PMID- 18419347
OWN - NLM
STAT- MEDLINE
DCOM- 20080721
LR  - 20151119
IS  - 0022-1899 (Print)
IS  - 0022-1899 (Linking)
VI  - 197
IP  - 12
DP  - 2008 Jun 15
TI  - Molecular markers of resistance to sulfadoxine-pyrimethamine during intermittent 
      preventive treatment for malaria in Mozambican infants.
PG  - 1737-42
LID - 10.1086/588144 [doi]
AB  - BACKGROUND: Intermittent preventive treatment in infants (IPTi) with 
      sulfadoxine-pyrimethamine (SP) is a potential malaria control strategy. There is 
      concern about the impact that increasing in vivo resistance to SP has on the 
      efficacy of IPTi, as well as about the potential contribution of IPTi to 
      increases in resistance. METHODS: We compared the frequency of clinical episodes 
      of malaria caused by P. falciparum parasites with mutations in dhfr and dhps 
      among sick children who received SP or placebo in the context of a randomized, 
      double-blind, placebo-controlled IPTi trial in Mozambique. RESULTS: Half of the 
      children who received placebo harbored quintuple-pure mutant parasites. 
      Nevertheless, the protective efficacy of IPTi within the 35 days after the third 
      dose was 70.8% (95% confidence interval [CI], 40.7%-85.6%). Between month 2 after 
      the third IPTi dose and the end of the follow-up period, children receiving SP 
      harbored more dhps codon 437 mixed infections (odds ratio [OR], 10.56 [95% CI, 
      1.30-86.14]) and fewer dhps double-pure mutant parasites (OR, 0.43 [95% CI, 
      0.22-0.84]) than did placebo recipients. CONCLUSIONS: IPTi appears to be 
      associated with some changes in the prevalence of genotypes involved in SP 
      resistance. In the face of a high prevalence of quintuple-mutant parasites, SP 
      exhibited a high level of efficacy in the prevention of new episodes of malaria 
      in infants.
FAU - Mayor, Alfredo
AU  - Mayor A
AD  - Centre de Recerca en Salut Internacional de Barcelona, Hospital Clinic/Institut 
      d'Investigacions Biomedicas August Pi i Sunyer, Universitat de Barcelona, 
      Barcelona, Spain. agmayor@clinic.ub.es
FAU - Serra-Casas, Elisa
AU  - Serra-Casas E
FAU - Sanz, Sergi
AU  - Sanz S
FAU - Aponte, John J
AU  - Aponte JJ
FAU - Macete, Eusebio
AU  - Macete E
FAU - Mandomando, Inacio
AU  - Mandomando I
FAU - Puyol, Laura
AU  - Puyol L
FAU - Berzosa, Pedro
AU  - Berzosa P
FAU - Dobano, Carlota
AU  - Dobano C
FAU - Aide, Pedro
AU  - Aide P
FAU - Sacarlal, Jahit
AU  - Sacarlal J
FAU - Benito, Agustin
AU  - Benito A
FAU - Alonso, Pedro
AU  - Alonso P
FAU - Menendez, Clara
AU  - Menendez C
LA  - eng
SI  - ClinicalTrials.gov/NCT00209794
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - J Infect Dis
JT  - The Journal of infectious diseases
JID - 0413675
RN  - 0 (Antimalarials)
RN  - 0 (Biomarkers)
RN  - 0 (Drug Combinations)
RN  - 37338-39-9 (fanasil, pyrimethamine drug combination)
RN  - 88463U4SM5 (Sulfadoxine)
RN  - Z3614QOX8W (Pyrimethamine)
SB  - IM
MH  - Animals
MH  - Antimalarials/*administration & dosage/*pharmacology
MH  - Biomarkers
MH  - Double-Blind Method
MH  - Drug Administration Schedule
MH  - Drug Combinations
MH  - Drug Resistance/genetics
MH  - Female
MH  - Humans
MH  - Infant
MH  - Malaria, Falciparum/*prevention & control
MH  - Male
MH  - Mozambique
MH  - Mutation
MH  - Plasmodium falciparum/*drug effects/genetics
MH  - Pyrimethamine/*administration & dosage/*pharmacology
MH  - Sulfadoxine/*administration & dosage/*pharmacology
EDAT- 2008/04/19 09:00
MHDA- 2008/07/22 09:00
CRDT- 2008/04/19 09:00
PHST- 2008/04/19 09:00 [pubmed]
PHST- 2008/07/22 09:00 [medline]
PHST- 2008/04/19 09:00 [entrez]
AID - 10.1086/588144 [doi]
PST - ppublish
SO  - J Infect Dis. 2008 Jun 15;197(12):1737-42. doi: 10.1086/588144.