Surveillance of Antimalarial Resistance Pfcrt , Pfmdr1 , and Pfkelch13 Polymorphisms in African Plasmodium falciparum imported to Shandong Province, China

摘要

Antimalarial drug resistance is a major public health problem in China. From 2012 to 2015, more than 75% of malaria cases in Shandong Province were P . falciparum returned from Africa. However, molecular marker polymorphisms of drug resistance in imported P . falciparum cases have not been evaluated. In this study, we analyzed polymorphisms of the Pfcrt , Pfmdr1 , and Pfkelch13 genes in 282 P . falciparum cases returned from Africa to Shandong between 2012 and 2015. Among the isolates, polymorphisms were detected in codons 74–76 of Pfcrt and 86, 184, 1246 of Pfmdr1 , among which K76T (36.6%) and Y184F (60.7%) were the most prevalent, respectively. Six Pfcrt haplotypes and 11 Pfmdr1 haplotypes were identified and a comparison was made on the prevalence of haplotypes among East Africa, West Africa, Central Africa and South Africa. One synonymous and 9 nonsynonymous mutations in Pfkelch13 were detected in the isolates (4.6%), among which a candidate artemisinin (ART) resistance mutation P553L was observed. The study establishes fundamental data for detection of chloroquine resistance (CQR) and ART resistance with molecular markers of the imported P . falciparum in China, and it also enriches the genetic data of antimalarial resistance for the malaria endemic countries in Africa.