Antimalarial resistance and DHFR/DHPS genotypes of Plasmodium falciparum three years after introduction of sulfadoxine-pyrimethamine and amodiaquine in rural Tanzania.

Mwankusye, S (author)

Mduma, S (author)

Kitua, A (author)

Swedberg, Göte (author): Uppsala universitet,Institutionen för medicinsk biokemi och mikrobiologi

Gustafsson, L L (author)

Warsame, M (author)

(creator_code:org_t)

Oxford University Press (OUP), 2008
2008
English.
In: Transactions of the Royal Society of Tropical Medicine and Hygiene. - : Oxford University Press (OUP). - 0035-9203 .- 1878-3503. ; 102:2, s. 137-142

Related links:: https://urn.kb.se/re...; show more...; https://doi.org/10.1...; http://kipublication...; show less...

Abstract Subject headings

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.

By the author/editor: Eriksen, J; Mwankusye, S; Mduma, S; Veiga, M I; Kitua, A; Tomson, G; show more...; Petzold, M G; Swedberg, Göte; Gustafsson, L L; Warsame, M; show less...

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