High Prevalence of Markers for Sulfadoxine and Pyrimethamine Resistance in Plasmodium falciparum in the Absence of Drug Pressure in the Ashanti Region of Ghana

Abstract

Markers of Plasmodium falciparum resistance to chloroquine (CQ) and pyrimethamine-sulfadoxine (PYR-SDX

Field-based evidence for the linkage of pfcrt and pfdhfr drug-resistant malaria genotypes and clinical profiles of severe malaria in Niger

“…Whatever mild and severe the malaria cases may be, the prevalence of pfcrt mutation seems to be homogeneous in this meso-endemic zone of malaria. However, the overall prevalence of pfdhfr S108N mutations (60.2%) in severe cases treated at Niamey Hospital was higher than the 45% reported for uncomplicated cases from Burkina Faso [16] or Mali [17], but lower than the 87% reported for asymptomatic adults from the hyperendemic malaria zone of Ghana [18].…”

Parasitological Rebound Effect and Emergence of Pyrimethamine Resistance inPlasmodium falciparumafter Single‐Dose Sulfadoxine‐Pyrimethamine

“…The parasitological rebound effect observed in infants treated with single-dose S-P raises considerable concern, in particular on the background of the preexisting high levels of drug resistance-associated mutations [10]. One might assume that S-P in IPTi provides a disadvantage (development of drug-resistant strains), rather than a benefi (prevention of disease).…”

“…Heelprick blood samples were collected at each visit, to assess parasite density and the firs appearance of isolates exhibiting either 4 or !4 drug resistance-associated mutations, as described elsewhere [10]. Clinical indices, including relevant anamnestic details, were documented, and, when clinical malaria was diagnosed, patients were treated with amodiaquine or, in the case of treatment failure, additionally with artesunate.…”

Surveillance of Molecular Markers of Plasmodium falciparum Resistance to Sulphadoxine-Pyrimethamine 5 Years after the Change of Malaria Treatment Policy in Ghana

“…From one of our study sites close to the area mentioned previously, similar prevalence data were observed for I51 and N108, 55% and 75%, respectively, for the year 2005. Before the change in treatment policy, a study conducted in Ghana specifically in the Ashanti region (in the forest zone) by Marks and others, 37 showed 86.5%, 65.5%, and 77.8% for samples collected in 2001 and 88.1%, 66.7%, and 79.7% for 2003 samples respectively for N108, I51, and R59 mutations.…”