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Review
. 2021 Apr-Jun;16(2):173-185.
doi: 10.18502/ijpa.v16i2.6265.

The Drug Resistance of Plasmodium falciparum and P. vivax in Iran: A Review Article

Aliehsan Heidari  1 , Hossein Keshavarz  2   3
Affiliations
Review

The Drug Resistance of Plasmodium falciparum and P. vivax in Iran: A Review Article

Aliehsan Heidari et al. Iran J Parasitol. 2021 Apr-Jun.

Abstract

Background: One of the main obstacles to malaria control in the world has been the emergence of resistance in Plasmodium falciparum to chloroquine and other anti-malarial drugs. This study aimed to review studies in Iran on resistance in P. falciparum and P. vivax to drugs, and to reveal the mechanisms and molecular markers of resistance of these two species.

Methods: The databases of PubMed, Scopus, Google Scholar, Magiran, and reputable Iranian journals were searched to find published studies on the resistance in P. falciparum and P. vivax to antimalarial drugs in Iran.

Results: There is a significant relationship between resistance to chloroquine in P. falciparum and the emergence of K76T mutation in the P. falciparum chloroquine-resistance transporter gene in Iran. Resistance to sulfadoxine-pyrimethamine (SP) in P. falciparum is also significantly associated with the development of mutations in the dihydrofolate reductase and dihydropteroate synthase genes. Resistance to chloroquine in P. vivax has not been reported in Iran and it is used as a first-line treatment for P. vivax malaria.

Conclusion: P. falciparum has become resistant to chloroquine in different regions of Iran and is not currently used to treat malaria. Besides, cases have emerged of P. falciparum resistance to SP in different parts of southern Iran, and SP is not administered alone for treating P. falciparum.

Keywords: Drug resistance; Iran; Malaria; Plasmodium falciparum; Plasmodium vivax.

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Conflict of interest statement

Conflict of interest The authors declare that there is no conflict of interest.

Figures

Fig. 1:
Fig. 1:
Map of Iran
Fig. 2:
Fig. 2:
Chemical structure of some anti-malarial drugs (Ar =Artesunate, Qui=Quinine)
Fig. 3:
Fig. 3:
Conversion of heme to hemozoin in the digestive vacuole in P. falciparum and the role of Pfcrt mutation in inhibiting chloroquine action
Fig. 4:
Fig. 4:
Mutation in codons 51, 59, 108 and 164 in Iranian P. falciparum isolates that confer resistance to pyrimethamine
Fig. 5:
Fig. 5:
Mutation in codons 436, 437, 540 and 581 in Iranian P. falciparum isolates that confer resistance to sulfadoxine
See this image and copyright information in PMC

References

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