Towards a re-emergence of chloroquine sensitivity in Côte d'Ivoire?

Malar J. 2018 Nov 7;17(1):413. doi: 10.1186/s12936-018-2551-7.

Abstract

Background: Resistance of Plasmodium falciparum to anti-malarial drugs has hampered efforts to eradicate malaria. Recent reports of a decline in the prevalence of chloroquine-resistant P. falciparum in several countries, including Malawi and Zambia, is raising the hope of reintroducing chloroquine in the near future, ideally in combination with another anti-malarial drug for the treatment of uncomplicated malaria. In Côte d'Ivoire, the decrease in the clinical efficacy of chloroquine, in addition to a high proportion of clinical isolates carrying the Thr-76 mutant allele of the pfcrt gene, had led to the discontinuation of the use of chloroquine in 2004. Previous studies have indicated the persistence of a high prevalence of the Thr-76 mutant allele despite the withdrawal of chloroquine as first-line anti-malarial drug. This present study is conducted to determine the prevalence of the Thr-76T mutant allele of the Pfcrt gene after a decade of the ban on the sale and use of chloroquine in Côte d'Ivoire.

Results: Analysis of the 64 sequences from all three study sites indicated a prevalence of 15% (10/64) of the Thr-76 mutant allele against 62% (40/64) of the Lys-76 wild-type allele. No mutation of the allele Thr-76 was observed at Anonkoua Kouté while this mutant allele was in 31% (5/16) and 25% (5/20) of isolate sequences from Port-Bouët and Ayamé respectively.

Conclusion: More than a decade after the discontinuation of the use of chloroquine in Côte d'Ivoire, the proportion of parasites sensitive to this anti-malarial seems to increase in Anonkoua-kouté, Port-bouët and Ayamé.

Keywords: Antimalarial drug resistance; Chloroquine sensitivity; Côte d’Ivoire; Pfcrt; Thr-76.

MeSH terms

  • Antimalarials / pharmacology*
  • Chloroquine / pharmacology*
  • Cote d'Ivoire
  • Drug Resistance / genetics*
  • Malaria, Falciparum / prevention & control
  • Membrane Transport Proteins / genetics*
  • Plasmodium falciparum / drug effects
  • Plasmodium falciparum / genetics*
  • Protozoan Proteins / genetics*

Substances

  • Antimalarials
  • Membrane Transport Proteins
  • PfCRT protein, Plasmodium falciparum
  • Protozoan Proteins
  • Chloroquine