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Malaria, a global health problem especially in the sub-Sahara region has been posing a recurrent problem due to the resistance of the parasites to the available antimalarial drugs despite the preventive measures provided by WHO.
Aims: This study is aimed at determining the prevalence of resistance markers in four Niger Delta states of Nigeria, a decade after withdrawal of chloroquine.
Methods: Eight hundred and forty six (846) subjects participated in the study and were distributed as follows, 192(22.7%) Bayelsa; 218(25.8%) Rivers; 196(23.2%) Edo and 240(28.4%) Delta respectively. Malaria parasite identification was carried out using standard parasitological techniques. Genotyping of the resistance markers Pfcrt K76T and Pfmdr 1 was carried out by Polymerase Chain Reaction-Restriction Fragment Length Polymorphism (PCR-RFLP).
Results: Our findings revealed that the prevalence of malaria infection in the four Niger Delta states were 78.1%, 68.8%, 62.8% and 58.8% in Bayelsa, Rivers States, Edo and Delta respectively. There was no statistical difference in the prevalence of malaria within the four Niger Delta states. (P>0.05). Children below the age of 5 years recorded the highest infection rates when compared to subjects in other age groups (P< 0.01). Our findings also revealed that the distribution of mutant Pfcrt K76T and Pfmdr 1 genes across the four states were 12.0% and 28.6%, 4.0% and 22.0%, 14.6% and 29.3%, 10.6% and 25.0% in Bayelsa, Rivers, Edo and Delta state respectively. However, the prevalence of Pfcrt K76T in Rivers State was statistically lower when compared to other states (P < 0.01) while no statistical difference existed in the distribution of Pfmdr 1 mutant genes (P>0.01).
Conclusion: Prevalence of Pfcrt and Pfmdr 1 remained elevated in the Niger Delta states despite the withdrawal of chloroquine over a decade ago. Hence, Nigeria is far from an eventual re-introduction of chloroquine as its resistance markers still persist in our communities. Furthermore, the root cause of the persistence of these resistance markers needs to be investigated.
Dorsey G, Fidock D, Wellems T, Rosenthal P. Mechanisms of quinoline resistance. In: Rosenthal PJ, ed. Antimalarial chemo-therapy: Mechanisms of action, resistance, and new directions in drug discovery. Totowa, NJ: Humana Press. 2001;153– 72.
Reed M, Saliba K, Caruana S, Kirk K, Cowman A. Pgh1 modulates sensitivity and resistance to multiple antimalarials in Plasmodium falciparum. Nature. 2000;403: 906–9.
WHO. Universal access to malaria diagnostic testing. Geneva: World Health Organization; 2012.
Djimde A, Doumbo O, Cortese J, Kayentao K, Doumbo S, Diourté Y. Molecular marker for chloroquine resistant falciparum malaria. Northern England Journal of Medicine. 2001;344:257–263.
Pullan R, Bukirwa H, Staedke S, Snow R, Baker S. Plasmodium infection and its risk factors in Eastern Uganda. Malaria Journal. 2010;9:2.
Gahutu JB, Steininger C, Shyirambere C, Zeile I, Cwinya-Ay N, Danquah I, et al. Prevalence and risk factors of malaria among children in southern highland Rwanda. Malarial Journal. 2011;10:134.
Krefis AC, Schwarz NG, Nkrumah B, Acquah S, Loag W. Principal component analysis of socioeconomic factors and their association with malaria in children from the Ashanti Region, Ghana. Malarial Journal. 2010;9:201.
Fidock D, Nomura T, Talley A, Cooper R, Dzekunov S, Ferdig M. Mutations in the P. Falciparum digestive vacuole transmem-brane protein PfCRT and evidence for their role in chloroquine resistance. Molecular Cell. 2000;861–871.
Duraisingh M, Cowman A. Contribution of the pfmdr1 gene to antimalarial drug-resistance. Acta Tropical. 2005;94:181-190.
Wilson ML. Laboratory diagnosis of malaria: Conventional and rapid diagnostic methods. Archeology Pathological Laboratory Medicine. 2013;137:805–11.
Raman J, Mauff K, Mulanga P, Mussa A, Maharaj R, Barnes K. Five years of anti-malarial resistance marker surveillance in Gaza Province, Mozambique, following artemisinin-based combination therapy roll out. Plos One. 2011;8.
Wurtz Nathaniel, Bécaye Fall, Aurélie Pascual, Silmane Diawara, Kowry Sow, Eric Baret, Bakary Diatta, Khadidiatou B Fall, Pape S. Mbaye, Khadidiatou B. Fall, Yaya Diéme, Christophe Rogie, Raymond Bercion Sébastien Briolant, Boubacar Wade, Bruno Pradines. Prevalence of molecular markers of Plasmodium falciparum drug resistance in Dakar, Senegal Malaria Journal. 2012; 11:197.
Kublin JG, Cortese J, Njunju E, Mukadam R, Wirima J, Kazembe P, Djimdé A, Kouriba B, Taylor T, Plowe C. Reemergence of chloroquine-sensitive Plasmodium falciparum malaria after cessation of chloroquine use in Malawi. Journal of Infection District. 2003;187: 1870-1875.
Chauhan K, Pande V, Das A. DNA sequence polymorphisms of the pfmdr1 gene and association of mutations with the pfcrt gene in Indian Plasmodium falciparum isolates. Infection Genetic Evolution. 2014; 26:213–222.
Wellems TE, Panton LJ, Gluzman IY, do Rosario VE, Gwadz RW, Walker-Jonah A. Chloroquine resistance not linked to mdr-like genes in a Plasmodium falciparum cross. Nature. 1990;345:253–255.
Awasthi G, Prasad G, Das A. Population genetic analyses of Plasmodium a. Falciparum chloroquine receptor transporter gene haplotypes reveal the evolutionary history of chloroquine-resistant malaria in India. International Journal of Parasitology. 2011;41:705–709.
Ekland E, Fidock D. Advances in understanding the genetic basis of antimalarial drug resistance. Curricular Opinion Microbiology. 2007;10:363–370.