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Parasitology Research

, Volume 117, Issue 3, pp 801–807 | Cite as

Prevalence of the Pfdhfr and Pfdhps mutations among asymptomatic pregnant women in Southeast Nigeria

  • Ekpereonne EsuEmail author
  • Costanza Tacoli
  • Prabhanjan Gai
  • Nicole Berens-Riha
  • Michael Pritsch
  • Thomas Loescher
  • Martin Meremikwu
Original Paper

Abstract

Sulfadoxine-pyrimethamine (SP) is the recommended drug for intermittent preventive treatment of malaria in pregnancy in most of sub-Saharan Africa. Resistance to SP is related to mutations in the dhfr and dhps gene of Plasmodium falciparum. This study determined the prevalence of Pfdhfr and Pfdhps polymorphisms found in asymptomatic pregnant women attending antenatal care in Calabar, Nigeria. From October 2013 to November 2014, asymptomatic pregnant women attending antenatal care clinics were enrolled after obtaining informed consent. Malaria diagnosis testing was done using thick and thin smears. Dried blood spot filter papers were collected. Parasite DNA was extracted from the filter papers using a chelex extraction. Extraction was followed by nested PCR and restriction enzyme digestion. P. falciparum infection was detected by microscopy in 7% (32/459) participants. Twenty-eight P. falciparum isolates were successfully genotyped. In the Pfdhfr gene, the triple mutation was almost fixed; S108N mutation was (100%), N51I (93%) and C59R mutations (93%), whereas the I164L mutation was absent. The prevalence of Pfdhps S436A, A437G, A581G and A613S mutations was 82.1% (23/28), 96.4% (27/28), 71.4% (20/28) and 71.4% (20/28) respectively. The K540E mutation was absent. The prevalence of the Pfdhfr triple mutation IRNI was 92.9% (26/28). The efficacy of SP as IPTp in Southeast Nigeria may be severely threatened. The continuous monitoring of SP molecular markers of resistance is required to assess thresholds. The evaluation of alternative preventive treatment strategies and drug options for preventing malaria in pregnancy may be necessary.

Keywords

Molecular markers SP resistance Malaria Antenatal clinic 

Abbreviations

ANC

antenatal care

DBS

dried blot spot

DHFR

dihydrofolate reductase enzyme

dhfr

dihydrofolate reductase gene

DHPS

dihydropteroate synthetase enzyme

dhps

dihydropteroate synthetase gene

IPTp

intermittent preventive treatment in pregnancy

ITN

insecticide-treated bed net

PCR-RFLP

polymerase chain reaction-restriction fragment length polymorphism

SP

sulfadoxine-pyrimethamine

WHO

World Health Organization

Notes

Acknowledgments

We thank the study participants, the staff of the antenatal clinic and management of the General Hospital Calabar where this study took place. Special thanks to Dr. Olabisi Oduwole, Ms.Obiamaka Okafo and Mr. David Agamse at the Calabar Institute of Tropical Diseases Research and Prevention, University of Calabar Teaching Hospital, Calabar, Nigeria, for their invaluable help. We acknowledge the assistance of Prof Dr. Frank Mockenhaupt at the Institute of Tropical Medicine and International Health, Charité-Universitätsmedizin Berlin, with genotyping of molecular markers. We are also grateful to the Center for International Health (CIH), Ludwig-Maximilians University of Munich, DAAD, BMZ and Exceed for supporting the first author for his PhD program.

Authors’ contributions

EE, MM, NB, MP and TL designed the study. CT and PG were responsible for the laboratory work. EE wrote the first draft of the paper. All authors contributed to the interpretation of the data and the revision of the manuscript.

Compliance with ethical standards

Consent for publication

Not applicable.

Availability of data and materials

The datasets generated during the current study are available from the corresponding author on reasonable request.

Conflict of interest

The authors declare that they have no competing interests.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Ekpereonne Esu
    • 1
    • 2
    Email author
  • Costanza Tacoli
    • 3
  • Prabhanjan Gai
    • 3
  • Nicole Berens-Riha
    • 4
  • Michael Pritsch
    • 4
  • Thomas Loescher
    • 4
  • Martin Meremikwu
    • 5
  1. 1.Center for International Health (CIH)Ludwig-Maximilians-Universität (LMU)MunichGermany
  2. 2.Department of Public Health, College of Medical SciencesUniversity of CalabarCalabarNigeria
  3. 3.Institute of Tropical Medicine and International HealthCharité-Universitätsmedizin BerlinBerlinGermany
  4. 4.Division of Infectious Diseases and Tropical MedicineMedical Center of the University of Munich (LMU)MunichGermany
  5. 5.Department of Paediatrics, College of Medical SciencesUniversity of CalabarCalabarNigeria

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