Return of widespread chloroquine-sensitive Plasmodium falciparum to Malawi

J Infect Dis. 2014 Oct 1;210(7):1110-4. doi: 10.1093/infdis/jiu216. Epub 2014 Apr 9.

Abstract

Background: The return of chloroquine-sensitive Plasmodium falciparum to the limited area of Blantyre, Malawi, has been well demonstrated in several studies.

Methods: To characterize chloroquine susceptibility over a wide geographic area, infants and children aged 6-59 months were selected using 2-stage cluster sampling in 8 Malawian districts. Pyrosequencing of the pfcrt gene codon 76 region was performed for children with asexual parasitemia.

Results: Of 7145 children, 1150 had microscopic asexual parasitemia, and sequencing was performed in 685, of whom 1 had a chloroquine-resistant genotype.

Conclusions: Systematic countrywide sampling demonstrates that the chloroquine pfcrt genotype has reached near-fixation, raising the possibility of reintroducing chloroquine for malaria prevention and treatment.

Keywords: Africa; Malawi; PfCRT; Plasmodium falciparum; chloroquine; malaria; resistance.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Antimalarials / pharmacology*
  • Child, Preschool
  • Chloroquine / pharmacology*
  • Cross-Sectional Studies
  • Genotype
  • Genotyping Techniques
  • Humans
  • Infant
  • Malaria, Falciparum / epidemiology*
  • Malaria, Falciparum / parasitology*
  • Malawi
  • Male
  • Membrane Transport Proteins / genetics*
  • Parasitic Sensitivity Tests
  • Plasmodium falciparum / drug effects*
  • Plasmodium falciparum / genetics*
  • Plasmodium falciparum / isolation & purification
  • Protozoan Proteins / genetics*
  • Sequence Analysis, DNA

Substances

  • Antimalarials
  • Membrane Transport Proteins
  • PfCRT protein, Plasmodium falciparum
  • Protozoan Proteins
  • Chloroquine