Levels of Chloroquine Resistance inPlasmodium falciparumAre Determined by Loci Other thanpfcrtandpfmdr1

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Abstract
To the Editor—Babiker et al. [1] recently demonstrated the association of high-level chloroquine resistance in Sudanese isolates of Plasmodium falciparum with mutations in pfcrt (K76T) and pfmdr1 (N86Y), suggesting a joint action of the 2 genes in high-level chloroquine resistance. We wondered whether the same type of association would be observed in parasite samples from other regions and whether additional sequence polymorphisms in pfmdr1 might also be related to different levels of chloroquine resistance. To answer these questions, sequence polymorphisms in pfmdr1 were determined in a set of parasite isolates previously analyzed in our laboratory for chloroquine susceptibilities and sequence polymorphisms in pfcrt [2]. The pfmdr1 gene was amplified by polymerase chain reaction. Codon positions 86 and 184 were analyzed by DNA sequencing and positions 1034, 1042, and 1246 by restriction fragment-length polymorphism [3].

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