Countrywide Survey Shows Very High Prevalence of Plasmodium falciparum Multilocus Resistance Genotypes in Cambodia

• DOI: 10.1128/aac.49.8.3147-3152.2005
• Publication Date: 2005-07-27T10:52:45Z
• Authors: Nimol Khim; Christiane Bouchier; Marie-Thérèse E...; Sandra Incardona; Pharath Lim; Eric Legrand; Ronan Jambou; Socheat Doung; Odile Mercereau P...; Thierry Fandeur
• Keywords: Dihydropteroate synthase; Dihydrofolate reductase; Artesunate; Antifolate

ABSTRACT Cambodia is located in an area of resistance to multiple antimalarials and has been the first country implement systematic use artesunate-mefloquine combination as first-line treatment for Plasmodium falciparum malaria. Little known, however, about prevalence mutations within natural parasite populations, impeding rational drug policy this context. Using direct sequencing PCR products, we have analyzed sequence polymorphism dihydrofolate reductase-thymidylate synthase, dihydropteroate synthetase, multidrug 1 genes a large number clinical P. isolates collected various areas Cambodia. This highlighted 100% haplotypes with target antifolates after more than decade without malaria therapy. A high Pfmdr1 , including associated decreased vitro susceptibility mefloquine quinine, was also observed. In addition, novel, low-frequency were detected . Our findings show alarming rate multilocus genotypes Cambodia, requiring diligent surveillance imposing limitations on possible future combinations.