Plasmodium falciparum: susceptibility in vitro and in vivo to chloroquine and sulfadoxine-pyrimethamine in Ghanaian schoolchildren

Landgraf, Barbara; Kollaritsch, Herwig; Wiedermann, G; Wernsdorfer, Walther H.

doi:10.1016/0035-9203(94)90424-3

Cited by 32 publications

(15 citation statements)

References 4 publications

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“…24 In the present study, the prevalence of three mutations in the P. falciparum DHFR gene (Asn-108 ϩ Ile-51 ϩ Arg-59) was 36%, and 81% of the isolates exhibited the gene core mutation Asn-108. The association between the DHFR gene alleles with the response to antifolates is less straightforward in vivo than in vitro possibly due to interfering factors such as pharmacokinetics and semi-immunity.…”

Section: Discussionmentioning

confidence: 93%

Plasmodium falciparum dihydrofolate reductase alleles and pyrimethamine use in pregnant Ghanaian women.

Mockenhaupt¹,

Eggelte²,

Böhme³

et al. 2001

The American Journal of Tropical Medicine and Hygiene

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Abstract. Drug resistance in Plasmodium falciparum affects prevention of malaria in pregnancy. In a crosssectional study of 530 pregnant Ghanaian women, P. falciparum dihydrofolate reductase (DHFR) gene mutations linked with pyrimethamine resistance were assessed and associations with pyrimethamine intake were analyzed. P. falciparum infected 69% of women without pyrimethamine use, 59% of those who had a history of pyrimethamine consumption but a negative urine test, and 53% of individuals with a positive urine test. Eighty-one percent, 43%, and 74% of the isolates contained the mutations Asn-108, Ile-51, and Arg-59, respectively. Thr-108 occurred in 8%. Pyrimethamine use was associated with increased frequencies of Asn-108 and Arg-59 but not of Ile-51 or Thr-108. In women with prophylaxis, wild-type parasites were absent and anemia tended to be more common with an increasing number of DHFR gene mutations. Pyrimethamine appears to be not adequately effective in this part of Ghana, most likely due to the predominance of resistant parasites. Selection for resistance following insufficient prophylaxis could possibly affect the efficacy of future intermittent sulfadoxine-pyrimethamine treatment.

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Section: Discussionmentioning

confidence: 93%

Plasmodium falciparum dihydrofolate reductase alleles and pyrimethamine use in pregnant Ghanaian women.

Mockenhaupt¹,

Eggelte²,

Böhme³

et al. 2001

The American Journal of Tropical Medicine and Hygiene

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show abstract

“…However, the results may also indicate the presence of drug resistance which has been described for the study region. 34 Drug intake may be an important modifying factor in the acquisition of immunity against malaria. In a longitudinal study in children, CLQ chemoprophylaxis reduced the multiplicity of infection.…”

Section: Discussionmentioning

confidence: 99%

Multiplicity of Plasmodium falciparum infection in pregnancy.

Beck¹,

Mockenhaupt²,

Bienzle³

et al. 2001

The American Journal of Tropical Medicine and Hygiene

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Abstract. Little is known about the distribution and disease association of multiple Plasmodium falciparum infections in pregnant women. Genotyping of the merozoite surface protein-1 region was performed in 332 P. falciparum infected pregnant women in Ghana, and clinical and epidemiologic data were obtained. Overall, 68% of the women were infected with more than one strain (mean number of strains per carrier ϭ 2.9). The multiplicity of infection decreased significantly with an increasing number of pregnancies, and infection with multiple P. falciparum strains was significantly associated with anemia. In logistic regression, women infected with four or more strains were 2.3 times more likely to be anemic than women harboring fewer strains. This association, however, was only observed in women with up to three pregnancies. The results suggest that with increasing gravidity and subsequent infections with multiple strains effective immune mechanisms against more and more strains develop. In pregnant women, the multiplicity of infection may be an important factor for the acquisition and maintenance of immunity against malaria.

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“…This became necessary because by 2003 parasitological responses to chloroquine were less than 50% in some areas of the country. Similar studies on the efficacy of sulphadoxine/pyrimethamine (SP) have shown 0-36% of RII resistance and 0-9% of RIII resistance [5,6]. …”

Section: Introductionmentioning

confidence: 99%

Effectiveness of combined intermittent preventive treatment for children and timely home treatment for malaria control

Ahorlu

Koram

Seakey³

et al. 2009

Malar J

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BackgroundWhiles awaiting for the arrival of an effective and affordable malaria vaccine, there is a need to make use of the available control tools to reduce malaria risk, especially in children under five years and pregnant women. Intermittent preventive treatment (IPT) has recently been accepted as an important component of the malaria control strategy. This study explored the potential of a strategy of intermittent preventive treatment for children (IPTC) and timely treatment of malaria-related febrile illness in the home in reducing the parasite prevalence and malaria morbidity in young children in a coastal village in Ghana.MethodsThe study combined home-based delivery of IPTC among six to 60 months old and home treatment of suspected febrile malaria illness within 24 hours. All children between six and 60 months of age received intermittent preventive treatment using amodiaquine and artesunate, delivered by community assistants every four months (three times in 12 months). Malaria parasite prevalence surveys were conducted before the first and after the third dose of IPTC.ResultsParasite prevalence was reduced from 25% to 3% (p < 0.00, Mann-Whitney) one year after the inception of the two interventions. At baseline, 13.8% of the children were febrile (axillary temperature greater than or equal to 37.5 degree Celsius) compared to 2.2% at evaluation (post IPTC3 combined with timely home management of fever) (p < 0.00, Mann-Whitney).ConclusionThe evaluation result indicates that IPTC given three times in a year combined with timely treatment of febrile malaria illness, impacts significantly on the parasite prevalence. The marked reduction in the parasite prevalence with this strategy points to the potential for reducing malaria-related childhood morbidity and mortality, and this should be explored by control programme managers.

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Plasmodium falciparum: susceptibility in vitro and in vivo to chloroquine and sulfadoxine-pyrimethamine in Ghanaian schoolchildren

Cited by 32 publications

References 4 publications

Plasmodium falciparum dihydrofolate reductase alleles and pyrimethamine use in pregnant Ghanaian women.

Plasmodium falciparum dihydrofolate reductase alleles and pyrimethamine use in pregnant Ghanaian women.

Multiplicity of Plasmodium falciparum infection in pregnancy.

Effectiveness of combined intermittent preventive treatment for children and timely home treatment for malaria control

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