KERAGAMAN GENETIK PETANDA P. falciparum DARI SPECIMEN SUBYEK PENELITIAN MONITORING DIHIDROARTEMISININ-PIPERAKUIN DI KALIMANTAN DAN SULAWESI

Treatment failure in falciparum malaria may be caused by parasite resistant to antimalarial drug or new infection. Polymorphism genetic marker of P. falciparum namely MSP1, MSP2 and GLURP locus genes in the population should be identified as a baseline to distinguish the cause of treatment failure. A nested Polymerase Chain Reaction (PCR) method was applied to each locus gene separately. A total 121 dried blood spot specimens from subjects infected with P. falciparum in monitoring Dihydroartemisinin-Piperaquine treatment in Kalimantan and Sulawesi Islands were analyzed. Locus genes of MSP1, MSP2 and GLURP were successful identified 82.6%, 96.7% and 81.0% respectively. However, the three (MSP1, MSP2 and GLURP) locus genes were only found in 71.9% (87 of 121) samples. All of MSP1 locus gene had just one allele, two alleles on most of MSP2 (67.5%) and few of GLURP (14.3%). Multi genotype infection was likely dominant than a single genotype infection (65.5% vs. 34.5%). Based on allele length classification, MSP2 locus gene shows more variety of allele class (12 alleles) than GLURP (9 alleles) and MSP1 (7 alleles), with an allele length mostly for MSP1: 440 - 479 bp, MSP2: 480–519 bp and GLURP: 580–639 bp. In this study, falciparum malaria cases were commonly as multi-genotype infection, and MSP2 was a dominant and polymorphic genetic marker of P.falciparum. Keywords: P. falciparum, PCR, MSP1, MSP2, GLURP, allele Abstrak Gagal pengobatan pada malaria falsiparum dapat disebabkan oleh parasit yang resisten terhadap obat antimalaria atau oleh infeksi baru. Keragaman genetik petanda Plasmodium falciparum yaitu lokus gen MSP1, MSP2 dan GLURP dalam suatu populasi perlu diidentifikasi sebagai dasar untuk membedakan penyebab gagal pengobatan. Metode pemeriksaan yang digunakan adalah nested Polymerase Chain Reaction (PCR) terhadap masing-masing lokus gen secara terpisah. Telah dianalisis 121 spesimen resapan darah kering pada kertas filter dari subyek terinfeksi P.falciparum pada studi monitoring pengobatan dengan Dihidroartemisinin-Piperakuin di Kalimantan dan Sulawesi. Masing-masing lokus gen MSP1, MSP2 dan GLURP yang dapat diidentifikasi sebanyak 82,6%, 96,7% and 81,0%. Sedangkan ketiga lokus gen tersebut ditemukan hanya pada 71,9% (87/121) sampel. Lokus gen MSP1 semuanya mempunyai 1 alel, sedangkan dua alel ditemukan pada sebagian besar MSP2 (67,5%) dan sebagian kecil GLURP (14,3%). Infeksi multi-genotip oleh dua atau lebih genotip P.falciparum ditemukan pada 65,5% sampel dan infeksi tunggal hanya 34,5% sampel. Keragaman klas alel paling banyak ditem