Polymorphism analysis of pfmdr1 gene in Plasmodium falciparum isolates 11 years post-adoption of artemisinin-based combination therapy in Saudi Arabia

Abstract

<p>A total of 227 <em>Plasmodium falciparum</em> isolates from Jazan region, southwestern Saudi Arabia were amplified for the <em>P. falciparum multi-drug resistance 1</em> (<em>pfmdr1</em>) gene to detect point mutations 11 years after the introduction of artemisinin-based combination therapy (ACT) in Saudi Arabia. The <em>pfmdr1</em> 86<strong>Y</strong> mutation was found in 11.5% (26/227) of the isolates while the N86 wild allele was detected in 88.5%. Moreover, 184<strong>F</strong> point mutations dominated (86.3%) the instances of <em>pfmdr1</em> polymorphism while no mutation was observed at codons 1034, 1042 and 1246. Three <em>pfmdr1</em> haplotypes were identified, N<strong>F</strong>SND (74.9%), NYSND (13.7%) and <strong>YF</strong>SND (11.4%). Associations of the prevalence of 86<strong>Y</strong> mutation and <strong>YF</strong>SND haplotype with participants’ nationality, residency and parasitaemia level were found to be significant (<em>P</em> < 0.05). The findings revealed significant decline in the prevalence of the <em>pfmdr1</em> 86<strong>Y</strong> mutation in <em>P. falciparum</em> isolates from Jazan region over a decade after the implementation of ACT treatment. Moreover, the high prevalence of the N<strong>F</strong>SND haplotype might be indicative of the potential emergence of CQ-sensitive but artemether-lumefantrine-resistant <em>P. falciparum</em> strains since the adoption of ACT. Therefore, continuous monitoring of the molecular markers of antimalarial drug resistance in Jazan region is highly recommended.</p>