Volume 78, Issue 4
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645


This study was designed to analyze the resistance transporter () and multidrug resistance 1 () mutations as markers of chloroquine (CQ) resistance in 200 blood samples collected from malaria patients in south-eastern Iran during 2002–2005. Among these, 25 (post-treatment) fulfilled the 28-day follow-up study. A high number of Iranian (97%) strains harbored quadruple mutations at codons 76T, 220S, 326D, and 356L. All post-treatment isolates harbored the mutant allele 76T, but low rates of the mutant allele 86Y (44%) of the gene were detected. No wild haplotype of (72-CVMNKAQNIR-371) was found in post-treatment samples; however, 56% of clinical “failure” samples carried the wild type of (NYSND). The present results suggest a strong association between 76T, but not 86Y mutation and CQ resistance. Furthermore, we found the CQ resistance-associated SVMNT haplotype, which previously had been seen in South American isolates. Although Iran is located more proximally to Southeast Asia than to South America, no CQ resistance-associated CVIET haplotye has been observed in this region. Therefore, these results were not consistent with the earlier presumed spread of CQR parasites from Southeast Asia to Africa via the Indian subcontinent. In conclusion, mutations associated with resistance to CQ are abundant in south-eastern Iran and this finding strongly supports that CQ as the first line drug is inadequate for treatment of uncomplicated falciparum malaria in Iran.


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  • Received : 19 May 2007
  • Accepted : 19 Nov 2007

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