RESEARCH Prevalence of pfmdr1 allel t t

Full list of author information is available at the end of the articleBackground The Plasmodium falciparum multi-drug resistance gene 1 (pfmdr1) and particularly, single nucleotide polymor-phisms (SNPs) resulting in an amino acid change in co-dons 86 (N86Y), 184 (Y184F), and 1246 (D1246Y) have been associated with changes in parasite susceptibility to various drugs, including artemisinin-based combination therapy (ACT) [1-4]. Initially, SNPs in pfmdr1 were asso-ciated with chloroquine (CQ) and amodiaquine (AQ) re-sistance [5]. For instance, the pfmdr1 86Y mutation has been associated with high CQ resistance [6,7], and the combination of pfmdr1 86Y, Y184, and 1246Y is likely se-lected by AQ monotherapy and associated with increased risk of treatment failure [1,2]. Although SNPs at positions 1034 and 1042 of pfmdr1 were described as being related to phenotype modulation by altering a drug pocket in PfMDR1 [8], they are very infrequent in Africa. ACT drug resistance has recently been reported at the Thai-Cambodian border [9-11]. Historical evidence shows that the emergence of drug-resistant P. falciparum strains first originated in Southeast Asia and then, spread to Africa [12]. East Africa has been a major focus of drug re-sistance spread, and development in sub-Saharan Afric