Mapping 'partially resistant', 'fully resistant', and 'super resistant' malaria.


Naidoo, I; Roper, C; (2013) Mapping 'partially resistant', 'fully resistant', and 'super resistant' malaria. Trends in parasitology, 29 (10). pp. 505-15. ISSN 1471-4922 DOI: 10.1016/j.pt.2013.08.002

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Abstract

: Sulfadoxine-pyrimethamine (SP) is used throughout Africa for intermittent preventive treatment (IPT) of malaria, but resistance threatens its efficacy. We found marked regional differences in the genotypes responsible for SP resistance when mapping recent surveys of dihydrofolate reductase (dhfr) and dihydropteroate synthase (dhps) mutations. In West Africa, a 'partially resistant' combination of dhfr N51I, N59R, and S108N with dhps A437G predominates, whereas in East Africa the 'fully resistant' combination of dhfr N51I, N59R, and S108N with dhps A437G+K540E is found. There are three East African foci where 'fully resistant' populations have additionally acquired dhps 581G and/or dhfr 164L to become 'super resistant'. SP-IPT in infants and pregnant women is reported to have failed in super resistant areas prompting review of SP-IPT use in affected areas.<br/>

Item Type: Article
Faculty and Department: Faculty of Infectious and Tropical Diseases > Dept of Pathogen Molecular Biology
Research Centre: Antimicrobial Resistance Centre (AMR)
Malaria Centre
PubMed ID: 24028889
Web of Science ID: 325589300006
URI: http://researchonline.lshtm.ac.uk/id/eprint/1217021

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