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ASSOCIATION OF PLASMODIUM FALCIPARUM ISOLATES ENCODING THE P. FALCIPARUM CHLOROQUINE RESISTANCE TRANSPORTER GENE K76T POLYMORPHISM WITH ANEMIA AND SPLENOMEGALY, BUT NOT WITH MULTIPLE INFECTIONS

The aim of the study was to assess whether infections with Plasmodium falciparum isolates encoding the P. falciparum chloroquine resistance transporter (pfcrt) gene K76T polymorphism, a molecular marker for chloroquine resistance, are associated with multiple infections, age, or clinical signs of malaria in a semi-immune population in a holoendemic area of Burkina Faso. The parameters of interest were investigated in 210 P. falciparum-positive inhabitants. Logistic regression analysis showed that pfcrt K76T-carrying isolates are significantly more likely to cause anemia and splenomegaly. Furthermore, we found that infections with P. falciparum isolates encoding pfcrt K76T are dependent on age rather than multiple infections. Our findings suggest that pfcrt K76T might serve as a valuable marker for assessing the long-term clinical effect of chronic infections with chloroquine-resistant P. falciparum isolates in populations, without the need of drug efficacy trials.

Received February 6, 2004. Accepted for publication November 2, 2004.

Acknowledgments: Ido Kolé, Xavier Pitroipa, Michael Scheiwein, Corneille Traoré and Issaka Zombra were invaluable members of the field team. We thank Oliver Razum for helping with the statistical analysis and Thomas Junghanss for critically reading the manuscript. Our special thanks go to the people of Bourasso for their continuous hospitality and willingness to participate in the study.

Financial support: This project was supported by the Sonderfor-schungsbreich 544, Kontrolle Tropischer Infektionskrankheiten. Inas Z. Abdel-Aziz was supported by a fellowship from the Deutscher Akademischer Austauschdienst.

Authors’ addresses: Inas Z. Abdel-Aziz, Nadja Oster, August Stich, Wendyam A. Guigemdé, Hannes Wickert, Kathy T. Andrews, and Michael Lanzer, Hygiene Institut, Abteilung Parasitologie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 324, 69120 Heidelberg, Germany, Telephone: 49-6221-567-845, Fax: 49-6221-564-643. E-mails: enasszak{at}hotmail.com, nadja_oster{at}med.uni-heidelberg.de, august.stich{at}mail.uni-wurzburg.dearmand_guigemde{at}med.uni-heidelberg.de, hannes_wickert{at}med.uni-heidelberg.de, katha49{at}hotmail.com, and michael_lanzer{at}med.uni-heidelberg.de. Boubacar Coulibaly and Bocar Kouyaté, Centre de Recherche en Santé à Nouna, BP02, Nouna, Burkina Faso, E-mail: bocar{at}fasonet.bf.