Drug-Resistant Polymorphisms and Copy Numbers in Plasmodium falciparum, Mozambique, 2015

Himanshu Gupta (1, 2, 3) , Eusebio Macete (4) , Helder Bulo (4) , Crizolgo Salvador (5) , Marian Warsame (6) , Eva Carvalho (6) , Didier Ménard (7, 8) , Pascal Ringwald (6) , Quique Bassat (1, 2, 3, 4, 9, 10) , Sonia Enosse (5) , Alfredo Mayor (3, 1, 2, 4)

1 ISGlobal - Instituto de Salud Global - Institute For Global Health [Barcelona]
2 UB - Universitat de Barcelona
3 CRESIB - Barcelona Centre for International Health Research, Hospital Clinic
4 CISM - Centro de Investigação em Saúde de Manhiça [Maputo, Mozambique]
5 INS - Instituto Nacional de Saude [Maputo, Mozambique]
6 OMS / WHO - Organisation Mondiale de la Santé / World Health Organization Office
7 Malaria Molecular Epidemiology
8 IP - Institut Pasteur [Paris]
9 ICREA - Institució Catalana de Recerca i Estudis Avançats
10 Hospital Sant Joan de Déu [Barcelona]

One of the fundamental steps toward malaria control is the use of antimalarial drugs. The success of antimalarial treatment can be affected by the presence of drug-resistant populations of Plasmodium falciparum. To assess resistance, we used molecular methods to examine 351 P. falciparum isolates collected from 4 sentinel sites in Mozambique for K13, pfmdr1, pfcrt, and pfdhps polymorphisms and for plasmepsin2 (pfpm2) and pfmdr1 copy numbers. We found multiple copies of pfpm2 in 1.1% of isolates. All isolates carried K13 wild-type alleles (3D7-like), except 4 novel polymorphisms (Leu619Leu, Phe656Ile, Val666Val, Gly690Gly). Prevalence of isolates with pfcrt mutant (K76T) allele was low (2.3%). 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. Piperaquine resistance isolates may spread in Mozambique as dihydroartemisinin/piperaquine drug pressure increases.

Keywords: vector-borne infections; K13; Mozambique; antimicrobial resistance; copy number; malaria; parasites; plasmepsin2; polymorphisms

Domains: Life Sciences [q-bio]; Human health and pathology; Infectious diseases; Life Sciences [q-bio]; Microbiology and Parasitology; Parasitology

Himanshu Gupta, Eusebio Macete, Helder Bulo, Crizolgo Salvador, Marian Warsame, et al.. Drug-Resistant Polymorphisms and Copy Numbers in Plasmodium falciparum, Mozambique, 2015. Emerging Infectious Diseases, 2018, 24 (1), pp.40-48. ⟨10.3201/eid2401.170864⟩. ⟨pasteur-02865089⟩