Pyrimethamine-sulfadoxine efficacy and selection for mutations in Plasmodium falciparum dihydrofolate reductase and dihydropteroate synthase in Mali.

Published

Journal Article

To assess pyrimethamine-sulfadoxine (PS) efficacy in Mali, and the role of mutations in Plasmodium falciparum dihydrofolate reductase (DHFR) and dihydropteroate synthase (DHPS) in in vivo PS resistance, 190 patients with uncomplicated P. falciparum malaria were treated with PS and monitored for 56 days. Mutation-specific polymerase chain reactions and digestion with restriction endonucleases were used to detect DHFR and DHPS mutations on filter paper blood samples from pretreatment and post-treatment infections. Only one case each of RI and RII level resistance and no cases of RIII resistance or therapeutic failure were observed. Post-PS treatment infections had significantly higher rates of DHFR mutations at codons 108 and 59. No significant selection for DHPS mutations was seen. Pyrimethamine-sulfadoxine is highly efficacious in Mali, and while the low level of resistance precludes assessing the utility of molecular assays for in vivo PS resistance, rapid selection of DHFR mutations supports their role in PS failure.

Full Text

Duke Authors

Cited Authors

  • Diourté, Y; Djimdé, A; Doumbo, OK; Sagara, I; Coulibaly, Y; Dicko, A; Diallo, M; Diakité, M; Cortese, JF; Plowe, CV

Published Date

  • March 1999

Published In

Volume / Issue

  • 60 / 3

Start / End Page

  • 475 - 478

PubMed ID

  • 10466980

Pubmed Central ID

  • 10466980

International Standard Serial Number (ISSN)

  • 0002-9637

Digital Object Identifier (DOI)

  • 10.4269/ajtmh.1999.60.475

Language

  • eng

Conference Location

  • United States