AAC Accepts, published online ahead of print on 24 August 2009

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Antimicrob. Agents Chemother. doi:10.1128/AAC.00610-09
Copyright (c) 2009, American Society for Microbiology and/or the Listed Authors/Institutions. All Rights Reserved.

P. falciparum drug resistance in Madagascar: facing the spread of unusual pfdhfr and pfmdr-1 haplotypes and the decrease of dihydroartemisinin susceptibility.

Valérie Andriantsoanirina, Arsène Ratsimbasoa, Christiane Bouchier, Martial Jahevitra, Stéphane Rabearimanana, Rogelin Radrianjafy, Voahangy Andrianaranjaka, Tantely Randriantsoa, Marie Ange Rason, Magali Tichit, Léon Paul Rabarijaona, Odile Mercereau-Puijalon, Rémy Durand, and Didier Ménard^*

Unité de Recherche sur le Paludisme, Institut Pasteur de Madagascar, Antananarivo, Madagascar; Departement de Santé Publique, Faculté de Médecine, Université d'Antananarivo, Antananarivo, Madagascar; Génopôle de l'Ile de France, Plate-forme Génomique, Institut Pasteur, Paris, France; Section Survie de l'Enfant, United Nations Children's Fund, Antananarivo, Madagascar; Unité d'Immunologie Moléculaire des Parasites, CNRS URA 2581, Institut Pasteur, Paris, France; Laboratoire de Parasitologie-Mycologie, AP-HP Hôpital Avicenne, Bobigny, France

^* To whom correspondence should be addressed. Email: dmenard{at}pasteur.fr.

The aim of this study was to provide the first comprehensive spatio-temporal picture of P. falciparum resistance in various geographic areas in Madagascar. Additional data about the antimalarials resistance in the neighboring islands of the Comoros Archipelago were also collected. We assessed the prevalence of pfcrt, pfmdr-1, pfdhfr, pfdhps mutations and pfmdr-1 gene copy number in 1596 P. falciparum isolates collected in 26 health centers (20 in Madagascar and 6 in the Comoros Island) in 2006-2008. The in vitro response of parasites for a panel of drugs was determined in 373 isolates. Results showed i) unusual profiles of CQ susceptibility in Madagascar, ii) the rapid rise in frequency of both pfdhfr and pfdhps mutant parasites, iii) the alarming emergence of the single pfdhfr 164L genotype and iv) the progressive loss of the most susceptible isolates to artemisinin derivatives. In the context of the implementation of the new national policy for the fight against malaria, a continued surveillance of P. falciparum resistance in the future is required.

This article has been cited by other articles:

• Andriantsoanirina, V., Bouchier, C., Tichit, M., Jahevitra, M., Rabearimanana, S., Randrianjafy, R., Ratsimbasoa, A., Mercereau-Puijalon, O., Durand, R., Menard, D. (2010). Origins of the Recent Emergence of Plasmodium falciparum Pyrimethamine Resistance Alleles in Madagascar. Antimicrob. Agents Chemother. 54: 2323-2329 [Abstract] [Full Text]  
• Andriantsoanirina, V., Menard, D., Rabearimanana, S., Hubert, V., Bouchier, C., Tichit, M., Bras, J. L., Durand, R. (2010). Association of Microsatellite Variations of Plasmodium falciparum Na+/H+ Exchanger (Pfnhe-1) Gene with Reduced In Vitro Susceptibility to Quinine: Lack of Confirmation in Clinical Isolates from Africa. Am J Trop Med Hyg 82: 782-787 [Abstract] [Full Text]