Abstract
Monitoring of anti-malarial drug resistance is vital in Northeast India as this region shares its international border with Southeast Asia. Genetic diversity of Plasmodium parasites regulates transmission dynamics, disease severity and vaccine efficacy. P. falciparum chloroquine resistance transporter (Pfcrt), multidrug resistance-1 (Pfmdr-1) and kelch 13 propeller (PfK-13) genes which govern antimalarial drug resistance and three genetic diversity markers, merozoite surface protein 1 and 2 (Pfmsp-1, Pfmsp-2) and glutamate rich protein (Pfglurp) were evaluated from Tripura, Northeast India using molecular tools. In the Pfcrt gene, 87% isolates showed triple mutations at codons M74I, N75E and K76T. 12.5% isolates in Pfmdr-1 gene showed mutation at N86Y. No polymorphism in PfK-13 propeller was found. Polyclonal infections were observed in 53.85% isolates and more commonly in adults (p = 0.0494). In the Pfmsp-1 locus, the K1 allelic family was predominant (71.2%) followed by the 3D7/IC family (69.2%) in the Pfmsp-2 locus. RII region of Pfglurp exhibited nine alleles with expected heterozygosity of 0.85. The multiplicity of infection for Pfmsp-1, Pfmsp-2 and Pfglurp were 1.56, 1.31 and 1.06 respectively. Overall, the study demonstrated a high level of chloroquine resistance and extensive parasite diversity in the region, necessitating regular surveillance in this population group.
Highlights
Monitoring of anti-malarial drug resistance is vital in Northeast India as this region shares its international border with Southeast Asia
All cases positive by rapid diagnostic tests (RDT) and microscopy were positive by nested Polymerase chain reaction (PCR) for species identification
P. falciparum P. falciparum chloroquine resistance transporter (Pfcrt), Pfmdr-1 and PfK-13 genes were amplified using a nested PCR protocol followed by Sanger sequencing
Summary
Monitoring of anti-malarial drug resistance is vital in Northeast India as this region shares its international border with Southeast Asia. P. falciparum chloroquine resistance transporter (Pfcrt), multidrug resistance-1 (Pfmdr-1) and kelch 13 propeller (PfK-13) genes which govern antimalarial drug resistance and three genetic diversity markers, merozoite surface protein 1 and 2 (Pfmsp-1, Pfmsp-2) and glutamate rich protein (Pfglurp) were evaluated from Tripura, Northeast. The NE region is strategically situated and shares a long international border with Southeast Asian countries such as Bhutan, Nepal, China, Myanmar and Bangladesh. This region is highly vulnerable for the importation of anti-malarial drug resistant strains of P. falciparum from surrounding Southeast. The state of Tripura is highly endemic to malaria and a large outbreak was reported in 2014 with around 10,000 malaria cases and more than a hundred deaths[2]
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