Stable high frequencies of sulfadoxine-pyrimethamine resistance associated mutations and absence of K13 mutations in Plasmodium falciparum 3 and 4 years after the introduction of artesunate plus sulfadoxine-pyrimethamine in Ujjain, Madhya Pradesh, India.

摘要: Artesunate plus sulfadoxine–pyrimethamine (ASP) is first-line treatment for uncomplicated Plasmodium falciparum malaria in most of India, except six North-eastern provinces where failure rates were high. In Ujjain, central the frequency mutations associated with increased drug tolerance, but not overt resistance to sulfadoxine and pyrimethamine 9% and > 80%, respectively, 2009 2010, just prior introduction ASP. The Ujjain 2015–2016 after 3–4 years ASP use, are reported. Blood samples from patients P. mono-infection verified by microscopy collected on filter-paper at all nine major pathology laboratories city. Codons pfdhfr 16–185, pfdhps 436–632 K13 407–689 identified sequencing. Pfcrt K76T pfmdr1 N86Y restriction fragment length polymorphism. Sulfadoxine–pyrimethamine resistance-associated 108 N 59R alleles found 100/104 (96%) 87/91 samples, respectively. Pfdhps 437G was 10/105 (10%) samples. Double mutant 59R + 108 N 75/81 (93%) Triple 6/78 (8%) Chloroquine-resistance-associated pfcrt 76T 102/102 (100%). Pfmdr1 N86 86Y 83/115 (72%) 32/115 (28%) reduced susceptibility remained high, did appear have significantly since No polymorphisms decreased artemisinin found. probably effective, supporting continued use.