Short Report: Prevalence of Antimalarial Drug Resistance Mutations in Plasmodium vivax and P-falciparum from a Malaria-Endemic Area of Pakistan

To study drug resistance in Bannu district, a malaria-endemic area in Pakistan, molecular-based analyses were undertaken. In Plasmodium vivax, antifolate resistance mutations were detected in pvdhfr gene codons 57, 58, and 117, with a 117N mutation frequency of 93.5%. All P. falciparum isolates exhibited double 59R + 108N mutations in pfdhfr, whereas the triple mutant 59R + 108N + 437G haplotype was found in 31.8% isolates. Furthermore, all (100%) P. falciparum isolates exhibited the key chloroquine resistance mutation, pfcrt 76T, which is also associated with resistance to amodiaquine. Additionally, pfmdr186Y and D1042Y mutations were, respectively, detected in 32% and 9% isolates. These results. indicate an emerging multi-drug resistance problem in P vivax and P. falciparum malaria parasites in Pakistan.