Abstract

Plasmodium falciparum Pfmdr1-86 gene polymorphisms were investigated in blood samples of patients > 6 months of age treated with Amodiaquine-Artesunate (ASAQ) and Artemether-Lumefantrine (AL) in Nanoro, Burkina Faso.  Treatments outcome was determined with a 28-day follow-up. The prevalence of Pfmdr-1 N86Y alleles was determined before and after treatment. The PCR-adjusted Adequate Clinical and Parasitological Response (ACPR) was higher in the ASAQ arm (100%) than in the AL arm (87.5%) [Risk difference = -12.50; 95% CI: -20.13; - 4.86 (p=0.001)]. The prevalence of Pfmdr-1 Y86 mutation in the ASAQ arm was significantly higher among patients who had a recurrent parasitaemia (54.54%) than those classified as ACPR (12.70%) (p = 0.007). Similarly, the prevalence of the mutant allele Pfmdr-1 Y86 before treatment (20.00%) was significantly lower than that found in post-treatment (55.56%)  in the ASAQ arm (p = 0.01). However, we did not see such difference in the AL arm either for post-treatment samples versus pre-treatment samples (p = 0.88), nor for patients with recurrent parasiteamia compared to those classified as ACPR (p = 0.65). In conclusion, our study showed that ASAQ is selected for parasites carrying the Pfmdr-1 Y86 mutation; however we were not able to demonstrate the reverse relationship between Pfmdr-1 86N and AL treatment as previously reported in Africa.

Key words: Malaria, Plasmodium falciparum, Amodiaquine-Artesunate, Artemether-Lumefantrine, Efficacy, Pfmdr-1, Burkina Faso.