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India accounts for approximately half of the global Plasmodium vivax cases, but information as to the presence of chloroquine (CQ) resistance is scarce. In an observational study in Mangaluru, south-western India, of 116 vivax malaria patients analyzed, 89.5% (102/114) had cleared parasitemia on days two or three of CQ treatment. Two remaining patients presented on days four and five without parasitemia. One hundred eight isolates of these 116 patients were successfully sequenced for pvmdr1 polymorphisms. Eight non-synonymous polymorphisms but no wild-type isolate were detected. Ten pvmdr1 haplotypes were observed with mutations T958M and F1076L occurring in all isolates, whereas the candidate CQ resistance marker Y976F was present in one isolate only. Pvmdr1 polymorphisms were not associated with early parasite clearance. The high proportion of early parasite clearance and the virtual absence of pvmdr1 Y976F and of sextuple pvmdr1 mutants suggest that CQ in the study area is still sufficiently effective. However, the abundance of pvmdr1 mutations in the local parasite population warrants monitoring.
Financial support: This study was supported by DFG grant GRK2046 and a stipend of the FAZIT-Foundation, Frankfurt, to C. T. and by DFG grant GRK1673 and a stipend of the Sonnenfeld-Foundation, Berlin, to P. P. G. The funding bodies had no role in the design of the study and collection, analysis, and interpretation of data and in writing the manuscript.
Authors’ addresses: Costanza Tacoli, Prabhanjan P. Gai, Konrad Siegert, Jakob Wedam, and Frank P. Mockenhaupt, Institute of Tropical Medicine and International Health, Charité-Universitätsmedizin Berlin, Berlin, Germany, E-mails: email@example.com, firstname.lastname@example.org, email@example.com, firstname.lastname@example.org, and email@example.com. Suyamindra S. Kulkarni, Rashmi Rasalkar, and Pramod Gai, Karnataka Institute for DNA Research, Dharwad, India, E-mails: firstname.lastname@example.org, email@example.com, and firstname.lastname@example.org. Archith Boloor, Animesh Jain, Chakrapani Mahabala, Shantaram Baliga, and Damodara Shenoy, Kasturba Medical College, Manipal University, Mangalore, India, E-mails: email@example.com, firstname.lastname@example.org, email@example.com, firstname.lastname@example.org, and email@example.com. Rajeshwari Devi, Wenlock Hospital, Mangaluru, India, E-mail: Rajeshwaridevi14@gmail.com.