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Molecular Analysis of Chloroquine and Sulfadoxine-Pyrimethamine Resistance-Associated Alleles in Plasmodium falciparum Isolates from Nicaragua
Chloroquine (CQ) is used as a first-line therapy for the treatment of Plasmodium falciparum malaria in Nicaragua. We investigated the prevalence of molecular markers associated with CQ and sulfadoxine-pyrimethamine (SP) resistance in P. falciparum isolates obtained from the North Atlantic Autonomous Region of Nicaragua. Blood spots for this study were made available from a CQ and SP drug efficacy trial conducted in 2005 and also from a surveillance study performed in 2011. Polymorphisms in P. falciparum CQ resistance transporter, dihydrofolate reductase, and dihydropteroate synthase gene loci that are associated with resistance to CQ, pyrimethamine, and sulfadoxine, respectively, were detected by DNA sequencing. In the 2005 dataset, only 2 of 53 isolates had a CQ resistance allele (CVIET), 2 of 52 had a pyrimethamine resistance allele, and 1 of 49 had a sulfadoxine resistance allele. In the 2011 dataset, none of 45 isolates analyzed had CQ or SP resistance alleles.
Author Notes
Financial support: This study was supported by the United States Agency for International Development under the Amazon Malaria Initiative, the Pan American Health Organization, the Network for Surveillance of Antimalarial Drug Resistance, the Ministry of Health of Nicaragua, and the Atlanta Research and Education Foundation (Decatur, GA). Sankar Sridaran was also partly supported by the Centers for Disease Control and Prevention Emerging Infectious Diseases Fellowship.
Authors' addresses: Sankar Sridaran, Case Western University School of Medicine, Cleveland, OH, E-mail: sxs973@case.edu. Betzabe Rodriguez, National Reference and Diagnosis Center, Ministry of Health, Managua, Nicaragua, E-mail: parasitología@minsa.gob.ni. Aida Mercedes Soto, Pan American Health Organization, Managua, Nicaragua, E-mail: sotoa@nic.ops-oms.org. Alexandre Macedo De Oliveira and Venkatachalam Udhayakumar, Malaria Branch, Centers for Disease Control and Prevention, Atlanta, GA, E-mails: acq7@cdc.gov and vxu0@cdc.gov.