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Title: Prevalence of Molecular markers associated with Chloroquine resistance in P·falciparum after withdrawal of the drug in Harbu, Ethiopia
Authors: Ewnet, Alemu
Advisors: Beyene Petros(Prof.)
Keywords: Plasmodium falciparum
Chloroquine resistance
Pfcrt
Pfmdr1
Copyright: Jun-2011
Date Added: 4-Jul-2012
Publisher: Addis Ababa University
Abstract: In Ethiopia, chloroquine was the first line anti-malarial drug used for the treatment of uncomplicated falciparum malaria for more than 40 years, until very high treatment failure rates were demonstrated through studies conducted in 1997/98. Following these findings, the national drug policy for uncomplicated falciparum malaria treatment was shifted to sulfadoxine/pyrimethamine (SP). Unfortunately, SP resistance became widely prevalent soon after its introduction and was replaced by artemether-lumefantrine (AL) in 2004. In order to assess the impact of this policy change on the prevalence of molecular markers linked to chloroquine resistance in Harbu, South Wollo, Amhara Region, a total of 144 blood samples were collected from P. falciparum mono-infected study participants using whatman filter paper in 2005 (N=72) and 2008 (N=72). PCR based dot blot-hybridization technique was performed to determine the change in prevalence of molecular marker genes, Pfcrt 76 Thr and Pfmdr1 86 Tyr that confer chloroquine resistance in P. falciparum isolates from 2005 and 2008. The study showed a slight reduction in the prevalence of Pfcrt 76 mutation (Lys 76 Thr) from 100% in 2005 to 98.21% in 2008 (95% CI, -0.017- 0.053; P= 0.29), whereas, Pfmdr1 86 mutation (Asn 86 Tyr) showed a statistically significant reduction of 15.9%, from 81.97% in 2005 to 66.07% in 2008 (95% CI, 0.001- 0.315; P= 0.049). The prevalence of wild allele of Pfcrt 76 Lys increased to1.79% in 2008 from 0% in 2005 (95% CI,-0.053- 0.017; P= 0.29). Similarly, the wild allele of Pfmdr1 86 Asn was also increased from 14.75% in 2005 to 23.21% in 2008 (95% CI, -0.227- 0.057; P= 0.24). Overall, the findings of the present study showed a decline in prevalence of chloroquine resistance conferring genes in spite of use of chloroquine for treatment of P. vivax in the study area. This is a good indication of the re-emergence of chloroquine sensitive P. falciparum in the study area. Therefore, it would be advisable to withdraw the use of chloroquine for vivax malaria treatment for a much faster re-emergence of chloroquine sensitive P. falciparumparasites, in order to maximize the likelihood of chloroquine reintroduction.
Description: A Thesis Presented to the School of Graduate Studies of the Addis Ababa University in Partial Fulfillment of the Requirementsfor the Degree of Master of Science in Biology (Applied Genetics Stream)
URI: http://hdl.handle.net/123456789/3255
Appears in:Thesis - Biology

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