2009
DOI: 10.1371/journal.pmed.1000055
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Multiple Origins and Regional Dispersal of Resistant dhps in African Plasmodium falciparum Malaria

Abstract: Cally Roper and colleagues analyze the distribution of sulfadoxine resistance mutations and flanking microsatellite loci to trace the emergence and dispersal of drug-resistant Plasmodium falciparum malaria in Africa.

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Cited by 178 publications
(229 citation statements)
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References 66 publications
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“…In Africa, the pattern of communities identified mirrors, to an extent, the distribution of antimalarial drug resistance lineages (29). This provides further evidence of the probable central role of migration in the regional dispersal of resistant malaria, and the need for further studies on human movement patterns around the world to design strategies for the control of any artemisininresistant strains that may arise.…”
Section: Discussionmentioning
confidence: 70%
“…In Africa, the pattern of communities identified mirrors, to an extent, the distribution of antimalarial drug resistance lineages (29). This provides further evidence of the probable central role of migration in the regional dispersal of resistant malaria, and the need for further studies on human movement patterns around the world to design strategies for the control of any artemisininresistant strains that may arise.…”
Section: Discussionmentioning
confidence: 70%
“…However, for clinical resistance to occur, additional mutations, commonly referred to as quintuple dihydrofolate reductase ( dhfr )-dihydropteroate synthase ( dhps ) mutations, are required. 7 In this study, we assessed the mutations of dhfr , dhps , and P. falciparum ATPase 6 ( pfatp6 ) genes associated with drug resistance in P. falciparum isolates obtained from children treated with artesunate-sulfadoxine-pyrimethamine (AS-SP) combination and followed-up for 28 days. We also assessed the usefulness of molecular markers as a complementary tool for the evaluation of therapeutic efficacy of ACT.…”
Section: Introductionmentioning
confidence: 99%
“…12 The DHFR amino acid residue 16 and DHPS amino acid residues 581 and 613 were not analyzed in this study because mutations at these positions are rare in African isolates and the Ala16Val substitution in DHFR occurs with the rare Ser108Thr substitution. 7 For pfatp6 mutation analysis, a gene fragment of 1,793 basepairs corresponding to exon 1 of the coding region was amplified by the nested polymerase chain reaction (PCR) protocol described in our previous study. 13 Amplification products were sequenced from the 5′-and 3′-ends by using an automated DNA sequencer (ABI Prism; Perkin Elmer Corp., Les Ulis, France) to determine the codons that were reported to be associated with artemisinin resistance (amino acid residues 263, 431, 623, and 769) and possible novel mutations in the pfatp6 gene.…”
mentioning
confidence: 99%
“…The national groupings adopted by African surveillance networks have subsequently been vindicated by studies into malaria migration 74 and drug-resistance dispersal patterns (figure 3). 65 Results of both of these studies show the regional character of malaria populations and reflect the strong economic, political, and cultural linkages between countries. These networks offer a framework for surveillance and future management of artemisinin resistance in Africa that is both pragmatic and underpinned by good scientific evidence.…”
Section: National and Regional Routine Sentinel Surveillance Networkmentioning
confidence: 98%
“…Endemic countries should embrace an empirical analysis of these risk factors, starting with historical data for the temporal and spatial emergence of resistance to chloroquine and sulfadoxine-pyrimethamine, to examine the mapped rates of spread of drug resistance alleles in populations exposed to diverse treatments and malaria transmission intensities. [64][65][66] Assembling these data will be difficult, but not impossible. Africa is witnessing a renaissance of malaria transmission-intensity mapping, and data for drug-use patterns are expanding.…”
Section: Risk Factor Analysis To Identify High-risk Areasmentioning
confidence: 99%