Abstract

BackgroundIn the absence of an effective vaccine, malaria treatment and eradication is still a challenge in most endemic areas globally. This is especially the case with the current reported emergence of resistance to artemisinin agents in Southeast Asia. This study therefore explored the prevalence of K13-propeller gene polymorphisms among Plasmodium falciparum parasites in northern Uganda.MethodsAdult patients (≥18 years) presenting to out-patients department of Lira and Gulu regional referral hospitals in northern Uganda were randomly recruited. Laboratory investigation for presence of plasmodium infection among patients was done using Plasmodium falciparum exclusive rapid diagnostic test, histidine rich protein-2 (HRP2) (Pf). Finger prick capillary blood from patients with a positive malaria test was spotted on a filter paper Whatman no. 903. The parasite DNA was extracted using chelex resin method and sequenced for mutations in K13-propeller gene using Sanger sequencing. PCR DNA sequence products were analyzed using in DNAsp 5.10.01software, data was further processed in Excel spreadsheet 2007.ResultsA total of 60 parasite DNA samples were sequenced. Polymorphisms in the K13-propeller gene were detected in four (4) of the 60 parasite DNA samples sequenced. A non-synonymous polymorphism at codon 533 previously detected in Cambodia was found in the parasite DNA samples analyzed. Polymorphisms at codon 522 (non-synonymous) and codon 509 (synonymous) were also found in the samples analyzed. The study found evidence of positive selection in the Plasmodium falciparum population in northern Uganda (Tajima’s D = −1.83205; Fu and Li’s D = −1.82458).ConclusionsPolymorphism in the K13-propeller gene previously reported in Cambodia has been found in the Ugandan Plasmodium falciparum parasites. There is need for continuous surveillance for artemisinin resistance gene markers in the country.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-016-1777-7) contains supplementary material, which is available to authorized users.

Highlights

  • In the absence of an effective vaccine, malaria treatment and eradication is still a challenge in most endemic areas globally

  • The study was conducted in the outpatient department laboratory of Lira and Gulu regional referral hospitals in northern Uganda

  • Sixty (60) parasite Deoxyribonucleic acid (DNA) samples that successfully amplified in the nested Polymerase chain reaction (PCR) reaction for K13-propeller gene were all sequenced

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Summary

Introduction

In the absence of an effective vaccine, malaria treatment and eradication is still a challenge in most endemic areas globally. This is especially the case with the current reported emergence of resistance to artemisinin agents in Southeast Asia. In Uganda, national policy for treatment of uncomplicated malaria was first changed from chloroquine (CQ) monotherapy to CQ plus sulfadoxine-pyrimethamine (SP) (CQ + SP) combination therapy in 2000. This was changed to the current artemisinin based combination (ACTs) antimalarial agents in 2004 due to wide spread resistance to the earlier agents [4]. With the experience of chloroquine resistance in which it resulted in doubling of malaria associated mortality in sub-Saharan Africa [8], the emergence of artemisinin resistance [9] could potentially pose a similar risk especially in malaria endemic areas of the world

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