| Antimalarial resistance and DHFR/DHPS genotypes of Plasmodium falciparum three years after introduction of sulfadoxine-pyrimethamine and amodiaquine in rural Tanzania. | |
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MedLine Citation:
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PMID: 18082233 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't Date: 2007-12-21 |
Journal Detail:
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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:
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Created Date: 2008-01-14 Completed Date: 2008-05-15 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7506129 Medline TA: Trans R Soc Trop Med Hyg Country: England |
Other Details:
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Languages: eng Pagination: 137-42 Citation Subset: IM |
Affiliation:
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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> |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Amodiaquine
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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:
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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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