Resistance of Plasmodium falciparum to antimalarial drugs in Kobeni department, southeastern Mauritania

Background In Kobeni department (Mauritania), the prevalence of resistance of Plasmodium falciparum to antimalarials is increasing. This study was carried out for 3 consecutive years (2015, 2016, and 2017) in 2326 subjects with fever suspected to be due to malaria consulting at Kobeni health center. Using epidemiological and molecular tools, the epidemiological profile of malaria, the genetic diversity of populations of P. falciparum, and the level of resistance of P. falciparum to antimalarials were investigated in this region bordering Mali. Methods Parasite DNA was extracted from dried blood spots on blotting papers using an automated nucleic acid extraction and purification system (MagMAX™ Express, Thermo Fisher Scientific, Montigny-le-Bretonneux, France) according to the manufacturer’s instructions. Results The prevalence of the CVIET mutant haplotype of Pfcrt gene, associated with chloroquine resistance and, to a lesser extent, resistance to amodiaquine, was 45.2%. Codon 86 and codon 184 of Pfmdr1 gene, associated with resistance to amodiaquine and lumefantrine, were mutated in 10.8% and 54% of isolates, respectively. No mutation in Pfk13 gene associated with artemisinin resistance was observed in Kobeni. Conclusions The level of resistance of P. falciparum to chloroquine and amodiaquine are very high, but there was no indication for resistance to artemisinin and its derivatives. However, efforts are needed to effectively control this disease for its elimination in the region.