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In Gabon, sulfadoxine-pyrimethamine (SP) is recommended for intermittent preventive treatment during pregnancy (IPTp-SP) and for uncomplicated malaria treatment through ACTs drug.  P. falciparum  strains resistant to SP are frequent in areas where this drug is highly used and is associated with the occurrence of mutations on  Plasmodium falciparum  dihydrofolate reductase ( Pfdhfr ) and dihydropteroate synthetase ( Pfdhps ) genes. The aim of the study was to compare the proportion of mutations on  Pfdhfr  and  Pfdhps  genes in isolates collected at Oyem in northern Gabon, in 2005 at the time of IPTp-SP introduction and three years later. Point mutations were analyzed by nested PCR-RFLP method. Among 91 isolates, more than 90% carried  Pfdhfr  108N and  Pfdhfr  59R alleles. Frequencies of  Pfdhfr  51I (98%) and  Pfdhps  437G (67.7%) mutant alleles were higher in 2008. Mutations at codons 164, 540, and 581 were not detected. The proportion of the triple  Pfdhfr  mutation and quadruple mutation including A437G was high: 91.9% in 2008 and 64.8% in 2008, respectively. The present study highlights an elevated frequency of  Pfdhfr  and  Pfdhps  mutant alleles, although quintuple mutations were not found in north Gabon. These data suggest the need of a continuous monitoring of SP resistance in Gabon.

malaria research and treatment

Increased Prevalence of Mutant Allele Pfdhps 437G and Pfdhfr Triple Mutation in Plasmodium falciparum Isolates from a Rural Area of Gabon, Three Years after the Change of Malaria Treatment Policy