Molecular markers of resistance to sulfadoxine-pyrimethamine during intermittent preventive treatment for malaria in Mozambican infants

The Journal of Infectious Diseases
Alfredo MayorC Menendez

Abstract

Intermittent preventive treatment in infants (IPTi) with sulfadoxine-pyrimethamine (SP) is a potential malaria control strategy. There is concern about the impact that increasing in vivo resistance to SP has on the efficacy of IPTi, as well as about the potential contribution of IPTi to increases in resistance. We compared the frequency of clinical episodes of malaria caused by P. falciparum parasites with mutations in dhfr and dhps among sick children who received SP or placebo in the context of a randomized, double-blind, placebo-controlled IPTi trial in Mozambique. Half of the children who received placebo harbored quintuple-pure mutant parasites. Nevertheless, the protective efficacy of IPTi within the 35 days after the third dose was 70.8% (95% confidence interval [CI], 40.7%-85.6%). Between month 2 after the third IPTi dose and the end of the follow-up period, children receiving SP harbored more dhps codon 437 mixed infections (odds ratio [OR], 10.56 [95% CI, 1.30-86.14]) and fewer dhps double-pure mutant parasites (OR, 0.43 [95% CI, 0.22-0.84]) than did placebo recipients. IPTi appears to be associated with some changes in the prevalence of genotypes involved in SP resistance. In the face of a high prevalence of quintupl...Continue Reading

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Citations

Aug 21, 2013·Trends in Parasitology·Meera VenkatesanChristopher V Plowe
Feb 4, 2011·Malaria Journal·Filomeno FortesDinora Lopes
Apr 17, 2013·The American Journal of Tropical Medicine and Hygiene·Magatte NdiayeMichael Alifrangis
Dec 15, 2010·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Clara MenéndezAlfredo Mayor
Jun 30, 2009·Tropical Medicine & International Health : TM & IH·R D GoslingD Chandramohan
Jul 11, 2012·Expert Opinion on Pharmacotherapy·Azucena BardajíClara Menéndez
Jul 21, 2011·Asian Pacific Journal of Tropical Medicine·Sumadhya Deepika FernandoSenaka Rajapakse
Nov 6, 2008·International Journal for Parasitology·Hans-Peter BeckWillie Weir
Nov 5, 2019·The Journal of Infectious Diseases·Silvie HuijbenAlfredo Mayor
Jul 13, 2021·Frontiers in Genetics·Alexandra T RouxMoses Okpeku

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