Plasmodium falciparum resistance to chloroquine has been
described in many
parts of the world particularly in Africa
where malaria is endemic. High levels of chloroquine resistance in our
study
area, Lambarene–Gabon, has led to the use
of an alternative regimen for treatment and prevention of P. falciparum
infection. In this study, we examined the in vitro
chloroquine sensitivity of 15 isolates from this area and assessed the
prevalence
of a putative chloroquine resistance associated Pfmdr1 polymorphism
(Asn86Tyr) using a novel allele-specific polymerase
chain reaction (PCR).
Only 4 of the isolates examined were chloroquine sensitive. The allele-specific
PCR shows that all
15 isolates carried the variant (86Tyr)
codon. Eleven of these were resistant to chloroquine suggesting a 73% agreement
between chloroquine resistance phenotype and the point mutation. This molecular
marker was examined in a further 73 Gabonese isolates, where 58 (79·5%)
showed
86Tyr and 15 (20·5%) showed 86Asn. In all,
4 (4·5%)
of the 88 isolates assessed carry both mutant and
wild-type codons, suggesting mixed parasite populations. The incomplete
agreement
found between chloroquine resistance phenotype and Pfmdr1 (86Tyr)
polymorphism would support the view that other genetic factors as well
as Pfmdr1 may
be involved in chloroquine resistance. While our results suggest a high
prevalence of 86Tyr
polymorphism in Lambarene, the Asp1246Tyr
polymorphism (a point mutation which to date has only been associated with
South American
P. falciparum) seems to be absent in our study area.