Sequence Polymorphisms inpfcrtAre Strongly Associated with Chloroquine Resistance inPlasmodium falciparum

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Abstract
To the Editor —A recent publication by Fidock et al. [1] reported a perfect correlation between the chloroquine-resistant (CQR) phenotype in Plasmodium falciparum and sequence polymorphisms in pfcrt [1]. A mutation, K76T, in pfcrt was shown to be present in all CQR isolates and absent from all chloroquine-susceptible (CQS) isolates tested. Besides K76T, all tested CQR parasites have multiple additional mutations, in various arrangements, at positions 72, 74, 75, 97, 220, 271, 326, 356, and 371 [1]. We wondered whether the same perfect correlation between the K76T mutation and chloroquine resistance would be observed if we used a different set of isolates and whether the additional mutations might possibly be related to different levels of chloroquine resistance. We attempted to answer these questions by determining chloroquine susceptibilities and sequence polymorphisms in pfcrt in parasite isolates collected from Bougainville, an island province of Papua New Guinea, and Thailand and in 15 parasite lines available in our laboratory

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