title: Molecular mutation profile of pfcrt in Plasmodium falciparum isolates imported from Africa in Henan province.
abstract: Anti-malarial drug resistance is a primary public health problem. Haplotypes of pfcrt gene have been implicated to be molecular markers of chloroquine (CQ) resistance. This study aims to explore the prevalence of polymorphisms in pfcrt in Plasmodium falciparum-infected patients imported from Africa in Henan province.
  
  
  
  Blood samples were collected from 502 patients who were infected with P. falciparum returning from Africa in Henan province during 2012-2015. The single nucleotide polymorphisms in pfcrt (codons 72-76) were assessed by nested PCR with DNA sequencing and restriction digestion, the haplotype prevalences were also determined.
  
  
  
  Four haplotypes coding 72-76 of pfcrt were found including CVMNK (wild type), CVIET (mutation type), CVIEK (mutation type), and CV M/I N/E/D/K K/T (mixed type), with 61.95 % (311/502), 33.07 % (166/502), 0.20 % (1/502), and 4.78 % (24/502) prevalence, respectively. Except mixed type, CVIET and CVIEK were the largest proportion of the mutant type in West Africa, accounting for 44.83 % (91/203), followed by East Africa (8/21, 38.10 %), North Africa (4/11, 36.36 %), Central Africa (36/135, 26.67 %), and South Africa (28/132, 21.21 %). There was significant difference among the groups (χ(2) = 23.78, P < 0.05). Mixed type was the largest proportion in North Africa (9.09 %), followed by Central Africa (6.67 %), East Africa (4.76 %), South Africa (4.55 %), and West Africa (3.45 %). There was no significant difference among the groups (χ(2) = 2.31, P > 0.05). The position 72 and 73 of pfcrt showed predominance for the wild type with rates of 100 % (502/502).
  
  
  
  This study identified four haplotypes of pfcrt in P. falciparum-infected patients imported from Africa in Henan province. The prevalence of mutations in the pfcrt was dropped comparing with other people's researches. It establishes fundamental data for detection of P. falciparum CQR with molecular markers for the imported P. falciparum in China, and it also provides complementary information of CQR for the malaria endemic countries and assesses the evolution of anti-malarial drug resistance.
authors.affiliation: Department of Parasite Disease Control and Prevention, Henan Province Center for Disease Control and Prevention, Zhengzhou, 450016, People's Republic of China.
authors.forename: Rui-Min
authors.initials: RM
authors.lastname: Zhou
authors.affiliation: Department of Parasite Disease Control and Prevention, Henan Province Center for Disease Control and Prevention, Zhengzhou, 450016, People's Republic of China.
authors.forename: Hong-Wei
authors.initials: HW
authors.lastname: Zhang
authors.affiliation: Department of Parasite Disease Control and Prevention, Henan Province Center for Disease Control and Prevention, Zhengzhou, 450016, People's Republic of China.
authors.forename: Cheng-Yun
authors.initials: CY
authors.lastname: Yang
authors.affiliation: Department of Parasite Disease Control and Prevention, Henan Province Center for Disease Control and Prevention, Zhengzhou, 450016, People's Republic of China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Parasite Disease Control and Prevention, Henan Province Center for Disease Control and Prevention, Zhengzhou, 450016, People's Republic of China.
authors.forename: Yu-Ling
authors.initials: YL
authors.lastname: Zhao
authors.affiliation: Department of Parasite Disease Control and Prevention, Henan Province Center for Disease Control and Prevention, Zhengzhou, 450016, People's Republic of China.
authors.forename: Su-Hua
authors.initials: SH
authors.lastname: Li
authors.affiliation: Department of Parasite Disease Control and Prevention, Henan Province Center for Disease Control and Prevention, Zhengzhou, 450016, People's Republic of China.
authors.forename: Dan
authors.initials: D
authors.lastname: Qian
authors.affiliation: Department of Parasite Disease Control and Prevention, Henan Province Center for Disease Control and Prevention, Zhengzhou, 450016, People's Republic of China. bianlixu@163.com.
authors.forename: Bian-Li
authors.initials: BL
authors.lastname: Xu
mesh_terms: D000293:Adolescent; D000328:Adult; D000349:Africa; D000368:Aged; D000962:Antimalarials / Q000494:pharmacology; D002681:China; D002738:Chloroquine / Q000494:pharmacology; D004351:Drug Resistance; D005260:Female; D005787:Gene Frequency; D006239:Haplotypes; D006801:Humans; D016778:Malaria, Falciparum / Q000469:parasitology*; D008297:Male; D026901:Membrane Transport Proteins / Q000235:genetics*; D008875:Middle Aged; D009154:Mutation; D016133:Polymerase Chain Reaction; D012150:Polymorphism, Restriction Fragment Length; D020641:Polymorphism, Single Nucleotide; D015800:Protozoan Proteins / Q000235:genetics*; D017422:Sequence Analysis, DNA; D014195:Travel; D055815:Young Adult
chemical_list: D000962:Antimalarials; D026901:Membrane Transport Proteins; C416369:PfCRT protein, Plasmodium falciparum; D015800:Protozoan Proteins; D002738:Chloroquine
keywords: Africa; Chloroquine resistance (CQR); Henan province; Imported; Pfcrt; Plasmodium falciparum