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Background  Artemisinin resistance is present in the Greater Mekong region and poses a significant threat for current anti-malarial treatment guidelines in Bangladesh. The aim of this molecular study was to assess the current status of drug resistance in the Chittagong Hill Tracts of Bangladesh near the Myanmar border.    Methods  Samples were obtained from patients enrolled into a Clinical Trial (NCT02389374) conducted in Alikadam, Bandarban between August 2014 and January 2015.  Plasmodium falciparum  infections were confirmed by PCR and all  P. falciparum  positive isolates genotyped for the  pfcrt  K76T and  pfmdr1  N86Y markers. The propeller region of the  kelch 13  ( k13)  gene was sequenced from isolates from patients with delayed parasite clearance.    Results  In total, 130  P. falciparum  isolates were available for analysis. The  pfcrt  mutation K76T, associated with chloroquine resistance was found in 81.5% (106/130) of cases and the  pfmdr1  mutation N86Y in 13.9% (18/130) cases. No single nucleotide polymorphisms were observed in the  k13  propeller region.    Conclusion  This study provides molecular evidence for the ongoing presence of chloroquine resistant  P. falciparum  in Bangladesh, but no evidence of mutations in the  k13  propeller domain associated with artemisinin resistance. Monitoring for artemisinin susceptibility in Bangladesh is needed to ensure early detection and containment emerging anti-malarial resistance.

malaria journal

Molecular analysis demonstrates high prevalence of chloroquine resistance but no evidence of artemisinin resistance in Plasmodium falciparum in the Chittagong Hill Tracts of Bangladesh