Abstract
Despite efforts to eliminate it, malaria remains a major public health concern, particularly in Côte d’Ivoire. Chloroquine (CQ) was one of the first drugs used for its treatment, but was officially withdrawn from the market in 2007 following reports of high levels of chloroquine resistance. The present study was carried out after the withdrawal of CQ and provides an update on the rates of CQ resistance in Côte d’Ivoire. Samples were collected between September 2013 and March 2014 in Abidjan and from January to May 2016 in Abengourou and San Pedro through cross-sectional studies. Parasitemia was assessed by microscopy, and single nucleotide polymorphism in the Pfcrt (codon 76) gene was analyzed by nested PCR and restriction fragment length polymorphism. A total of 343 samples were analyzed: 119, 106 and 118 were from Abidjan, Abengourou, and San Pedro, respectively. The sex ratio of patients was 0.92. The mean age of patients enrolled was 9.6 years (SD = 10.8). The geometric mean of parasite density was 21,337 parasites/μL (SD = 49,508; range, 2,000–200,000). Molecular analysis revealed 57 K76T mutants (16.6%): 33, 9, and 15 in Abidjan, Abengourou and in San Pedro, respectively. Most of these were found in patients aged ≤15 years (42/57) who had parasitemia greater than 10,000 parasites/μL (40/57). This is the first study conducted in Côte d’Ivoire reporting a decline in Pfcrt K76T mutation rate. Thus, our results indicate the importance of following up on the observed trend also at a national level.
Conflicts of interests. The authors declare that they have no competing interests.
Authors’ contributions. YW, MEIH supervised the study. A-DM, TKD, B-TAV, GAP, and KA supervised the samples collection. KA and GAP done molecular analysis. KA analysed the data and wrote this paper. All authors contributed to the drafting of the manuscript.
Acknowledgements
We hereby thank the clinical study team and our administrative staff. We are also grateful to the patients who took part in this study. Sample collection was a part of a study which received financial support from Global funds through the National Malaria Control Program (NMCP). Funders had no involvement in the study design, data collection, data analysis, data interpretation, manuscript drafting or the decision to submit it for publication. The authors declare that they have no competing interests.
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