| Summary: | Background. Malaria is an infectiousn desease that is caused by Plasmodium sp,
and transmitted by female Anophelini mosquito. About 45 % Indonesian peoples
live at malaria endemic area. Pesawaran district is one of malaria endemic area in
Lampung Province with Anual Parasite Incidence in 2010 and 2011 are 2,77 and
4,76 respectively. One factor that can hinder among the malaria control is
resistance to antimalarial drugs. PfMDR1 and PfATP6 genes have been associated
with resistance to artemisinin combination therapy.
Objectives. To Analyze the extent of Single Nucleotide Polymorphism (SNP) of
PfMDR1 and PfATP6 genes, among the Plasmodium falciparum isolated from
falciparum malaria patients in Pesawaran District.
Methods. This study was observational analytic study and cohort of falciparum
malaria patients treated with ACT and primaquine at Hanura Primary Health
Centre (Puskesmas). Minimal sample size are 55 subjects base on WHO criteria.
Subjects are patients with malaria falciparum infection, that were treated at PHC
Hanura according to the inclusion and exclusion criteria. Thin and thick blood
smears as well as blood blot on filter paper were made following finger prick.
Global Positioning System (GPS) coordinate of the patients house was also
recorded using GPS device. DNA isolation was done with DNA QIAmp DNA
Mini Kit. Amplification of PfMDR1 and PfATP6 genes was done with
appropriate forward and reverse primer and procedures that had been optimized
firt. DNA from PCR Product was analyzed with sequencing analysis.
Results. The GPS coordinate of the patients scaltered in areas of S 05
0
29'53.666\"
until 05
0
32'01.315\" and E 105
0
14'20.944\" until 105
0
15'47.516\". The PCR result
revealed one SNP at PfMDR1 gene. Nucleotide number 256 Adenin (A) was
change to Tymine (T), so cause change of amino acid Asparagin (N) to Tyrosin
(Y) at codon 86. The PCR result did not revealed a mutation at PfATP6 gene.
DHP-PQ effectiveness was still wellness with failure therapy 4.55%. AAQ-PQ
effectiveness was still decreased with failure therapy 24.00%. There are failure
therapy of primaquine in 12.50% with gametosit persistent until Day 7 and 14.
The spatial analysis result showed grouping of malaria patients at Hanura Primary
Health Centre, but only one cluster significant with P = 0.0027.
Conclusion. There was one SNP of PfMDR1 at N86Y codon. There was not SNP
at PfATP6 gene. Efeectivenes of DHP-PQ was still wellness than AAQ-PQ. There
are failure therapi of primaquine. There were 5 grouping malaria patients and 1
grouping of malaria patient with failure therapy.
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