Selection of antimalarial drug resistance after intermittent preventive treatment of infants and children (IPTi/c) in Senegal

Am J Trop Med Hyg. 2013 Jun;88(6):1124-1129. doi: 10.4269/ajtmh.12-0739. Epub 2013 Apr 15.

Abstract

Our study investigated the possible impact of SP-IPT given to infants and children on the prevalence of SP-resistant haplotypes in the Plasmodium falciparum genes Pfdhfr and Pfdhps, comparing sites with and without IPTi/c. P. falciparum positive samples (N = 352) collected from children < 5 years were analyzed to determine the prevalence of SP resistance-related haplotypes by nested PCR followed by sequence-specific oligonucleotide probe-enzyme-linked immunosorbent assay. The prevalence of the Pfdhfr triple mutant haplotype (CIRN) increased in both groups, but only significantly in the IPTi/c group from 41% to 65% in 2011 (P = 0.005). Conversely, the Pfdhps 437G mutation decreased in both groups from 44.6% to 28.6% (P = 0.07) and from 66.7% to 47.5% (P = 0.02) between 2010 and 2011 in the control and the IPTi/c groups, respectively. A weak trend for decreasing prevalence of quadruple mutants (triple Pfdhfr + Pfdhps 437G) was noted in both groups (P = 0.15 and P = 0.34). During the two cross-sectional surveys some significant changes were observed in the SP resistance-related genes.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antimalarials / therapeutic use
  • Artemisinins / therapeutic use
  • Artesunate
  • Child, Preschool
  • Cross-Sectional Studies
  • DNA, Protozoan / isolation & purification*
  • Drug Resistance*
  • Follow-Up Studies
  • Haplotypes
  • Humans
  • Infant
  • Malaria, Falciparum / drug therapy*
  • Malaria, Falciparum / epidemiology*
  • Malaria, Falciparum / prevention & control*
  • Mutation
  • Pilot Projects
  • Plasmodium falciparum / drug effects
  • Plasmodium falciparum / genetics*
  • Polymerase Chain Reaction
  • Polymorphism, Single Nucleotide
  • Protozoan Proteins / genetics
  • Protozoan Proteins / metabolism
  • Pyrimethamine / therapeutic use
  • Senegal / epidemiology
  • Sequence Analysis, DNA
  • Sulfadoxine / therapeutic use

Substances

  • Antimalarials
  • Artemisinins
  • DNA, Protozoan
  • Protozoan Proteins
  • Artesunate
  • Sulfadoxine
  • Pyrimethamine