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Am. J. Trop. Med. Hyg., 69(6), 2003, pp. 614-620
Copyright © 2003 by The American Society of Tropical Medicine and Hygiene

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FREQUENCY DISTRIBUTION OF ANTIMALARIAL DRUG-RESISTANT ALLELES AMONG ISOLATES OF PLASMODIUM FALCIPARUM IN PURWOREJO DISTRICT, CENTRAL JAVA PROVINCE, INDONESIA

D. SYAFRUDDIN, PUJI B. S. ASIH, SONA L. AGGARWAL, AND ANURAJ H. SHANKAR
Eijkman Institute for Molecular Biology, Jakarta, Indonesia; Department of Parasitology, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia; Department of International Health, Johns Hopkins School of Public Health; Johns Hopkins School of Medicine, Baltimore, Maryland; Helen Keller International, Jakarta, Indonesia

Treatment failures to the first- and second-lines antimalarial drugs chloroquine and sulfadoxine-pyrimethamine have increased in the Purworejo district on the island of Java, Indonesia. A molecular epidemiologic study was conducted to determine the frequency distribution of mutant alleles of the genes associated with the resistance among the isolates of Plasmodium falciparum from the area. Analyses using a polymerase chain reaction and restriction fragment length polymorphism showed that nearly all of the 111 samples carried mutant alleles in genes associated with chloroquine resistance: P. falciparum multi-drug resistance 1 (pfmdr1) 86Y (92%), 1042D (4.5%), and P. falciparum chloroquine resistance transporter (pfcrt) 76T (99.1%). Mutant alleles of the in the dihydrofolate reductase (dhfr) gene were also high (84.7%), either as 108N and 108T or paired with 59R, and 16V, respectively. Mutant alleles in the dihydropteroate synthase gene were the least common, either as a single 437G mutation (35.3%) or paired with 540E (26.5%). These results are consistent with the antimalarial drug resistance situation in the area and emphasize the need for a proper treatment strategy.

Received March 26, 2003. Accepted for publication September 13, 2003.

Acknowledgments: We thank officials of the Ministry of Health in Purworejo District and at the selected subdistrict and villages for providing us with technical support during the malariometric surveys, Dr. F. Laihad (Malaria Section, Center for Communicable Diseases Control, The Ministry of Health) and Dr. M. Duffy (Australia-Indonesia Medical Research Initiative) for critically reading the manuscript. We also thank Professor Sangkot Marzuki (Director of the Eijkman Institute, Jakarta) for his invaluable support and input.

Financial support: This work was supported in part by The Indonesian Government through Bappenas, the Australia-Indonesia Medical Research Initiative project, a fellowship from the American Society of Tropical Medicine and Hygiene awarded to Sona L. Aggarwal, and by a Prebluda Fellowship grant awarded to Anuraj H. Shankar.

This work also received support from the Nutrition and Health Surveillance System Cooperative Agreement No. 497-a-00-99-00033-00 between USAID-Indosia and Helen Keller International.

Authors’ addresses: D. Syafruddin, Eijkman Institute for Molecular Biology, Jl. Diponegoro 69, Jakarta 10430, Indonesia and Department of Parasitology, Faculty of Medicine, Hasanuddin University, Jl. Perintis Kemerdekaan Km 10, Makassar 90245, Indonesia. Puji B. S. Asih, Eijkman Institute for Molecular Biology, Jl. Diponegoro 69, Jakarta 10430, Indonesia. Sona L. Aggarwal, Johns Hopkins School of Medicine, Baltimore, MD 21205. Anuraj H. Shankar, Helen Keller International, Jl. Bungur Dalam 23 A, Kemang, Jakarta 12730, Indonesia.

Reprint requests: D. Syafruddin, Eijkman Institute for Molecular Biology, Jalan Diponegoro 69, Jakarta 10430, Indonesia, Telephone: 62-21-3917131, Fax: 62-21-3147982, E-mail: din{at}eijkman.go.id




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Home page
 Am J Trop Med HygHome page
D. SYAFRUDDIN, P. B. S. ASIH, G. J. CASEY, J. MAGUIRE, J. K. BAIRD, H. S. NAGESHA, A. F. COWMAN, and J. C. REEDER
MOLECULAR EPIDEMIOLOGY OF PLASMODIUM FALCIPARUM RESISTANCE TO ANTIMALARIAL DRUGS IN INDONESIA
Am J Trop Med Hyg, February 1, 2005; 72(2): 174 - 181.
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