Molecular surveillance of the antifolate-resistant mutation I164L in imported African isolates of Plasmodium falciparum in Europe: sentinel data from TropNetEurop.
BACKGROUND
Malaria parasites that carry the DHFR-mutation I164L are not only highly resistant to sulfadoxine-pyrimethamine but also to the new antimalarial drug chlorproguanil-dapsone. The spread of this mutation in Africa would result in a public health disaster since there is a lack of effective alternatives that are both affordable and safe. Up to now, this mutation has only been described in Asian and Latin-American countries. The objective of this study was to assess the prevalence of this mutation in African isolates of Plasmodium falciparum that have been imported into Europe through travellers.


METHODS
TropNetEurop is a network for the surveillance of travel-associated diseases and seems to cover approximately 12% of all malaria cases imported into Europe. Within this network we screened 277 imported African isolates of P. falciparum with the help of PCR- and enzyme-digestion-methods for the antifolate-resistant mutation I164L.


RESULTS
The I164L mutation was not detected in any of the isolates tested.


CONCLUSIONS
Continuous molecular surveillance of mutations in P. falciparum, as it is practised within TropNetEurop, is an essential tool for the understanding and early detection of the spread of antimalarial drug resistance in Africa.
Wichmann
Ole
O
Institute of Tropical Medicine, Charité, Humboldt University, Berlin, Germany. ole.wichmann@charite.de
Jelinek
Tomas
T
Peyerl-Hoffmann
Gabriele
G
Mühlberger
Nikolai
N
Grobusch
Martin P
MP
Gascon
Joaquim
J
Matteelli
Alberto
A
Hatz
Christoph
C
Laferl
Hermann
H
Schulze
Marco
M
Burchard
Gerd
G
da Cunha
Saraiva
S
Beran
Jiøi
J
McWhinney
Paul
P
Kollaritsch
Herwig
H
Kern
Peter
P
Cuadros
Juan
J
Alifrangis
Michael
M
Gjørup
Ida
I
D019943:Amino Acid Substitution / Q000235:genetics; D000818:Animals; D018432:Drug Resistance, Multiple / Q000235:genetics*; D005493:Folic Acid Antagonists / Q000378:metabolism*; D006801:Humans; D007532:Isoleucine / Q000235:genetics; D007930:Leucine / Q000235:genetics; D016778:Malaria, Falciparum / Q000175:diagnosis / Q000453:epidemiology / Q000235:genetics / Q000378:metabolism; D010963:Plasmodium falciparum / Q000187:drug effects* / Q000235:genetics* / Q000302:isolation & purification; D011159:Population Surveillance
D005493:Folic Acid Antagonists; D007532:Isoleucine; D007930:Leucine