Genotyping of Plasmodium falciparum using antigenic polymorphic markers and to study anti-malarial drug resistance markers in malaria endemic areas of Bangladesh

Jasmin Akter, Kamala Thriemer, Wasif A. Khan, David J Sullivan, Harald Noedl, Rashidul Haque

Research output: Contribution to journalArticle

Abstract

Background: In the past many regions of Bangladesh were hyperendemic for malaria. Malaria control in the 1960s to 1970s eliminated malaria from the plains but in the Chittagong Hill Tracts remained a difficult to control reservoir. The Chittagong Hill Tracts have areas with between 1 and 10% annual malaria rates, predominately 90-95% Plasmodium falciparum. In Southeast Asia, multiplicity of infection for hypo-endemic regions has been approximately 1.5. Few studies on the genetic diversity of P. falciparum have been performed in Bangladesh. Anderson et al. performed a study in Khagrachari, northern Chittagong Hill Tracts in 2002 on 203 patients and found that parasites had a multiplicity of infection of 1.3 by MSP-1, MSP-2 and GLURP genotyping. A total of 94% of the isolates had the K76T Pfcrt chloroquine resistant genotype, and 70% showed the N86Y Pfmdr1 genotype. Antifolate drug resistant genotypes were high with 99% and 73% of parasites having two or more mutations at the dhfr or dhps loci. Methods. Nested and real-time polymerase chain reaction (PCR) methods were used to genotype P. falciparum using antigenic polymorphic markers and to study anti-malarial drug resistance markers in malaria endemic areas of Bangladesh. Results: The analysis of polymorphic and drug resistant genotype on 33 paired recrudescent infections after drug treatment in the period 2004 to 2008 in the Chittagong Hill Tracts, which is just prior to countrywide provision of artemisinin combination therapy. Overall the multiplicity of infection for MSP-1 was 2.7 with a slightly smaller parasite diversity post-treatment. The 13 monoclonal infections by both GLURP and MSP-1 were evenly divided between pre- and post-treatment. The MSP-1 MAD block was most frequent in 66 of the samples. The prevalence of the K76T PfCRT chloroquine resistant allele was approximately 82% of the samples, while the resistant Pfmdr1 N86Y was present in 33% of the samples. Interestingly, the post-treatment samples had a small but significantly higher frequency of the sensitive PfCRT alleles by RT-PCR. Conclusion: The parasite population retains high population diversity despite hypo-endemic transmission with retention, but decrease in the chloroquine-resistant allele and Pfmdr1 resistant alleles in the Chittagong Hill Tracts of Bangladesh.

Original languageEnglish (US)
Article number386
JournalMalaria Journal
Volume11
DOIs
StatePublished - 2012

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Bangladesh
Antimalarials
Plasmodium falciparum
Drug Resistance
Merozoite Surface Protein 1
Malaria
Genotype
Chloroquine
Parasites
Alleles
Infection
Therapeutics
Pharmaceutical Preparations
Folic Acid Antagonists
Southeastern Asia
Population
Real-Time Polymerase Chain Reaction
Polymerase Chain Reaction
Mutation

Keywords

  • Anti-malarial drug resistance markers
  • Genotype
  • Malaria
  • MSP-1 and pfcrt
  • Plasmodium falciparum

ASJC Scopus subject areas

  • Infectious Diseases
  • Parasitology

Cite this

Genotyping of Plasmodium falciparum using antigenic polymorphic markers and to study anti-malarial drug resistance markers in malaria endemic areas of Bangladesh. / Akter, Jasmin; Thriemer, Kamala; Khan, Wasif A.; Sullivan, David J; Noedl, Harald; Haque, Rashidul.

In: Malaria Journal, Vol. 11, 386, 2012.

