1. Distribution pattern of amino acid mutations in chloroquine and antifolate drug resistance associated genes in complicated and uncomplicated Plasmodium vivax isolates from Chandigarh, North India.
- Author
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Kaur H, Sehgal R, Kumar A, Bharti PK, Bansal D, Mohapatra PK, Mahanta J, and Sultan AA
- Subjects
- Adolescent, Child, Child, Preschool, Chloroquine therapeutic use, DNA, Protozoan genetics, DNA, Protozoan metabolism, Female, Folic Acid Antagonists therapeutic use, Haplotypes, Humans, India, Male, Multidrug Resistance-Associated Proteins genetics, Plasmodium vivax isolation & purification, Polymorphism, Single Nucleotide, Young Adult, Antimalarials therapeutic use, Drug Resistance genetics, Malaria, Vivax drug therapy, Plasmodium vivax genetics, Protozoan Proteins genetics
- Abstract
Background: The increasing antimalarial drug resistance is a significant hindrance to malaria control and elimination programs. For the last six decades, chloroquine (CQ) plus pyrimethamine remains the first-line treatment for P. vivax malaria. Regions where both P. falciparum and P. vivax co-exist, P. vivax is exposed to antifolate drugs due to either misdiagnosis or improper treatment that causes selective drug pressure to evolve. Therefore, the present study aims to estimate antimalarial drug resistance among the complicated and uncomplicated P. vivax patients., Methods: A total of 143 P. vivax malaria positive patients were enrolled in this study, and DNA was isolated from their blood samples. Pvcrt-o, Pvmdr-1, Pvdhps, and Pvdhfr genes were PCRs amplified, and drug resistance-associated gene mutations were analyzed. Statistical analysis of the drug resistance genes and population diversity was performed using MEGA vs. 7.0.21 and DnaSP v software., Results: Among the CQ resistance marker gene Pvcrt-o, the prevalence of K10 insertion was 17.5% (7/40) and 9.5% (7/73) of complicated and uncomplicated P vivax group isolates respectively. In Pvmdr-1, double mutant haplotype (M
958 /L1076 ) was found in 99% of the clinical isolates. Among the pyrimethamine resistance-associated gene Pvdhfr, the double mutant haplotype I13 P33 F57 R58 T61 N117 I173 was detected in 23% (11/48) in complicated and 20% (17/85) in uncomplicated group isolates. In the sulphadoxine resistance-associated Pvdhps gene, limited polymorphism was observed with the presence of a single mutant (D459A) among 16 and 5% of the clinical isolates in the complicated and uncomplicated group respectively., Conclusion: The study presents the situations of polymorphism in the antimalarial drug resistance-associated genes and emphasizes the need for regular surveillance. It is imperative for the development of suitable antimalarial drug policy in India.- Published
- 2020
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