Molecular epidemiology of Plasmodium falciparum resistance to antimalarial drugs in Indonesia

Am J Trop Med Hyg. 2005 Feb;72(2):174-81.

Abstract

The extent of gene polymorphisms associated with resistance to chloroquine and sulfadoxine-pyrimethamine was examined in field isolates of Plasmodium falciparum from Indonesia. Eight malaria-endemic areas, representing a broad region of the western and eastern Indonesian Archipelago were surveyed. Blood from 20-50 patients was collected at each site, DNA was isolated, and the sequences of four different genes (dihydrofolate reductase [dhfr], dihydropteroate synthase [dhps], P. falciparum multidrug resistance 1 [pfmdr1], and P. falciparum chloroquine resistance transporter [pfcrt]) were analyzed using polymerase chain reaction and restriction fragment length polymorphisms to detect polymorphisms previously shown to be associated with resistance. This analysis identified polymorphisms in dhfr at 108-Asn/Thr, 16-Val, and 59-Arg. Polymorphisms in dhps were found less frequently, either 437-Gly alone or paired with 540-Glu. The pfcrt 76-Thr polymorphism was fixed in all parasite populations and pfmdr1 86-Tyr polymorphisms in all populations except in the most eastern regions. The pfmdr1 1042-Asp polymorphism occurred less frequently. These findings indicate that polymorphisms in genes associated with drug resistance in P. falciparum are found across a broad region of Indonesia.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • ATP-Binding Cassette Transporters / genetics
  • Animals
  • Antimalarials / administration & dosage
  • Antimalarials / therapeutic use
  • DNA, Protozoan / genetics
  • Drug Resistance, Multiple / genetics*
  • Genes, MDR / genetics*
  • Humans
  • Indonesia / epidemiology
  • Malaria, Falciparum / drug therapy
  • Malaria, Falciparum / epidemiology
  • Malaria, Falciparum / etiology
  • Plasmodium falciparum / genetics*
  • Polymerase Chain Reaction
  • Protozoan Proteins / genetics

Substances

  • ATP-Binding Cassette Transporters
  • Antimalarials
  • DNA, Protozoan
  • Protozoan Proteins
  • mdr gene protein, Plasmodium