Research output: Contribution to journalArticle

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abstract = "Background: In the past many regions of Bangladesh were hyperendemic for malaria. Malaria control in the 1960s to 1970s eliminated malaria from the plains but in the Chittagong Hill Tracts remained a difficult to control reservoir. The Chittagong Hill Tracts have areas with between 1 and 10{\%} annual malaria rates, predominately 90-95{\%} Plasmodium falciparum. In Southeast Asia, multiplicity of infection for hypo-endemic regions has been approximately 1.5. Few studies on the genetic diversity of P. falciparum have been performed in Bangladesh. Anderson et al. performed a study in Khagrachari, northern Chittagong Hill Tracts in 2002 on 203 patients and found that parasites had a multiplicity of infection of 1.3 by MSP-1, MSP-2 and GLURP genotyping. A total of 94{\%} of the isolates had the K76T Pfcrt chloroquine resistant genotype, and 70{\%} showed the N86Y Pfmdr1 genotype. Antifolate drug resistant genotypes were high with 99{\%} and 73{\%} of parasites having two or more mutations at the dhfr or dhps loci. Methods. Nested and real-time polymerase chain reaction (PCR) methods were used to genotype P. falciparum using antigenic polymorphic markers and to study anti-malarial drug resistance markers in malaria endemic areas of Bangladesh. Results: The analysis of polymorphic and drug resistant genotype on 33 paired recrudescent infections after drug treatment in the period 2004 to 2008 in the Chittagong Hill Tracts, which is just prior to countrywide provision of artemisinin combination therapy. Overall the multiplicity of infection for MSP-1 was 2.7 with a slightly smaller parasite diversity post-treatment. The 13 monoclonal infections by both GLURP and MSP-1 were evenly divided between pre- and post-treatment. The MSP-1 MAD block was most frequent in 66 of the samples. The prevalence of the K76T PfCRT chloroquine resistant allele was approximately 82{\%} of the samples, while the resistant Pfmdr1 N86Y was present in 33{\%} of the samples. Interestingly, the post-treatment samples had a small but significantly higher frequency of the sensitive PfCRT alleles by RT-PCR. Conclusion: The parasite population retains high population diversity despite hypo-endemic transmission with retention, but decrease in the chloroquine-resistant allele and Pfmdr1 resistant alleles in the Chittagong Hill Tracts of Bangladesh.",
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T1 - Genotyping of Plasmodium falciparum using antigenic polymorphic markers and to study anti-malarial drug resistance markers in malaria endemic areas of Bangladesh

AU - Akter, Jasmin

AU - Thriemer, Kamala

AU - Khan, Wasif A.

AU - Sullivan, David J

AU - Noedl, Harald

AU - Haque, Rashidul

PY - 2012

Y1 - 2012

N2 - Background: In the past many regions of Bangladesh were hyperendemic for malaria. Malaria control in the 1960s to 1970s eliminated malaria from the plains but in the Chittagong Hill Tracts remained a difficult to control reservoir. The Chittagong Hill Tracts have areas with between 1 and 10% annual malaria rates, predominately 90-95% Plasmodium falciparum. In Southeast Asia, multiplicity of infection for hypo-endemic regions has been approximately 1.5. Few studies on the genetic diversity of P. falciparum have been performed in Bangladesh. Anderson et al. performed a study in Khagrachari, northern Chittagong Hill Tracts in 2002 on 203 patients and found that parasites had a multiplicity of infection of 1.3 by MSP-1, MSP-2 and GLURP genotyping. A total of 94% of the isolates had the K76T Pfcrt chloroquine resistant genotype, and 70% showed the N86Y Pfmdr1 genotype. Antifolate drug resistant genotypes were high with 99% and 73% of parasites having two or more mutations at the dhfr or dhps loci. Methods. Nested and real-time polymerase chain reaction (PCR) methods were used to genotype P. falciparum using antigenic polymorphic markers and to study anti-malarial drug resistance markers in malaria endemic areas of Bangladesh. Results: The analysis of polymorphic and drug resistant genotype on 33 paired recrudescent infections after drug treatment in the period 2004 to 2008 in the Chittagong Hill Tracts, which is just prior to countrywide provision of artemisinin combination therapy. Overall the multiplicity of infection for MSP-1 was 2.7 with a slightly smaller parasite diversity post-treatment. The 13 monoclonal infections by both GLURP and MSP-1 were evenly divided between pre- and post-treatment. The MSP-1 MAD block was most frequent in 66 of the samples. The prevalence of the K76T PfCRT chloroquine resistant allele was approximately 82% of the samples, while the resistant Pfmdr1 N86Y was present in 33% of the samples. Interestingly, the post-treatment samples had a small but significantly higher frequency of the sensitive PfCRT alleles by RT-PCR. Conclusion: The parasite population retains high population diversity despite hypo-endemic transmission with retention, but decrease in the chloroquine-resistant allele and Pfmdr1 resistant alleles in the Chittagong Hill Tracts of Bangladesh.

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