Abstract
BackgroundMalaria continues being a public health problem worldwide. Plasmodium vivax is the species causing the largest number of cases of malaria in Asia and South America. Due to the lack of a completely effective anti-malarial vaccine, controlling this disease has been based on transmission vector management, rapid diagnosis and suitable treatment. However, parasite resistance to anti-malarial drugs has become a major yet-to-be-overcome challenge. This study was thus aimed at determining pvmdr1, pvdhfr, pvdhps and pvcrt-o gene mutations and haplotypes from field samples obtained from an endemic area in the Colombian Amazonian region.MethodsFifty samples of parasite DNA infected by a single P. vivax strain from symptomatic patients from the Amazonas department in Colombia were analysed by PCR and the pvdhfr, pvdhps, pvmdr1 and pvcrt-o genes were sequenced. Diversity estimators were calculated from the sequences and the haplotypes circulating in the Colombian Amazonian region were obtained.Conclusionpvdhfr, pvdhps, pvmdr1 and pvcrt-o genes in the Colombian Amazonian region are characterized by low genetic diversity. Some resistance-associated mutations were found circulating in this population. New variants are also being reported. A selective sweep signal was located in pvdhfr and pvmdr1 genes, suggesting that these mutations (or some of them) could be providing an adaptive advantage.
Highlights
Malaria continues being a public health problem worldwide
First-line treatment for uncomplicated P. vivax malaria in Colombia is currently based on a combination of chloroquine (CQ) for eliminating blood stages and primaquine (PQ) for liver stages [5]
Plasmodium falciparum/P. vivax multiple infections could go unnoticed during diagnosis [6, 20] and the attending doctor cannot prescribe suitable treatment for patients; in turn, this could exercise selective pressure on parasite populations
Summary
Malaria continues being a public health problem worldwide. Plasmodium vivax is the species causing the largest number of cases of malaria in Asia and South America. Malaria continues being a worldwide problem; it is a vector-born disease (VBD) transmitted by parasites from the genus Plasmodium [1]. First-line treatment for uncomplicated P. vivax malaria in Colombia is currently based on a combination of chloroquine (CQ) for eliminating blood stages (schizonts) and primaquine (PQ) for liver stages (hypnozoites) [5]. Treatment is based on the use of sulfadoxine–pyrimethamine (SP) [6] These drugs remain effective overall, cases of resistance have been recorded during the last few years, making this one of the greatest problems in controlling and eliminating malaria. Regarding P. falciparum, parasite genes associated with resistance to anti-malarial drugs have been established with greater certainty. Pfmdr, pfdhfr and pfdhps genes have arisen/ been fixed in several parasite populations and, since they confer drug resistance, this facilitates their dispersion
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