High efficacy of artemether-lumefantrine and declining efficacy of artesunate + sulfadoxine-pyrimethamine against Plasmodium falciparum in Sudan (2010–2015): evidence from in vivo and molecular marker studies

Table 4 Comparison of the frequency of dhps gene haplotypes in four sentinel sites in Sudan 2011

Number of mutations	Dhps haplotype	Kassala	Gedaref	Sennar	KostiI	Pearson’s Chi square	p value
None	wild dhps type	14 (17.3 %)	22 (22.9 %)	30 (30.0 %)	57(64.0 %)^a	52.127	<0.001
Single	S436A	0	2	1	2
	A437G	0	4	0	4
	K540E	0	3	1	0
	A581G	1	0	1	1
	S436C	0	0	9	0
Double	A437G, K540E	26 (32.1 %)	44 (45.8 %)	34 (34.0 %)	24 (27.0 %)^b	7.824	0.050
	S436C, A581G	0	0	2	0
	S436C, K540E	0	0	1	0
	A437G, A581G	0	0	1	0
Triple	S436A, A437G, K540E	6 (7.4 %)	6 (6.2 %)	0	0
Triple	A437G, K540E, A581G	33 (40.7 %)	15 (15.6 %)	20 (20 %)	1 (1 %)^c		<0.001^d
Quadruple	S436A, A437G, K540E, A581G	1	0	0	0
Total		81	96	100	89

^aKosti wild type is significantly higher than Gedaref (Chi square = 31.93, p < 0.001), Kassala (Chi Square = 38.12, p < 0.001) and Sennar (Chi square = 21.97, p < 0.001)
^bKosti mutant is significantly lower than Gedaref (Chi square = 7.07, p = 0.008), not significantly different from Kassala (Chi Square = 0.54 p = 0.462) or Sennar (Chi square = 1.10, p = 0.295)
^cThe proportion of Kosti mutant isolates is significantly lower than Gedaref p < 0.001, Kassala, p < 0.001 and Sennar p < 0.001, Fisher’s exact test
^dFisher’s exact test

ISSN: 1475-2875