title: Prevalence of antimalarial drug resistance mutations in Plasmodium vivax and P. falciparum from a malaria-endemic area of Pakistan.
abstract: To study drug resistance in Bannu district, a malaria-endemic area in Pakistan, molecular-based analyses were undertaken. In Plasmodium vivax, antifolate resistance mutations were detected in pvdhfr gene codons 57, 58, and 117, with a 117N mutation frequency of 93.5%. All P. falciparum isolates exhibited double 59R + 108N mutations in pfdhfr, whereas the triple mutant 59R + 108N + 437G haplotype was found in 31.8% isolates. Furthermore, all (100%) P. falciparum isolates exhibited the key chloroquine resistance mutation, pfcrt 76T, which is also associated with resistance to amodiaquine. Additionally, pfmdr1 86Y and D1042Y mutations were, respectively, detected in 32% and 9% isolates. These results indicate an emerging multi-drug resistance problem in P. vivax and P. falciparum malaria parasites in Pakistan.
authors.affiliation: Department of Biochemistry, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, Pakistan. lubnabch@hotmail.com
authors.forename: Lubna
authors.initials: L
authors.lastname: Khatoon
authors.forename: Frederick N
authors.initials: FN
authors.lastname: Baliraine
authors.forename: Mariangela
authors.initials: M
authors.lastname: Bonizzoni
authors.forename: Salman A
authors.initials: SA
authors.lastname: Malik
authors.forename: Guiyun
authors.initials: G
authors.lastname: Yan
mesh_terms: D000818:Animals; D000962:Antimalarials / Q000494:pharmacology*; D004351:Drug Resistance / Q000235:genetics; D019353:Endemic Diseases; D006801:Humans; D016778:Malaria, Falciparum / Q000453:epidemiology* / Q000469:parasitology; D016780:Malaria, Vivax / Q000453:epidemiology* / Q000469:parasitology; D009154:Mutation; D010154:Pakistan / Q000453:epidemiology; D010963:Plasmodium falciparum / Q000187:drug effects* / Q000235:genetics; D010966:Plasmodium vivax / Q000187:drug effects* / Q000235:genetics; D015995:Prevalence
chemical_list: D000962:Antimalarials
references.citation: Mol Biochem Parasitol. 1997 Nov;89(2):161-77
references.pmid: 9364963
references.citation: J Infect Dis. 2008 Feb 15;197(4):510-8
references.pmid: 18240951
references.citation: Am J Trop Med Hyg. 2008 Aug;79(2):173-7
references.pmid: 18689620
references.citation: Trends Parasitol. 2007 May;23(5):213-22
references.pmid: 17368986
references.citation: Am J Trop Med Hyg. 1996 Aug;55(2):131-7
references.pmid: 8780449
references.citation: Acta Trop. 2009 Jan;109(1):37-40
references.pmid: 18950599
references.citation: Am J Trop Med Hyg. 2005 Jul;73(1):199-203
references.pmid: 16014858
references.citation: Am J Trop Med Hyg. 2009 Mar;80(3):470-4
references.pmid: 19270300
references.citation: Antimicrob Agents Chemother. 2007 Mar;51(3):857-63
references.pmid: 17194833
references.citation: Lancet Infect Dis. 2002 Apr;2(4):209-18
references.pmid: 11937421
references.citation: Malar J. 2009 Jan 28;8:20
references.pmid: 19175936
references.citation: Am J Trop Med Hyg. 1999 Apr;60(4):687-92
references.pmid: 10348249
references.citation: Am J Trop Med Hyg. 2008 Mar;78(3):462-7
references.pmid: 18337344
references.citation: PLoS Clin Trials. 2006 Jul 21;1(3):e15
references.pmid: 16871318
references.citation: JAMA. 2007 May 23;297(20):2201-9
references.pmid: 17519409
references.citation: J Ayub Med Coll Abbottabad. 2008 Jan-Mar;20(1):98-102
references.pmid: 19024199
references.citation: J Infect Dis. 2009 Jul 1;200(1):66-74
references.pmid: 19476434
references.citation: Malar J. 2008 Oct 02;7:199
references.pmid: 18831737
references.citation: J Infect Dis. 2004 Feb 15;189(4):744-50
references.pmid: 14767830
references.citation: Antimicrob Agents Chemother. 2005 Oct;49(10):4393-5
references.pmid: 16189131
references.citation: Antimicrob Agents Chemother. 2008 Dec;52(12):4233-40
references.pmid: 18809933
references.citation: Am J Trop Med Hyg. 1999 Sep;61(3):367-74
references.pmid: 10497972