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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
immunology and microbiology
Differential effect of regional drug pressure on dihydrofolate reductase and dihydropteroate synthetase mutations in Southern Mozambique
American Journal of Tropical Medicine and Hygiene, Volume 78, No. 2, Year 2008
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Description
The prevalence and frequency of the dihydrofolate reductase (dhfr) and dihydropteroate synthetase (dhps) mutations associated with sulfadoxine- pyrimethamine (SP) resistance at 13 sentinel surveillance sites in southern Mozambique were examined regularly between 1999 and 2004. Frequency of the dhfr triple mutation increased from 0.26 in 1999 to 0.96 in 2003, remaining high in 2004. The dhps double mutation frequency peaked in 2001 (0.22) but declined to baseline levels (0.07) by 2004. Similarly, parasites with both dhfr triple and dhps double mutations had increased in 2001 (0.18) but decreased by 2004 (0.05). The peaking of SP resistance markers in 2001 coincided with a SP-resistant malaria epidemic in neighboring KwaZulu-Natal, South Africa. The decline in dhps (but not dhfr) mutations corresponded with replacement of SP with artemether-lumefantrine as malaria treatment policy in KwaZulu-Natal. Our results show that drug pressure can exert its influence at a regional level rather than merely at a national level. Copyright © 2008 by The American Society of Tropical Medicine and Hygiene.
Authors & Co-Authors
Raman, Jaishree
Unknown Affiliation
Sharp, Brian L.
Unknown Affiliation
Kleinschmidt, Immo
Unknown Affiliation
Roper, Cally
Unknown Affiliation
Streat, Elizabeth
Unknown Affiliation
Kelly, V. J.
Unknown Affiliation
Barnes, Karen Irma
Unknown Affiliation
Statistics
Citations: 32
Authors: 7
Affiliations: 5
Identifiers
Doi:
10.4269/ajtmh.2008.78.256
ISSN:
00029637
Research Areas
Cancer
Health System And Policy
Infectious Diseases
Study Design
Cross Sectional Study
Study Locations
Mozambique
South Africa