Mapping ‘partially resistant’, ‘fully resistant’, and ‘super resistant’ malaria

descriptionPublicationkeyboard_double_arrow_right Article 01 Oct 2013 English Publisher:Elsevier BVJournal:Trends in Parasitology, volume 29, pages 505-515 (issn: 1471-4922,

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Authors: Inbarani, Naidoo; Cally, Roper;

doi: 10.1016/j.pt.2013.08.002

pmid: 24028889

Mapping ‘partially resistant’, ‘fully resistant’, and ‘super resistant’ malaria

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Abstract

Sulfadoxine-pyrimethamine (SP) is used throughout Africa for intermittent preventive treatment (IPT) of malaria, but resistance threatens its efficacy. We found marked regional differences in the genotypes responsible for SP resistance when mapping recent surveys of dihydrofolate reductase (dhfr) and dihydropteroate synthase (dhps) mutations. In West Africa, a 'partially resistant' combination of dhfr N51I, N59R, and S108N with dhps A437G predominates, whereas in East Africa the 'fully resistant' combination of dhfr N51I, N59R, and S108N with dhps A437G+K540E is found. There are three East African foci where 'fully resistant' populations have additionally acquired dhps 581G and/or dhfr 164L to become 'super resistant'. SP-IPT in infants and pregnant women is reported to have failed in super resistant areas prompting review of SP-IPT use in affected areas.

Related Organizations

University of London
United Kingdom
Medical Research Council
United Kingdom
London School of Hygiene & Tropical Medicine
United Kingdom

Keywords

Plasmodium falciparum, Drug Resistance, Geographic Mapping, Antimalarials, Drug Combinations, Pyrimethamine, Africa, Sulfadoxine, Prevalence, Malaria, Falciparum

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