ABSTRACT
The aim of the present study was to analyse the mutation patterns of DHFR and DHPS genes in falciparum from Myanmar adult patients. Five patients were treated with two tablets of co-trimoxazole twice daily for 5 days and another 5 patients were treated with a single dose of three tables of Fansidar. Blood samples from uncomplicated cases of falciparum malaria were collected by finger prick onto glass fibre membrane or filter paper before and 3 or 7 days after treatment. Fragments of genes were amplified by nested polymerase chain reaction (PCR) and variants were identified by specific restriction enzyme digestion. Out of 10 patients, 7 patients were clinically cured at day 37. However, PCR positivity was found in those patients after treatment. Positive PCR may result from amplification of DNA from gametocytes of P.falciparum. The results of pre-treatmentsamples revealed that P.falciparum from malaria patients had point mutations in both DHFR and DHPS genes. 108-Asn and 59-Arg mutations were noted in 9 patients.437-Gly mutation in all 10 patients and 540-Glu mutation in 6 patients. In the post-treatment samples, 108-Asn and 437-Gly mutations were found in all patients.59-arg in 8 patients and 540-Glu in 7 patients. It can be concluded that P.falciparum circulating in Myanmar has already mutated in DHFR and DHPS genes. Even after treatment with antimalarials, the patients still harboured mutated P.falciparum probably gametocyte forms, although they responded well clinically. Therefore, there seems to be no association between mutation patterns in these genes andthe cilnical response to co-trimoxazole and Fansidar.