Table 3.
Plasmodium drug resistance, the location where documented and its resistance mechanism.
| Parasite | Drug Resistance | Location Where Plasmodium Resistance Has Been Documented | Resistance Mechanism | Ref. |
|---|---|---|---|---|
| P. vivax | CQ | Asia and Oceanian (Papua New Guinea and Indonesia), South America (Brazil) Africa (Madasgascar and South and Southeast Asia (India, Myanmar, Nepal, and Thailand) | Develops a transporter for chloroquine, encoded pvcrt-o Mutation of pvmdr1 and pvdhfr |
[72,73,74,75,76] |
| MQ | Southeast Asia (Western border of Thailand) and South America (Brazil) | Amplification of pvmdrl and over-expression of pghl | [75,77] | |
| AQ | Southeast Asia (Western border of Thailand) | Reduced dhfr affinity | [75,76] | |
| P. falciparum | ART | Southeast Asia and East Asia (Thailand, Vietnam, Myanmar, Laos, China), and Sub-Saharan Africa | Not well known Mutation of pfk13 in specific sequences of the BTB-POZ domains and six kelch domains (probably) |
[78,79] |
| AS | Southeast Asia (Western Cambodia) |
[78] | ||
| AR | Southeast Asia and Sub-Saharan Africa | [78,79] | ||
| LR | Southeast Asia and Sub-Saharan Africa | [77,78] | ||
| CQ | Southeast Asia (Western border of Thailand), Africa (Sub-Saharan Africa), South America (Brazil) | Develops a transporter for chloroquine, encoded pfcrt; Mutation of pfmdr1 and pfdhfr |
[75,80] | |
| AQ | Western border of Thailand | Reduced affinity for binding of the DHFR competitive inhibitor | [76] | |
| QUIN | Southeast Asia (Thailand, Thai Myanmar and Thai-Cambodian borders) | Amplification of pfmdrl and pghl overexpression | [76,81,82] | |
| PG | Southeast Asia (Thailand, Thai Myanmar and Thai-Cambodian borders) | Reduced affinity for binding of the dhfr competitive inhibitor | [76,81] | |
| MQ | Southeast Asia (Western border of Thailand, Thai-Myanmar and Thai-Cambodian borders) South America (Brazil) | Amplification of pfmdrl and pghl over-expression | [75,76,81,82,83,84] | |
| HF | Southeast Asia (Thailand) | Amplification of pfmdrl and pghl over-expression | [80,81] | |
| SULF | Southeast Asia (Western border of Thailand, Thai-Myanmar and Thai-Cambodian borders) |
dhps mutations | [75,76,81] | |
| PMT | Southeast Asia (Western border of Thailand, Thai-Myanmar and Thai-Cambodian borders) |
Reduced affinity for binding of the dhfr competitive inhibitor | [75,76,81] |
Abbreviations: CQ—chloroquine; MQ—mefloquine; AQ—amodiaquine; ART—artemisinin; AS—artesunate; AR—artemether; LR—lumefantrine; QUIN—quinine; PG—proguanil; HF—halofantrine; SULF—sulfadoxine; PMT—pyrimethamine; pvcrt-o—P. vivax chloroquine resistance transporter orthologue gene; pvdhfr—P. vivax dihydropteroate reductase; pvmde1—P. vivax multidrug resistance gene 1; pgh1—P-glycoprotein homologue 1 protein; DHFR—dihydrofolate reductase; pfk13—P. falciparum Kelch protein 13; pfcrt—P. falciparum chloroquine resistance transporter gene; pfmdr1—P. falciparum multidrug resistance gene 1; pfdhfr—P. falciparum dihydropteroate reductase; dhfr—competitive inhibitor to dihydro-folate reductase; dhps—deoxyhypusine synthase; BTB-POZ—domain-containing protein 1.