Document Detail


High prevalence of markers for sulfadoxine and pyrimethamine resistance in Plasmodium falciparum in the absence of drug pressure in the Ashanti region of Ghana.
MedLine Citation:
PMID:  15728909     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Markers of Plasmodium falciparum resistance to chloroquine (CQ) and pyrimethamine-sulfadoxine (PYR-SDX) are widespread in areas where malaria is endemic. In an area where the use PYR-SDX is negligible, the Ashanti Region of Ghana, West Africa, adult individuals were enrolled in an analysis of CQ- and PYR-SDX-associated molecular resistance markers in 2001 (n = 177) and 2003 (n = 180). Parasite prevalence, as assessed by PCR assays, were 56.5 and 48.8% in 2001 and 2003, respectively. A high frequency of CQ, PYR, and SDX resistance markers was observed, whereby, as a weak trend, the frequency was higher in 2003. The quintuple combination of three pfdhfr mutations and two pfdhps mutations has previously been recognized to be the most important determinant of PYR-SDX resistance. Approximately 60% of parasite carriers harbored fourfold mutated parasites, indicative of a considerable risk for a switch to high-level PYR-SDX resistance in an area where the rate of PYR-SDX use is low. Among the factors contributing to the high frequency of PYR-SDX resistance-associated mutations are background use of PYR-SDX, past use of PYR for malaria prophylaxis, cross-resistance of trimethoprim with PYR, and the sufficient biological fitness of resistant parasites in the absence of drug pressure.
Authors:
Florian Marks; Jennifer Evans; Christian G Meyer; Edmund N Browne; Christa Flessner; Vera von Kalckreuth; Teunis A Eggelte; Rolf D Horstmann; Jürgen May
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Antimicrobial agents and chemotherapy     Volume:  49     ISSN:  0066-4804     ISO Abbreviation:  Antimicrob. Agents Chemother.     Publication Date:  2005 Mar 
Date Detail:
Created Date:  2005-02-24     Completed Date:  2005-05-09     Revised Date:  2013-04-18    
Medline Journal Info:
Nlm Unique ID:  0315061     Medline TA:  Antimicrob Agents Chemother     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1101-5     Citation Subset:  IM    
Affiliation:
Department of Molecular Medicine, Bernhard-Nocht Institute for Tropical Medicine, Bernhard Nocht Str. 74, 20359 Hamburg, Germany.
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MeSH Terms
Descriptor/Qualifier:
Adult
Animals
Antimalarials / pharmacology*
Biological Markers
Chloroquine / pharmacology
Drug Combinations
Drug Resistance
Humans
Plasmodium falciparum / drug effects*
Pyrimethamine / pharmacology*
Sulfadoxine / pharmacology*
Chemical
Reg. No./Substance:
0/Antimalarials; 0/Biological Markers; 0/Drug Combinations; 2447-57-6/Sulfadoxine; 37338-39-9/fanasil, pyrimethamine drug combination; 54-05-7/Chloroquine; 58-14-0/Pyrimethamine
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