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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Trends in drug resistance codons in Plasmodium falciparum dihydrofolate reductase and dihydropteroate synthase genes in Kenyan parasites from 2008 to 2012
Malaria Journal, Volume 13, No. 1, Article 250, Year 2014
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Description
Background: Sulphadoxine-pyrimethamine (SP), an antifolate, was replaced by artemether-lumefantrine as the first-line malaria drug treatment in Kenya in 2004 due to the wide spread of resistance. However, SP still remains the recommended drug for intermittent preventive treatment in pregnant women and infants (IPTP/I) owing to its safety profile. This study assessed the prevalence of mutations in dihydrofolate reductase (Pfdhfr) and dihydropteroate synthase (Pfdhps) genes associated with SP resistance in samples collected in Kenya between 2008 and 2012. Methods. Field isolates collected from Kisumu, Kisii, Kericho and Malindi district hospitals were assessed for genetic polymorphism at various loci within Pfdhfr and Pfdhps genes by sequencing. Results: Among the Pfdhfr mutations, codons N51I, C59R, S108N showed highest prevalence in all the field sites at 95.5%, 84.1% and 98.6% respectively. Pfdhfr S108N prevalence was highest in Kisii at 100%. A temporal trend analysis showed steady prevalence of mutations over time except for codon Pfdhps 581 which showed an increase in mixed genotypes. Triple Pfdhfr N51I/C59R/S108N and double Pfdhps A437G/ K540E had high prevalence rates of 86.6% and 87.9% respectively. The Pfdhfr/Pfdhps quintuple, N51I/C59R/S108N/A437G/K540E mutant which has been shown to be the most clinically relevant marker for SP resistance was observed in 75.7% of the samples. Conclusion: SP resistance is still persistently high in western Kenya, which is likely due to fixation of key mutations in the Pfdhfr and Pfdhps genes as well as drug pressure from other antifolate drugs being used for the treatment of malaria and other infections. In addition, there is emergence and increasing prevalence of new mutations in Kenyan parasite population. Since SP is used for IPTP/I, molecular surveillance and in vitro susceptibility assays must be sustained to provide information on the emergence and spread of SP resistance. © 2014 Juma et al.; licensee BioMed Central Ltd.
Available Materials
https://efashare.b-cdn.net/share/pmc/articles/PMC4094641/bin/1475-2875-13-250-S1.pdf
https://efashare.b-cdn.net/share/pmc/articles/PMC4094641/bin/1475-2875-13-250-S2.pdf
https://efashare.b-cdn.net/share/pmc/articles/PMC4094641/bin/1475-2875-13-250-S3.pdf
https://efashare.b-cdn.net/share/pmc/articles/PMC4094641/bin/1475-2875-13-250-S4.pdf
Authors & Co-Authors
Juma, Dennis W.
Kenya, Nairobi
Kenya Medical Research Institute
Omondi, Angela A.
Kenya, Nairobi
Kenya Medical Research Institute
Ingasia, Luicer Anne Olubayo
Kenya, Nairobi
Kenya Medical Research Institute
Opot, Benjamin H.
Kenya, Nairobi
Kenya Medical Research Institute
Cheruiyot, Agnes C.
Kenya, Nairobi
Kenya Medical Research Institute
Yeda, Redemptah A.
Kenya, Nairobi
Kenya Medical Research Institute
Okudo, Charles Okello
Kenya, Nairobi
Kenya Medical Research Institute
Cheruiyot, Jelagat
Kenya, Nairobi
Kenya Medical Research Institute
Muiruri, Peninah
Kenya, Nairobi
Kenya Medical Research Institute
Ngalah, Bidii S.
Kenya, Nairobi
Kenya Medical Research Institute
Chebon, Lorna J.
Kenya, Nairobi
Kenya Medical Research Institute
Eyase, Fredrick Lunyagi
Kenya, Nairobi
Kenya Medical Research Institute
Johnson, Jacob D.
Kenya, Nairobi
Kenya Medical Research Institute
Bulimo, Wallace Dimbuson
Kenya, Nairobi
Kenya Medical Research Institute
Akala, Hoseah M.
Kenya, Nairobi
Kenya Medical Research Institute
Andagalu, Ben M.
Kenya, Nairobi
Kenya Medical Research Institute
Kamau, Edwin
Kenya, Nairobi
Kenya Medical Research Institute
Statistics
Citations: 17
Authors: 17
Affiliations: 1
Identifiers
Doi:
10.1186/1475-2875-13-250
e-ISSN:
14752875
Research Areas
Genetics And Genomics
Infectious Diseases
Study Design
Cross Sectional Study
Study Locations
Kenya
Participants Gender
Female