Selection of pfcrt k76 and pfmdr1 n86 coding alleles after uncomplicated malaria treatment by artemether-lumefantrine in mali

Hamma Maiga, Anastasia Grivoyannis, Issaka Sagara, Karim Traore, Oumar B. Traore, Youssouf Tolo, Aliou Traore, Amadou Bamadio, Zoumana I. Traore, Kassim Sanogo, Ogobara K. Doumbo, Christopher V. Plowe, Abdoulaye A. Djimde

Research output: Contribution to journalArticlepeer-review


Background: Artemether-lumefantrine is a highly effective artemisinin-based combination therapy that was adopted in Mali as first-line treatment for uncomplicated Plasmodium falciparum malaria. This study was designed to measure the efficacy of artemether-lumefantrine and to assess the selection of the P. falciparum chloroquine resistance transporter (pfcrt) and P. falciparum multi-drug resistance 1 (pfmdr1) genotypes that have been associated with drug resistance. Methods: A 28-day follow-up efficacy trial of artemether-lumefantrine was conducted in patients aged 6 months and older suffering from uncomplicated falciparum malaria in four different Malian areas during the 2009 malaria transmission season. The polymorphic genetic markers MSP2, MSP1, and Ca1 were used to distinguish between recrudescence and reinfection. Reinfection and recrudescence were then grouped as recurrent infections and analyzed together by PCR-restriction fragment length polymorphism (RFLP) to identify candidate markers for artemether-lumefantrine tolerance in the P. falciparum chloroquine resistance transporter (pfcrt) gene and the P. falciparum multi-drug resistance 1 (pfmdr1) gene. Results: Clinical outcomes in 326 patients (96.7%) were analyzed and the 28-day uncorrected adequate clinical and parasitological response (ACPR) rate was 73.9%. The total PCR-corrected 28-day ACPR was 97.2%. The pfcrt 76T and pfmdr1 86Y population prevalence decreased from 49.3% and 11.0% at baseline (n = 337) to 38.8% and 0% in patients with recurrent infection (n = 85); p = 0.001), respectively. Conclusion: Parasite populations exposed to artemether-lumefantrine in this study were selected toward chloroquine-sensitivity and showed a promising trend that may warrant future targeted reintroduction of chloroquine or/and amodiaquine.

Original languageEnglish (US)
Article number6057
JournalInternational journal of molecular sciences
Issue number11
StatePublished - Jun 1 2021


  • Artemether-lumefantrine
  • Mali
  • Pfcrt
  • Pfmdr1
  • Plasmodium falciparum

ASJC Scopus subject areas

  • Catalysis
  • Molecular Biology
  • Spectroscopy
  • Computer Science Applications
  • Physical and Theoretical Chemistry
  • Organic Chemistry
  • Inorganic Chemistry


Dive into the research topics of 'Selection of pfcrt k76 and pfmdr1 n86 coding alleles after uncomplicated malaria treatment by artemether-lumefantrine in mali'. Together they form a unique fingerprint.

Cite this