Date of Award

January 2020

Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)

Department

School of Public Health

First Advisor

Amy Bei

Second Advisor

Sunil Parekh

Abstract

This study aimed to use molecular markers to do surveillance of antimalarial drug resistance and inform drug policy. The focus was on sulfadoxine-pyrimethamine drug resistance since that was the first-line treatment in Tanzania for an uncomplicated malaria infection of Plasmodium falciparum. There are five mutations across two genes that are associated with this drug. On the dhfr gene, mutations at the 51 (N51I), 59 (C59R), and 108 (S108N) position are associated with pyrimethamine drug resistance. On the dhps gene, mutations at the 437 (A437G) and 540 (K540E) positions are associated with sulfadoxine drug resistance. Samples were collected from Tanzania in 2004, and the blood samples analyzed via high resolution melting (HRM). The peaks of each sample were compared to reference strains to determine the genotype of each sample. The prevalence of 51I, 59R, 108N, 437G, and 540E was 50%, 42.3%, 69.3%, 28.0%, and 0%, respectively. Individual genotypes were reported for those samples that were completed for all the quintuple mutations (n = 50). For the dhfr gene, 76% had a mutation at the 108 position, 52% had a mutation at the 51 position, and 42% had a mutant allele at the 59 position. For the dhps gene, 28% had a mutant genotype at the 437 position, and 0% had a mutation at the 540 positions. These prevalence results were like those of other studies. However, the individual genotypes differed from other studies. Further research must be conducted to determine the reasons for these differences.

Comments

This is an Open Access Thesis.

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