Prevalence of the chloroquine resistance genotype among young children in Uganda.

Abstract

Plasmodium falciparum is the main malaria causative agent in Uganda and in several parts of the world resulting into millions of deaths per year. Up to date, even with use of various antimalarials, an effective drug comparable to the impact of the previously used chloroquine has not been used. However, due to the problem of resistance that was wide spread in Uganda and other parts of the world, chloroquine was withdrawn as a drug for treatment of uncomplicated malaria. The prevalence of the chloroquine marker (PfcrtK76T) was thus determined in this study at six Infectious Diseases Research Collaboration (IDRC) study sites with different transmission intensities that is to say Lamwo, Amolatar, Kole, Kabale, Jinja, and Tororo. Of the 105 successfully amplified and Apo1 enzyme digested samples, 86 (81.9%) samples had wild- type genotype whereas 19 (18.1%) samples had the mutant genotype (76T). Kole, Kabale, Amolatar and Jinja had no mutant 76T genotype. Tororo had the highest number of chloroquine resistant genotype 17 (89.5%) and whereas Lamwo had 2 (10.5%). The continued prevalence of the chloroquine resistance genotype was associated to the presence of other pfcrt mutations that confer the resistant parasites a selective advantage through mediating resistance to the currently used ACTs or to the delayed withdrawal of chloroquine in these areas. However, this study supports the revival of chloroquine as a drug for treatment of uncomplicated malaria in some areas where treatment failure to ACTs is observed and calls for further and larger studies on improvement of chloroquine to enhance on the fight against malaria.