ArticlePloS one2014
Molecular evidence of increased resistance to anti-folate drugs in Plasmodium falciparum in North-East India: a signal for potential failure of artemisinin plus sulphadoxine-pyrimethamine combination therapy.
Article in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 2 of them syntheses that pooled it.
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29 citing papers in PubMed, 2 syntheses or guidelines pooled it, 46 citations in OpenAlex.
- Systematic Review and Geospatial Modeling of Molecular Markers of Resistance to Artemisinins and Sulfadoxine-Pyrimethamine in Plasmodium falciparum in India.The American journal of tropical medicine and hygiene · 2024Pooled it
- Molecular assays for determining sulphadoxine-pyrimethamine drug resistance in India: a systematic review.Parasitology research · 2022Pooled it
- Dietary Saccharomyces Cerevisiae and Pseudomonas Aeruginosa Enhance Growth Performance, Nutrient Utilization, Intestinal Morphology, and Hemato-Biochemical Profile in Red Tilapia (Oreochromis sp.).Probiotics and antimicrobial proteins · 2026Article
- Therapeutic efficacy of artemether-lumefantrine in North-Eastern states of India and prevalence of drug resistance-associated molecular markers.Malaria journal · 2025Article
- Spatiotemporal epidemiology of indigenous and imported malaria cases in Goa, western India.Malaria journal · 2025Article
- Assessment of Plasmodium falciparum drug resistance associated molecular markers in Mandla, Madhya Pradesh, India.Malaria journal · 2023Article
- Malaria hotspots and climate change trends in the hyper-endemic malaria settings of Mizoram along the India-Bangladesh borders.Scientific reports · 2023Article
- Article
- Molecular detection of drug-resistantThe Indian journal of medical research · 2023Article
- International Center of Excellence for Malaria Research for South Asia and Broader Malaria Research in India.The American journal of tropical medicine and hygiene · 2022Article
- Genomic characterization ofFrontiers in cellular and infection microbiology · 2022Article
- Genetic polymorphism ofAccess microbiology · 2022Article
- Article
- Epidemiology of malaria and chloroquine resistance in Mizoram, northeastern India, a malaria-endemic region bordering Myanmar.Malaria journal · 2020Article
- Malaria in North-East India: Importance and Implications in the Era of Elimination.Microorganisms · 2019Review
- DecreasedAntimicrobial agents and chemotherapy · 2019Article
- Characterization of drug resistance and genetic diversity of Plasmodium falciparum parasites from Tripura, Northeast India.Scientific reports · 2019Article
- Molecular surveillance of putative drug resistance markers of antifolate and artemisinin among importedPathogens and global health · 2019Article
- Development and Evaluation of a Novel HNB Based Isothermal Amplification Assay for Fast Detection of Pyrimethamine Resistance (S108N) inInternational journal of environmental research and public health · 2019Article
- Molecular Evidence forThe American journal of tropical medicine and hygiene · 2018Article
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Authors and funding
9 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
North-east India, being a corridor to South-east Asia, is believed to play an important role in transmitting drug resistant Plasmodium falciparum malaria to India and South Asia. North-east India was the first place in India to record the emergence of drug resistance to chloroquine as well as sulphadoxine/pyrimethamine. Presently chloroquine resistance is widespread all over the North-east India and resistance to other anti-malarials is increasing. In this study both in vivo therapeutic efficacy and molecular assays were used to screen the spectrum of drug resistance to chloroquine and sulphadoxine/pyrimethamine in the circulating P. falciparum strains. A total of 220 P. falciparum positives subjects were enrolled in the study for therapeutic assessment of chloroquine and sulphadoxine/pyrimethamine and assessment of point mutations conferring resistances to these drugs were carried out by genotyping the isolates following standard methods. Overall clinical failures in sulphadoxine/pyrimethamine and chloroquine were found 12.6 and 69.5% respectively, while overall treatment failures recorded were 13.7 and 81.5% in the two arms. Nearly all (99.0%) the isolates had mutant pfcrt genotype (76 T), while 68% had mutant pfmdr-1 genotype (86 Y). Mutation in dhps 437 codon was the most prevalent one while dhfr codon 108 showed 100% mutation. A total of 23 unique haplotypes at the dhps locus and 7 at dhfr locus were found while dhps-dhfr combined loci revealed 49 unique haplotypes. Prevalence of double, triple and quadruple mutations were common while 1 haplotype was found with all five mutated codons (F/AGEGS/T) at dhps locus. Detection of quadruple mutants (51 I/59 R/108 N/164 L) in the present study, earlier recorded from Car Nicobar Island, India only, indicates the presence of high levels of resistance to sulphadoxine/pyrimethamine in north-east India. Associations between resistant haplotypes and the clinical outcomes and emerging resistance in sulphadoxine/pyrimethamine in relation to the efficacy of the currently used artemisinin combination therapy are discussed.
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