Impact of treatment and re-treatment with Artemether-Lumefantrine and Artesunate-Amodiaquine on selection of Plasmodium falciparum Multidrug Resistance Gene-1 polymorphisms in the Democratic Republic of Congo and Uganda

Background The emergence of resistance against artemisinin combination treatment is a major concern for malaria control. ACTs are recommended as the rescue treatment, however, there is limited evidence as to whether treatment and re-treatment with ACTs select for drug-resistant P. falciparum parasites. Thus, the present study wanted to investigate the impact of treatment and re-treatment using artesunate-amodiaquine (ASAQ) and artemether-lumefantrine (AL) on the selection of P. falciparum multidrug resistance-1 (pfmdr1) alleles in clinical settings. Methods P. falciparum positive samples were collected from children aged 12-59 months in a clinical trial in DR Congo and Uganda. Pfmdr1 single nucleotide polymorphisms (SNPs) analysis at codons N86Y, Y184F, and D1246Y were performed at baseline and post-treatment with either AL or ASAQ as a rescue treatment using nested PCR followed by restriction fragment length polymorphism (RFLP) assays. Results The pre-treatment prevalence of Pfmdr1 N86...