Frequency Distribution of Antimalarial Drug Resistance Alleles among Plasmodium falciparum Isolates from Gezira State, Central Sudan, and Gedarif State, Eastern Sudan

In 2004. Sudan adopted artesunate + sulfadoxine/pyrimethamine (SP) combination as the first-line drug, in response to the high level of falciparum resistance to antimalarials In 2007. a molecular study on antimalarial resistance linked genes, pfcrt, pfmdr1, pfdhfr, pfdhps, and pfATPase6, was conducted on 198 isolates from central and eastern Sudan We observed a high frequency of point mutations at almost all loci analyzed, mainly of pfcrt 76T (72 7%). pfdhfr 511 (75 3%), and pfdhfr 108N (72 7%) alleles The MARK Ill in vitro test for chloroquine sensitivity in 45 P falciparum isolates showed that 37 8% of the isolates were low resistant and 6 7% were fully resistant. This study represents the most recent molecular investigation on antimalarial resistance in this area after the adoption of artemisinin-based combination therapy (ACT), and underlines the importance of the analysis of SP resistance evolution to monitor the efficacy of ACT therapy in endemic areas