EVALUATION OF PLASMODIUM FALCIPARUM CHLOROQUINE RESISTANT MARKERS IN SELECTED HEALTH FACILITIES IN CENTRAL REGION AFTER SEVEN YEARS OF BANNING CHLOROQUINE TREATMENT IN GHANA

ABSTRACT

The continuous Chloroquine (CQ) use resulted in intensified parasite resistance to

CQ. This led to adaptation of artemisinin based combination therapy (ACT) as the

first-line antimalarial drug for the treatment of uncomplicated malaria in January,

2005. Despite the replacement, anecdotal evidences suggest that CQ is still being

used in many communities in Ghana. This study was conducted to investigate the

continuous use of CQ and its effect on CQ resistance markers in the Central

Region, Ghana. Using questionnaire, mystery buying and Sakar-Solomon’s urine

CQ assay method, a survey was conducted to ascertain the continuous use of CQ.

The prevalence of point mutations of Pfcrt and Pfmdr1 genes were assessed from

Plasmodium falciparum infected blood samples of subjects, employing the nested

PCR and RFLP techniques. Out of 618 subjects, 2.43% of the subjects preferred

to use CQ injection while 0.49% confirmed the use CQ for treatment of malaria.

Out of 69 community pharmacies and chemical shops surveyed, 14.49% had

stocks of CQ which were being dispensed. Qualitative urine assay revealed that

16.9% out of 444 participants had CQ in their urine samples. Of the 214 P.

falciparum isolates, 71.9% were found to have the K76T mutation of Pfcrt. The

risk of becoming infected with CQ resistant P. falciparum strain with mutation at

position 76 of pfcrt in people who had chloroquine in their urine was thirteen

times [OR=12.63, 95%CI (8.57-18.62)], p

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