Low-Dose Treatment with Sulfadoxine-Pyrimethamine Combinations Selects for Drug-Resistant Plasmodium falciparum Strains
AUTOR(ES)
Kun, Jürgen F. J.
FONTE
American Society for Microbiology
RESUMO
A total of 252 children were enrolled in a drug trial to assess the effect of minimal doses of sulfadoxine (Sdx) and pyrimethamine (Pyr). Parasite samples isolated from these patients were analyzed before and after treatment to investigate the level of drug-resistant strains. The parasite genes encoding dihydrofolate reductase (DHFR) and dihydropteroate synthase (DHPS) were assayed for point mutations that are associated with resistance against drugs. Before treatment, Pyrr genotypes of the DHFR gene were found in 42% of all samples, 8% of the patients harbored a mixed parasite population and 50% had a sensitive DHFR genotype. In terms of the DHPS gene, we found mutations in 45% of the parasites. Twenty-four percent had a Ser436 mutation, and 26% had a Gly437 mutation. Recrudescent parasites were highly enriched for both Pyrr and Sdxr strains after treatment (P < 0.001 and P = 0.029, respectively).
ACESSO AO ARTIGO
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=89447Documentos Relacionados
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