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ROLES OF SPECIFIC PLASMODIUM FALCIPARUM MUTATIONS IN RESISTANCE TO AMODIAQUINE AND SULFADOXINE-PYRIMETHAMINE IN BURKINA FASO

CHRISTIAN DOKOMAJILARDepartment of Medicine, San Francisco General Hospital, University of California, San Francisco, California; Universite de Ouagadougou, Ouagadougou, Burkina Faso; Institut de Recherche en Science de la Sante, Bobo-Dioulasso, Burkina Faso

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ZAMBENDE MOISE LANKOANDEDepartment of Medicine, San Francisco General Hospital, University of California, San Francisco, California; Universite de Ouagadougou, Ouagadougou, Burkina Faso; Institut de Recherche en Science de la Sante, Bobo-Dioulasso, Burkina Faso

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GRANT DORSEYDepartment of Medicine, San Francisco General Hospital, University of California, San Francisco, California; Universite de Ouagadougou, Ouagadougou, Burkina Faso; Institut de Recherche en Science de la Sante, Bobo-Dioulasso, Burkina Faso

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ISSAKA ZONGODepartment of Medicine, San Francisco General Hospital, University of California, San Francisco, California; Universite de Ouagadougou, Ouagadougou, Burkina Faso; Institut de Recherche en Science de la Sante, Bobo-Dioulasso, Burkina Faso

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JEAN-BOSCO OUEDRAOGODepartment of Medicine, San Francisco General Hospital, University of California, San Francisco, California; Universite de Ouagadougou, Ouagadougou, Burkina Faso; Institut de Recherche en Science de la Sante, Bobo-Dioulasso, Burkina Faso

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PHILIP J. ROSENTHALDepartment of Medicine, San Francisco General Hospital, University of California, San Francisco, California; Universite de Ouagadougou, Ouagadougou, Burkina Faso; Institut de Recherche en Science de la Sante, Bobo-Dioulasso, Burkina Faso

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We evaluated associations between key polymorphisms in target genes and responses to treatment with sulfadoxine-pyrimethamine (SP) or amodiaquine (AQ) for uncomplicated Plasmodium falciparum malaria in Bobo-Dioulasso, Burkina Faso. Presence of the dihydrofolate reductase (dhfr) 108N or 59R mutations (but not dhfr 51I or dihydropteroate synthetase [dhps] 437G) and P. falciparum chloroquine resistance transporter (pfcrt) 76T or P. falciparum multidrug resistance 1 (pfmdr1) 86Y or 1246Y mutations (but not pfmdr1 184F) predicted recrudescence after treatment with SP and AQ, respectively. Treatment led to significant increases in the prevalence of the same mutations (except 1246Y) in new infections that presented after therapy. The dhfr 164L and dhps 540E mutations were not seen in any isolates. These results clarify the key roles of a small number of mutations in P. falciparum resistance to SP and AQ in west Africa.

Author Notes

Reprint requests: Philip J. Rosenthal, Box 0811, University of California, San Francisco, CA 94143, Telephone: 415-206-8845, Fax: 415-648-8425, E-mail: Philip.Rosenthal@ucsf.edu.
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