Plasmodium falciparum and P. vivax co-exist at different endemicity levels across Ethiopia. For over two decades Artemether-Lumefantrine (AL) is the first line treatment for uncomplicated P. falciparum, while chloroquine (CQ) is still used to treat P. vivax. It is currently unclear whether a shift from CQ to AL for P. falciparum treatment has implications for AL efficacy and results in a reversal of mutations in genes associated to CQ resistance, given the high co-endemicity of the two species and the continued availability of CQ for the treatment of P. vivax. This study thus assessed the prevalence of Pfcrt-K76T and Pfmdr1-N86Y point mutations in P. falciparum. 18S RNA gene based nested PCR confirmed P. falciparum samples (N = 183) collected through community and health facility targeted cross-sectional surveys from settings with varying P. vivax and P. falciparum endemicity were used. The proportion of Plasmodium infections that were P. vivax was 62.2% in Adama, 41.4% in Babile, 30.0% in Benishangul-Gumuz to 6.9% in Gambella. The Pfcrt-76T mutant haplotype was observed more from samples with higher endemicity of P. vivax as being 98.4% (61/62), 100% (31/31), 65.2% (15/23) and 41.5% (22/53) in samples from Adama, Babile, Benishangul-Gumuz and Gambella, respectively. However, a relatively higher proportion of Pfmdr1-N86 allele (77.3-100%) were maintained in all sites. The observed high level of the mutant Pfcrt-76T allele in P. vivax co-endemic sites might require that utilization of CQ needs to be re-evaluated in settings co-endemic for the two species. A country-wide assessment is recommended to clarify the implication of the observed level of variation in drug resistance markers on the efficacy of AL-based treatment against uncomplicated P. falciparum malaria.

中文翻译：

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在埃塞俄比亚具有不同水平间日疟原虫共流行的环境中，恶性疟原虫Pfcrt和Pfmdr1等位基因的患病率。

恶性疟原虫和间日疟原虫在埃塞俄比亚以不同的流行水平共存。在过去的二十多年中，蒿甲醚-卢美他汀（AL）是简单的恶性疟原虫的一线治疗，而氯喹（CQ）仍用于治疗间日疟原虫。目前尚不清楚，鉴于恶性疟原虫的治疗从CQ转变为AL是否对AL疗效有影响，并导致与CQ抗性相关的基因突变逆转，因为这两个物种具有很高的共存性和CQ用于治疗间日疟原虫。因此，这项研究评估了恶性疟原虫中Pfcrt-K76T和Pfmdr1-N86Y点突变的患病率。基于18S RNA基因的嵌套式PCR证实了恶性疟原虫样品（N = 183）是通过社区和卫生机构针对性的横断面调查从不同的P设置中收集的。间质和恶性疟原虫流行。间日疟原虫感染的比例在阿达玛占62.2％，在巴比勒占41.4％，在贝尼桑古尔-古穆兹占30.0％，在甘贝拉占6.9％。从具有较高间日疟原虫流行性的样品中观察到Pfcrt-76T突变单倍型分别为98.4％（61/62），100％（31/31），65.2％（15/23）和41.5％（22/53） ）分别来自Adama，Babile，Benishangul-Gumuz和Gambella。但是，在所有位点中都保留了相对较高比例的Pfmdr1-N86等位基因（77.3-100％）。在间日疟原虫共流行位点中观察到的高水平突变体Pfcrt-76T等位基因可能需要在这两个物种共流行的环境中重新评估CQ的利用。