and R371I point mutations. The N86Y and Y184F mutant alleles of the <i>P. falciparum multidrug resistance 1</i> gene were present in 84.7 and 62.4% of the isolates, respectively. No mutation was found in the <i>P. falciparum Kelch-13</i> gene. This study revealed that chloroquine resistance markers are present at high frequencies, while the parasite remains sensitive to artemisinin (ART). The continuous monitoring of ART-resistant markers and in vitro susceptibility testing are strongly recommended to track resistant strains in real time.