Abstract
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
51I (75.3%), and
pfdhfr
108N (72.7%) alleles. The MARK III
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.