Plasmodium falciparum sulfadoxine resistance is geographically and genetically clustered within the DR Congo.
Understanding the spatial clustering of Plasmodium falciparum populations can assist efforts to contain drug-resistant parasites and maintain the efficacy of future drugs. We sequenced single nucleotide polymorphisms (SNPs) in the dihydropteroate synthase gene (dhps) associated with sulfadoxine resistance and 5 microsatellite loci flanking dhps in order to investigate the genetic backgrounds, genetic relatedness, and geographic clustering of falciparum parasites in the Democratic Republic of the Congo (DRC). Resistant haplotypes were clustered into subpopulations: one in the northeast DRC, and the other in the balance of the DRC. Network and clonal lineage analyses of the flanking microsatellites indicate that geographically-distinct mutant dhps haplotypes derive from separate lineages. The DRC is therefore a watershed for haplotypes associated with sulfadoxine resistance. Given the importance of central Africa as a corridor for the spread of antimalarial resistance, the identification of the mechanisms of this transit can inform future policies to contain drug-resistant parasite strains.
Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina , Chapel Hill, USA. steve.taylor@duke.edu
Steve M
SM
Taylor
Alejandro L
AL
Antonia
Christian M
CM
Parobek
Jonathan J
JJ
Juliano
Mark
M
Janko
Michael
M
Emch
Md Tauqeer
MT
Alam
Venkatachalam
V
Udhayakumar
Antoinette K
AK
Tshefu
Steven R
SR
Meshnick
D000962:Antimalarials / Q000494:pharmacology*; D016000:Cluster Analysis; D003223:Congo; D004094:Dihydropteroate Synthase / Q000235:genetics; D004351:Drug Resistance / Q000235:genetics; D005828:Genetics, Population; D062306:Geography, Medical; D006239:Haplotypes; D006801:Humans; D016778:Malaria, Falciparum / Q000453:epidemiology; D018895:Microsatellite Repeats; D009154:Mutation; D010963:Plasmodium falciparum / Q000187:drug effects* / Q000235:genetics*; D015995:Prevalence; D013413:Sulfadoxine / Q000494:pharmacology*
D000962:Antimalarials; D013413:Sulfadoxine; D004094:Dihydropteroate Synthase