In addition, increased pfmdr1 copies have been associated with resistance to mefloquine (in vivo, in vitro, or both) and partially to lumefantrine ( 13– 18). Recently, plasmepsin 2 ( pfpm2) copy number and pfcrt C101F polymorphism have been associated with piperaquine resistance ( 10– 12). In Cambodia, polymorphisms in the K13 propeller domain (mainly Y493H, R539T, I543T, and C580Y) were associated with in vitro prolonged parasite survival rates and in vivo delayed parasite clearance rates ( 8, 9). falciparum associated with artemisinin resistance have subsequently provided an additional tool for monitoring resistance to antimalarial drugs ( 7, 8). Detectable polymorphisms in the Kelch 13 ( K13) propeller domain in P. The emergence of artemisinin resistance in Plasmodium falciparum, with reduced in vivo susceptibility to artesunate, was reported in Southeast Asia ( 3, 6). Unfortunately, the effectiveness of antimalarial drugs used for malaria treatment and chemoprevention during pregnancy has been threatened by the emergence of drug-resistant parasite populations ( 2– 5). A fundamental pillar for contributing to the reduction of the malaria burden has been artemisinin-based combination therapy. Piperaquine resistance isolates may spread in Mozambique as dihydroartemisinin/piperaquine drug pressure increases.ĭuring the past decade, malaria control strategies have substantially reduced the malaria burden worldwide several countries are advancing toward malaria elimination ( 1, 2). Prevalence of isolates with pfdhps mutant alleles (A437G and K540E) was >80%, indicating persistence of sulfadoxine/pyrimethamine resistance however, markers of artemisinin were absent, and markers of piperaquine resistance were low. Prevalence of isolates with pfcrt mutant (K76T) allele was low (2.3%). All isolates carried K13 wild-type alleles (3D7-like), except 4 novel polymorphisms (Leu619Leu, Phe656Ile, Val666Val, Gly690Gly). We found multiple copies of pfpm2 in 1.1% of isolates.
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falciparum isolates collected from 4 sentinel sites in Mozambique for K13, pfmdr1, pfcrt, and pfdhps polymorphisms and for plasmepsin2 ( pfpm2) and pfmdr1 copy numbers. To assess resistance, we used molecular methods to examine 351 P. The success of antimalarial treatment can be affected by the presence of drug-resistant populations of Plasmodium falciparum. One of the fundamental steps toward malaria control is the use of antimalarial drugs.