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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
immunology and microbiology
Plasmodium falciparum dhfr but not dhps mutations associated with sulphadoxine-pyrimethamine treatment failure and gametocyte carriage in northern Ghana
Tropical Medicine and International Health, Volume 10, No. 9, Year 2005
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Description
Both use of sulphadoxine-pyrimethamine (SP) and SP-resistance of Plasmodium falciparum are increasing in sub-Saharan Africa. Mutations in the P. falciparum dihydrofolate reductase (dhfr) and dihydropteroate synthase (dhps) genes can predict treatment failure of SP, however, the degree of this relationship varies regionally. In northern Ghana, pre-treatment dhfr/dhps genotypes were examined in 126 children and associations with PCR-corrected SP treatment outcome and gametocyte carriage were analysed. SP treatment failure within 4 weeks of follow-up occurred in 28%. Among all pre-treatment isolates, the dhfr triple mutation (Ile-51 + Arg-59 + Asn-108) was detected in 47%. Compared with dhfr wildtype parasites, the presence of the dhfr triple mutation increased the risk of treatment failure tenfold. Likewise, parasite clearance was delayed in the presence of dhfr variants. Dhfr mutants and dhps Gly-437 were selected in treatment failure isolates. Gametocytaemia 1 week following treatment was strongly associated with dhfr mutations. Remarkably, this was also true for the prevalence of gametocytes at recruitment. Dhps alleles did neither influence treatment outcome nor gametocyte carriage. In northern Ghana, the prevalence of the dhfr triple mutation can be used as a tool to screen for and to monitor SP resistance. The lack of association between dhps alleles and SP treatment outcome suggests a minor role of these molecular markers in this region at present. © 2005 Blackwell Publishing Ltd.
Authors & Co-Authors
Mockenhaupt, Frank Peter
Germany, Berlin
Charité – Universitätsmedizin Berlin
Germany, Berlin
Institute of Tropical Medicine
Bousema, J. Teun
Netherlands, Nijmegen
Radboud University Medical Center
Eggelte, Teunis A.
Netherlands, Amsterdam
Amsterdam Umc - University of Amsterdam
Schreiber, Jonas
Germany, Berlin
Charité – Universitätsmedizin Berlin
Germany, Berlin
Institute of Tropical Medicine
Ehrhardt, Stephan
Germany, Berlin
Charité – Universitätsmedizin Berlin
Germany, Hamburg
Bernhard Nocht Institut Fur Tropenmedizin Hamburg
Wassilew, Nasstasja
Germany, Berlin
Charité – Universitätsmedizin Berlin
Germany, Berlin
Institute of Tropical Medicine
Otchwemah, Rowland N.
Ghana, Tamale
University for Development Studies Ghana
Sauerwein, Robert W.
Netherlands, Nijmegen
Radboud University Medical Center
Bienzle, Ulrich
Germany, Berlin
Charité – Universitätsmedizin Berlin
Germany, Berlin
Institute of Tropical Medicine
Dzisi, Stephen Y.
United States, New York
Unicef
Statistics
Citations: 76
Authors: 10
Affiliations: 7
Identifiers
Doi:
10.1111/j.1365-3156.2005.01471.x
ISSN:
13602276
Research Areas
Cancer
Maternal And Child Health
Study Design
Cross Sectional Study
Cohort Study
Study Locations
Ghana