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Molecular Surveillance as Monitoring Tool for Drug-Resistant Plasmodium falciparum in Suriname

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  • Department of Biochemistry, Faculty of Medical Sciences, Anton de Kom Universiteit van Suriname, Paramaribo, Suriname; Prof. Dr. Paul C. Flu Institute for Biomedical Sciences, Paramaribo, Suriname; Pan American Health Organization–Ecuador, Quito, Ecuador

The aim of this translational study was to show the use of molecular surveillance for polymorphisms and copy number as a monitoring tool to track the emergence and dynamics of Plasmodium falciparum drug resistance. A molecular baseline for Suriname was established in 2005, with P. falciparum chloroquine resistance transporter (pfcrt) and P. falciparum multidrug resistance (pfmdr1) markers and copy number in 40 samples. The baseline results revealed the existence of a uniformly distributed mutated genotype corresponding with the fully mefloquine-sensitive 7G8-like genotype (Y184F, S1034C, N1042D, and D1246Y) and a fixed pfmdr1 N86 haplotype. All samples harbored the pivotal pfcrtK76T mutation, showing that chloroquine reintroduction should not yet be contemplated in Suriname. After 5 years, 40 samples were assessed to trace temporal changes in the status of pfmdr1 polymorphisms and copy number and showed minor genetic alterations in the pfmdr1 gene and no significant changes in copy number, thus providing scientific support for prolongation of the current drug policy in Suriname.

Author Notes

* Address correspondence to Malti R. Adhin, Anton de Kom Universiteit van Suriname, Faculty of Medical Sciences, Kernkampweg #5, PO Box 537, Paramaribo, Suriname. E-mail: m.adhin@uvs.edu

Financial support: This work was supported by Pan American Health Organization's Amazon Network for the Surveillance of Antimalarial Drug Resistance (RAVREDA) in cooperation with the US Agency for International Development (USAID)'s Amazon Malaria Initiative SU/CNT/0600030.001, SU/CNT/0700015.001, and SU/CNT/1100012.001.

Authors' addresses: Malti R. Adhin, Faculty of Medical Sciences, Department of Biochemistry, Anton de Kom Universiteit van Suriname, Paramaribo, Suriname, E-mail: m.adhin@uvs.edu. Mergiory Labadie-Bracho, Prof. Dr. Paul C. Flu Institute for Biomedical Sciences, Paramaribo, Suriname, E-mail: mergiorybracho@yahoo.com. Gustavo Bretas, Pan American Health Organization–Ecuador, Quito, Ecuador, E-mail: bretasg@ecu.ops-oms.org.

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