Surveillance of molecular markers of plasmodium falciparum resistance to sulphadoxine-pyrimethamine 5 years after the change of malaria treatment policy in Ghana.
Date
2012-12
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Abstract
In 2005, sulphadoxine-pyrimethamine (SP) became the drug of choice for intermittent preventive treatment of Plasmodium falciparum malaria in pregnancy (IPTp) in Ghana. Reports suggest the use of SP by others to treat uncomplicated malaria. Because of the increased use of SP, the prevalence of mutations in the genes, dihydrofolate reductase (dhfr), and dihydropteroate synthetase (dhps), linked to SP resistance in P. falciparum were determined. Blood samples from 945 children with uncomplicated malaria collected at nine sites from 2003 to 2010 were analyzed using polymerase chain reaction and restriction fragment length polymorphism. Prevalence of the dhfr triple and dhfr plus dhps quadruple mutations showed significant increase in trend from 2003 to 2010 (χ2 = 18.78, P < 0.001, χ2 = 15.11, P < 0.001, respectively). For dhps double mutant G437 + E540 the prevalence was low (1.12%) caused by the very low prevalence of E540. Our findings show the wide use of SP in Ghana and therefore its use for IPTp needs to be closely monitored. Copyright © 2012 by The American Society of Tropical Medicine and Hygiene.
Description
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EMTREE drug terms: dihydrofolate reductase; dihydropteroate synthase; molecular marker; pyrimethamine plus sulfadoxine EMTREE medical terms: allele; antimalarial drug resistance; article; blood sampling; child; gene mutation; Ghana; health care policy; human; infant; major clinical study; malaria falciparum; nonhuman; Plasmodium falciparum; polymerase chain reaction; practice guideline; pregnancy; preschool child; prevalence; restriction fragment length polymorphism
Citation
Duah, N. O., Quashie, N. B., Abuaku, B. K., Sebeny, P. J., Kronmann, K. C., & Koram, K. A. (2012). Surveillance of molecular markers of plasmodium falciparum resistance to sulphadoxine-pyrimethamine 5 years after the change of malaria treatment policy in Ghana. American Journal of Tropical Medicine and Hygiene, 87(6), 996-1003.