PMID- 20064223
OWN - NLM
STAT- MEDLINE
DCOM- 20100312
LR  - 20211020
IS  - 1475-2875 (Electronic)
IS  - 1475-2875 (Linking)
VI  - 9
DP  - 2010 Jan 10
TI  - Molecular markers of resistance to sulphadoxine-pyrimethamine one year after 
      implementation of intermittent preventive treatment of malaria in infants in 
      Mali.
PG  - 9
LID - 10.1186/1475-2875-9-9 [doi]
AB  - BACKGROUND: Intermittent preventive treatment in infants (IPTi) with 
      sulphadoxine-pyrimethamine (SP) given during routine vaccinations is efficacious 
      in preventing malaria disease and shows no interaction with the vaccines. 
      However, there is a fear that IPTi may result in a rapid increase of parasite 
      resistance to SP. METHODS: To evaluate the impact of IPTi on SP-resistance point 
      mutations, the 22 health sub-districts in the district of Kolokani, Mali, were 
      randomized in a 1:1 ratio and starting in December 2006, IPTi with SP was 
      implemented in 11 health sub-districts (intervention zone), while the other 11 
      health sub-districts served as the control (non-intervention zone). Blood smears 
      and blood dots on filter paper were obtained from children aged 0-5 years, 
      randomly selected in each of heath sub-districts during two cross-sectional 
      surveys. The first survey was conducted in May 2007 before the start of the 
      transmission season to collect baseline prevalence of the molecular markers of 
      resistance to SP and the second in December 2007 after the end of the 
      transmission season and one year after implementation of IPTi. A total of 427 and 
      923 randomly selected blood samples from the first and second surveys 
      respectively were analysed by PCR for dhfr and dhps mutations. RESULTS: Each of 
      the three dhfr mutations at codons 51, 59 and 108 was present in 35% and 57% of 
      the samples during the two surveys with no significant differences between the 
      two zones. Dhps mutations at codons 437 and 540 were present respectively in 
      about 20% and 1% of the children during the two surveys in both zones at similar 
      proportion. The prevalence of quadruple mutants (triple dhfr-mutants + dhps-437G) 
      associated with in-vivo resistance to SP in Mali after one year implementation of 
      IPTi was also similar between the two zones (11.6% versus 11.2%, p = 0.90) and to 
      those obtained at baseline survey (10.3% versus 8.1%). CONCLUSION: This study 
      shows no increase in the frequency of molecular markers of SP resistance in areas 
      where IPTi with SP was implemented for one year.
FAU - Dicko, Alassane
AU  - Dicko A
AD  - Malaria Research and Training Center, Department of Epidemiology of Parasitic 
      Diseases, Faculty of Medicine Pharmacy and Dentistry, University of Bamako, PO 
      Box 1805 Bamako, Mali. adicko@mrtcbko.org
FAU - Sagara, Issaka
AU  - Sagara I
FAU - Djimde, Abdoulaye A
AU  - Djimde AA
FAU - Toure, Sidy O
AU  - Toure SO
FAU - Traore, Mariam
AU  - Traore M
FAU - Dama, Souleymane
AU  - Dama S
FAU - Diallo, Abdoulbaki I
AU  - Diallo AI
FAU - Barry, Amadou
AU  - Barry A
FAU - Dicko, Mohamed
AU  - Dicko M
FAU - Coulibaly, Oumar M
AU  - Coulibaly OM
FAU - Rogier, Christophe
AU  - Rogier C
FAU - de Sousa, Alexandra
AU  - de Sousa A
FAU - Doumbo, Ogobara K
AU  - Doumbo OK
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20100110
PL  - England
TA  - Malar J
JT  - Malaria journal
JID - 101139802
RN  - 0 (Antimalarials)
RN  - 0 (DNA, Protozoan)
RN  - 0 (Drug Combinations)
RN  - 0 (Protozoan Proteins)
RN  - 37338-39-9 (fanasil, pyrimethamine drug combination)
RN  - 88463U4SM5 (Sulfadoxine)
RN  - Z3614QOX8W (Pyrimethamine)
SB  - IM
MH  - Antimalarials/*pharmacology/*therapeutic use
MH  - Child, Preschool
MH  - Cross-Sectional Studies
MH  - DNA Mutational Analysis
MH  - DNA, Protozoan/genetics
MH  - Drug Combinations
MH  - Humans
MH  - Infant
MH  - Infant, Newborn
MH  - Malaria/*drug therapy
MH  - Male
MH  - Mali
MH  - Plasmodium/*drug effects/*genetics
MH  - Point Mutation
MH  - Polymerase Chain Reaction/methods
MH  - Protozoan Proteins/genetics
MH  - Pyrimethamine/*pharmacology/*therapeutic use
MH  - Sulfadoxine/*pharmacology/*therapeutic use
MH  - Treatment Failure
PMC - PMC2820043
EDAT- 2010/01/13 06:00
MHDA- 2010/03/13 06:00
PMCR- 2010/01/10
CRDT- 2010/01/13 06:00
PHST- 2009/09/14 00:00 [received]
PHST- 2010/01/10 00:00 [accepted]
PHST- 2010/01/13 06:00 [entrez]
PHST- 2010/01/13 06:00 [pubmed]
PHST- 2010/03/13 06:00 [medline]
PHST- 2010/01/10 00:00 [pmc-release]
AID - 1475-2875-9-9 [pii]
AID - 10.1186/1475-2875-9-9 [doi]
PST - epublish
SO  - Malar J. 2010 Jan 10;9:9. doi: 10.1186/1475-2875-9-9.