title: Molecular surveillance of the antifolate-resistant mutation I164L in imported African isolates of Plasmodium falciparum in Europe: sentinel data from TropNetEurop.
abstract: 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.
authors.affiliation: Institute of Tropical Medicine, Charité, Humboldt University, Berlin, Germany. ole.wichmann@charite.de
authors.forename: Ole
authors.initials: O
authors.lastname: Wichmann
authors.forename: Tomas
authors.initials: T
authors.lastname: Jelinek
authors.forename: Gabriele
authors.initials: G
authors.lastname: Peyerl-Hoffmann
authors.forename: Nikolai
authors.initials: N
authors.lastname: Mühlberger
authors.forename: Martin P
authors.initials: MP
authors.lastname: Grobusch
authors.forename: Joaquim
authors.initials: J
authors.lastname: Gascon
authors.forename: Alberto
authors.initials: A
authors.lastname: Matteelli
authors.forename: Christoph
authors.initials: C
authors.lastname: Hatz
authors.forename: Hermann
authors.initials: H
authors.lastname: Laferl
authors.forename: Marco
authors.initials: M
authors.lastname: Schulze
authors.forename: Gerd
authors.initials: G
authors.lastname: Burchard
authors.forename: Saraiva
authors.initials: S
authors.lastname: da Cunha
authors.forename: Jiøi
authors.initials: J
authors.lastname: Beran
authors.forename: Paul
authors.initials: P
authors.lastname: McWhinney
authors.forename: Herwig
authors.initials: H
authors.lastname: Kollaritsch
authors.forename: Peter
authors.initials: P
authors.lastname: Kern
authors.forename: Juan
authors.initials: J
authors.lastname: Cuadros
authors.forename: Michael
authors.initials: M
authors.lastname: Alifrangis
authors.forename: Ida
authors.initials: I
authors.lastname: Gjørup
mesh_terms: 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
chemical_list: D005493:Folic Acid Antagonists; D007532:Isoleucine; D007930:Leucine