- Introduction
- Materials and Methods
- Selection of subjects.
- Collection of sample.
- In vivo drug testing.
- In vitro drug sensitivity assay.
- Isolation of parasitic DNA.
- Polymerase chain reaction/restriction fragment-length polymorphism analysis of pfcrt and pfmdr-I.
- Multiplicity of infection and prevalence of monoclonal infections.
- Assessment of antimalarial drug pressure and population mobility.
- Statistical analysis.
- Results
- Discussion
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Association between Prevalence of Chloroquine Resistance and Unusual Mutation in pfmdr-I and pfcrt Genes in India
This study deals with the underlying causes of failure of chloroquine in the treatment of Plasmodium falciparum infection in some malaria-endemic regions of India. Samples were collected from 141 patients in Purulia from March of 2007 to April of 2008. In vitro drug susceptibility tests, parasitic DNA isolation followed by polymerase chain reaction, and restriction fragment-length polymorphisms of different codons of the pfcrt gene (76) and pfmdr-I genes (86, 1042, and 1246) were assessed. The responses of 141 patients to chloroquine were determined. Prevalence of double pfmdr-I (58.16%) mutation (86Y+1246Y) and some (14.89%) single pfcrt mutations with triple pfmdr-I mutation (76T+86Y+1042D+1246Y) were found. Interestingly, double pfmdr-I mutation (86Y and 1246Y codons) was observed with the early treatment failure cases. These results show, for the first time in India that in vitro chloroquine resistance and in vivo chloroquine treatment failure were caused by double pfmdr-I (P < 0.001) mutation.
Author Notes
Authors' addresses: Sabyasachi Das, Subhankari Prasad Chakraborty, and Somenath Roy, Immunology and Microbiology Laboratory, Department of Human Physiology with Community Health, Vidyasagar University, Midnapore, West Bengal, India, E-mails: sdas.vu@gmail.com, subhankariprasad@gmail.com, and roysomenath@hotmail.com. Amiya Kumar Hati, Department of Medical Entomology, Calcutta School of Tropical Medicine, Kolkata, West Bengal, India, E-mail: amiya_hati@rediffmail.com.