Antimalarial Drug Resistance Associated Molecular Markers in South Eastern Nigeria: A Preliminary Report

Abstract

This preliminary study reported the first documented evidence of  antimalarial drug resistance polymorphisms in South Eastern Nigeria. Real Time PCR (RT-PCR) assay was used to type for pfmdr1 genes whereas pfdhfr, pfdhps and pfcrt genes were typed with the Restriction Fragment Length Polymorphism of PCR(PCR-RFLP) from blood spots of two hundred under five children attending pediatric clinics in the Federal Medical Centre, Owerri, South Eastern Nigeria. Treatment with antimalarial drug in the last two days was reported by 10.3 % of the children. Antimalaria drug resistance mutations was detected in all the samples with pfdhfr  S108T(76%) and pfdhps A438G(72%) recording the highest prevalence. Mutation in the pfcrt gene however was only detected in 43% of the samples. Mixed polymorphisms was observed more in triple mutations of pfdhps (69%) and pfdhfr (64%) respectively while quintuple and sextuple mutations accounted for 20% and 32% respectively. The results established the prevalence of antimalarial drug resistance polymorphisms in South Eastern Nigeria with their changing patterns of occurrence. This may form a baseline for the continuous monitoring of drug resistance
markers in South Eastern Nigeria to inform more effective and sustainable planning and implementation of evidence based antimalarial drug policies.
Keywords: Malaria, antimalarials, quintuple mutations, Sextuple mutation.