Abstract:
Resistance to the artemisinins has been reported in less than a decade after their
global deployment. The molecular markers for artemisinin resistance, however,
have not been clearly characterized. The aim of this study is to determine and
describe the genetic polymorphisms of the Pfcrt, Pfmdrl, and PfATPase6 genes
as associated to artemisinin resistance. A total of 1,318 subjects were recruited for
the study. A 12.75% prevalence of malaria was recorded. Malaria transmission
was not found to be seasonal. PCR-RFLP was employed to analyze mutations at
codon positions 76 of the Pfcrt gene as well as positions 86 and 184 of the Pfmdrl
gene which have been associated with artemisinin resistance. These mutations
were found in very high prevalence among 246 cases of 1,318 subjects recruited
for the study. Mutations in the PfATPase6 gene were analyzed by PCR-RFLP and
Sequencing. The SNPs of PfATPase6 gene that are said to confer resistance to
artemisinins were not found in this study, like in many others, suggesting a
growing irrelevance of the PfATPase6 gene as a marker for artemisinin resistance.
Two novel SNPs in the PfATPase6 gene were, however, discovered confirming
the highly diverse nature of this gene. With the current artemisinin drug pressure
and the observed high prevalence of SNPs associated with artemisinin resistance,
it is only a matter of time for a stable drug resistance to be recorded in Ghana. A
national programme to monitor the development of resistance to artemisinin is,
thus, crucially needed.
