Volume 73, Issue 5
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645


A molecular epidemiology study was conducted to determine the distribution of antimalarial drug resistance alleles among field isolates of . Samples were obtained during an epidemic affecting Kuna Amerindians in Panama. A high prevalence of mutations associated with chloroquine, pyrimethamine, and sulfadoxine was observed. Genotype analysis of msp2 revealed a low genetic diversity of parasites circulating in the studied area. The public health implications of these findings for the Central American region are discussed.


Article metrics loading...

The graphs shown below represent data from March 2017
Loading full text...

Full text loading...



  1. Ministerio de Salud, Panamá, República de Panamá, Departamento de Vigilancia de los Factores Protectores y de Riesgo a la Salud y Enfermedad. Situación epidemiológica de la malaria en Panamá. Año 2003.
  2. Djimde A, Doumbo OK, Cortese JF, Kayentao K, Doumbo S, Diourte Y, Dicko A, Su XZ, Nomura T, Fidock DA, Wellems TE, Plowe CV, 2001. A molecular marker for chloroquine-resistant falciparum malaria. N Engl J Med 344 : 257–263. [Google Scholar]
  3. Schneider AG, Premji Z, Felger I, Smith T, Abdulla S, Beck HP, Mshinda H, 2002. A point mutation in codon 76 of pfcrt of P. falciparum is positively selected for by chloroquine treatment in Tanzania. Infect Genet Evol 1 : 183–189. [Google Scholar]
  4. Foote SJ, Kyle DJ, Martin SK, Oduola AMJ, Forsyth K, Kemp DJ, Cowman AF, 1990. Several alleles of the multi-drug resistance gene are closely linked to chloroquine resistance in Plasmodium falciparum. Nature 345 : 255–258. [Google Scholar]
  5. Price RN, Cassar C, Brockman A, Duraisingh M, Vugt M, White NJ, Nosten F, Krishna S, 1999. The pfmdr1 gene is associated with a multidrug-resitant phenotype in Plasmodium falciparum from the western border of Thailand. Antimicrob Agents Chemother 43 : 2943–2949. [Google Scholar]
  6. Reed MB, Saliba KJ, Caruana SR, Kirk K, Cowman AF, 2000. Pgh 1 modulates sensitivity and resistance to multiple antimalarials in Plasmodium falciparum. Nature 403 : 906–909. [Google Scholar]
  7. Bhattacharya PR, Biswas S, Kabilan L, 1997. Alleles of the Plasmodium falciparum pfmdr 1 gene appear not to be associated with chloroquine resistance in India. Trans R Soc Trop Med Hyg 91 : 454–455. [Google Scholar]
  8. Basco LK, Ringwald P, 1998. Molecular epidemiology of malaria in Yaounde, Cameroon. Analysis of chloroquine resistance and point mutations in the multidrug resistance (pfmdr 1) gene of Plasmodium falciparum. Am J Trop Med Hyg 59 : 577–581. [Google Scholar]
  9. Plowe CV, Cortese JF, Djimde A, Nwanyanwu OC, Watkins WM, Winstanley PA, Estrada-Franco JG, Mollinedo RE, Avila JC, Cespedes JL, Carter D, Doumbo OK, 1997. Mutations in Plasmodium falciparum dihydrofolate reductase and dihydropteroate synthase and epidemiologic patterns of pyrimethamine-sulfadoxine use and resistance. J Infect Dis 176 : 1590–1596. [Google Scholar]
  10. Basco LK, Tahar R, Ringwald P, 1998. Molecular basis of in vivo resistance to sulphadoxine-pyrimethamine in African adult patients infected with Plasmodium falciparum malaria parasites. Antimicrob Agents Chemother 42 : 1811–1814. [Google Scholar]
  11. Nzila-Mounda A, Mberu EK, Sibley CH, Plowe CV, Winstanley PA, Watkins WM, 1998. Kenyan Plasmodium falciparum field isolates: correlation between pyrimethamine and Chlorcy-cloguanil activity in vitro and point mutations in the dihydrofolate reductase domain. Antimicrob Agents Chemother 42 : 164–169. [Google Scholar]
  12. Tirasophon W, Rajkulchai P, Ponglikitmongkol M, Wilairat P, Boonsaeng V, Panyim S, 1994. A highly sensitive, rapid, and simple polymerase chain reaction-based method to detect human malaria (Plasmodium falciparum and Plasmodium vivax) in blood samples. Am J Trop Med Hyg 51 : 308–313. [Google Scholar]
  13. Felger I, Irion A, Steiger S, Beck HP, 1999. Genotypes of merozoite surface protein of Plasmodium falciparum in Tanzania. Trans R Trop Med Hyg 93 (Suppl 1): 3–9. [Google Scholar]
  14. Schmider N, Peyerl-Hoffmann G, Restrepo M, Jelinek T, 2003. Point mutations in the dihydrofolate reductase and dihydropteroate synthase genes of Plasmodium falciparum isolates from Colombia. Trop Med Int Health 8 : 129–132. [Google Scholar]
  15. Méndez F, Muñoz A, Carrasquilla G, Jurado D, Herrera-Arévalo M, Cortese J, Plowe CV, 2002. Determinants of treatment response to sulfadoxine-pyrimethamine and subsequent transmission potential in falciparum malaria. Am J Epidemiol 156 : 230–238. [Google Scholar]
  16. Montoya L, Maetre J, Carmona J, Lopes D, Rosario Do V, Blair S, 2003. Plasmodium falciparum: diversity studies of isolates from two Colombian regions with different endemicity. Exp Parasitol 104 : 14–19. [Google Scholar]
  17. Haddad D, Snounou G, Mattei D, Enamorado I, Figueroa J, Stahl S, Berzins K, 1999. Limited genetic diversity of Plasmodium falciparum in field isolates from Honduras. Am J Trop Med Hyg 60 : 30–34. [Google Scholar]
  18. Gómez D, Chaparro J, Rubiano C, Rojas MO, Wasseman M, 2002. Genetic diversity of Plasmodium falciparum field isolates from an isolated Colombian village. Am J Trop Med Hyg 67 : 611–616. [Google Scholar]
  19. Roll Back Malaria/World Health Organization (WHO), 2001. The use of antimalarial drugs. Report of a WHO informal consultation. Geneva: WHO.
  20. Talisuna AO, Bloland P, D́ Alessandro U, 2004. History, dynamics, and public health importance of malaria parasite resistance. Clin Microbiol Rev 17 : 235–254. [Google Scholar]

Data & Media loading...

  • Received : 31 Mar 2005
  • Accepted : 10 Jun 2005

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error