Pregnant women are highly vulnerable to malaria infection in its endemic areas, particularly infection by Plasmodium falciparum that can cause premature, low birth weight, severe anemia in pregnant women, and death. Sulfadoxine-pyrimethamine (SP) for Intermittent Preventive Treatment for pregnant (IPTp) is used for malaria control in pregnancy recommended by the World Health Organization that has already been implemented in Africa. The P. falciparum resistance to SP has been reported in several malarial endemic areas, and mutations in the genes of Plasmodium falciparum Dihydrofolate Reductase (Pfdhfr) and Dihydropteroate Synthase (Pfdhps) are shown to be associated with parasite resistance to SP treatment. Genetic analysis of Pfdhfr and Pfdhps genes in pregnant women infected with P. falciparum has not yet been examined in Indonesia. The cross-sectional study was conducted at two subdistricts, Sungai Pinang and Peramasan, in Banjar district of South Kalimantan Province, where 127 pregnant women were recruited from 2008 to April 2010. Two important mutations in Pfdhfr gene (amino acid positions at N51 and S108) and three in Pfdhps gene (A437, K540 and A581) were analyzed by nested PCR-RFLP method. All of the seven pregnant women samples infected with P. falciparum presented PfDHFR 108N and PfDHPS 437G mutations. One of the samples had the additional mutation at PfDHPS 540, in which Lys is substituted by Glu. These results suggested that P. falciparum might present only some resistance to SP at Sungai Pinang and Peramasan subdistricts, Banjar District, South Kalimantan province, Indonesia. Although there were limited number of samples, this study showed only few mutations of Pfdhfr and Pfdhps genes in P. falciparum at Banjar district, South Kalimantan Province, that suggests SP might be effective for IPTp in this area. Thus, further analysis of the other mutation sites in Pfdhfr and Pfdhps genes and in vivo efficacy study of SP with more sufficient sample numbers will be necessary to confirm this preliminarily result .
It is known that soil-transmitted helminths (STHs) infection in children associates with growth and developed restriction in children, which is shown by nutritional status. However, the studies which are investigating this phenomenon is still limited in Indonesia. This recent study aimed to compare students who infected and non-infected with STH towards their nutritional status. An analytic cross-sectional research design was conducted in two elementary school students at Mayamuk sub-district, Sorong district, in January 2020. STHs infection was identifi ed by lugol stained wet mount smear from their stool under a light microscope. Children nutritional status was determined by body mass index based on age. A total of 164 children (67.5%, 164/243) were voluntary to participate by informed consent and eligible. Twenty-seven children (16.5%, 27/164) were infected with one or more STH species of Ascaris lumbricoides, Trichuris trichiura, hookworm, and Strongyloides stercoralis. T. trichiura (81.5%, 22/27) was the most common species found, either in single or mixed infection. Children nutritional status was observed as thinness, normal, overweight, and obese, that was 6.1% (10/164), 75% (123/164), 6.7% (11/164), and 12.2 % (20/164) respectively. STHs infection occurred in children with nutritional status of thinness 3.7% (1/27), normal 74.1% (20/27), overweight 3.7% (1/27), and obese 18.5% (5/27). There was no signifi cant diff erence between STHs infected children and non-infected children on their nutritional status (p=0.616, ChiSquare test). Thus, it indicated that STHs infection was not only the factor to induce the impairment of nutritional status in children at Mayamuk sub-district. It needs further investigation to clarify the factors which are leading to the thinness, overweight, and obese in Mayamuk children.
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