Document Detail


Antimalarial resistance and DHFR/DHPS genotypes of Plasmodium falciparum three years after introduction of sulfadoxine-pyrimethamine and amodiaquine in rural Tanzania.
MedLine Citation:
PMID:  18082233     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We assessed the efficacy of sulfadoxine-pyrimethamine (SP) and amodiaquine (AQ) and DHFR/DHPS genotypes of Plasmodium falciparum in rural Tanzania, 3 years after their introduction as first- and second-line treatments for uncomplicated malaria, respectively. Under five children with uncomplicated malaria were given standard treatments of either SP (n=66) or AQ (n=30) and treatment outcomes after 14 and 28 days were determined. Total treatment failure of 18 and 42.5% was observed for SP on days 14 and 28, respectively. For AQ, total treatment failure of 27 and 53% was found on day 14 and 28, respectively. On day 14, significantly lower SP total treatment failures were observed in 2004 compared with results from a study conducted in 1999 in the same location. No relationship was detected between clinical outcome and DHFR/DHPS genotypes, but the point mutation prevalence in parasites was higher than in 1999. Pre-treatment blood levels of SP were detected in a quarter of the study children: less than expected. We report unacceptably high levels of total treatment failures, both for first- and second-line treatments for uncomplicated malaria in Tanzania 3 years after their introduction, supporting the decision to replace them with artemisinin-based combination therapy.
Authors:
J Eriksen; S Mwankusye; S Mduma; M I Veiga; A Kitua; G Tomson; M G Petzold; G Swedberg; L L Gustafsson; M Warsame
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2007-12-21
Journal Detail:
Title:  Transactions of the Royal Society of Tropical Medicine and Hygiene     Volume:  102     ISSN:  0035-9203     ISO Abbreviation:  Trans. R. Soc. Trop. Med. Hyg.     Publication Date:  2008 Feb 
Date Detail:
Created Date:  2008-01-14     Completed Date:  2008-05-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7506129     Medline TA:  Trans R Soc Trop Med Hyg     Country:  England    
Other Details:
Languages:  eng     Pagination:  137-42     Citation Subset:  IM    
Affiliation:
Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska Institutet at Karolinska University Hospital Huddinge, Stockholm, Sweden. jaran.eriksen@ki.se <jaran.eriksen@ki.se>
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MeSH Terms
Descriptor/Qualifier:
Amodiaquine / therapeutic use*
Animals
Antimalarials / therapeutic use*
Child, Preschool
Dihydropteroate Synthase / genetics
Drug Combinations
Drug Resistance
Female
Follow-Up Studies
Genotype
Humans
Infant
Malaria, Falciparum / drug therapy*,  parasitology
Male
Plasmodium falciparum / drug effects*,  genetics
Point Mutation
Pyrimethamine / blood,  therapeutic use*
Rural Health
Sulfadoxine / blood,  therapeutic use*
Tanzania
Tetrahydrofolate Dehydrogenase / genetics
Treatment Failure
Chemical
Reg. No./Substance:
0/Antimalarials; 0/Drug Combinations; 2447-57-6/Sulfadoxine; 37338-39-9/sulfadoxine-pyrimethamine; 58-14-0/Pyrimethamine; 86-42-0/Amodiaquine; EC 1.5.1.3/Tetrahydrofolate Dehydrogenase; EC 2.5.1.15/Dihydropteroate Synthase

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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