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Sustained use of insecticide-treated curtains is not associated with greater circulation of drug-resistant malaria parasites, or with higher risk of treatment failure among children with uncomplicated malaria in Burkina Faso.
- Source :
-
The American journal of tropical medicine and hygiene [Am J Trop Med Hyg] 2007 Feb; Vol. 76 (2), pp. 237-44. - Publication Year :
- 2007
-
Abstract
- The impact of vector control measures on the evolution of antimalarial drug resistance is an important issue for malaria control programs. We investigated whether the in vivo efficacy of chloroquine (CQ) in children aged 6-59 months with uncomplicated malaria differed in 9 villages that had benefited from long-term use of insecticide-treated curtains (ITCs) and in 9 nearby non-ITC villages. We also compared the prevalence of genetic markers of resistance to CQ and sulfadoxine-pyrimethamine (SP) between the two groups of villages. The study enrolled 1,035 children with uncomplicated malaria and 231 infected but asymptomatic children. After taking account of re-infections, the proportions of children who experienced clinical failure after treatment with CQ were 14% and 19% in ITC and non-ITC villages, respectively (OR = 0.68; 95% CI: 0.39, 1.18). Parasitologic failure was observed in 49% of children in ITC villages and 58% of children in non-ITC villages (OR = 0.71 95%CI: 0.44, 1.13). The proportion of symptomatic children who harbored parasites carrying the pfcrt-76T allele was 43% in ITC villages and 40% in non-ITC villages (OR = 1.09; 95%CI: 0.80, 1.50). The pfmdr1-86Y allele was detected in 31% and 29% of children in the two groups of villages (OR = 1.14; 95%CI: 0.75, 1.72). Triple mutations in the dhfr gene were observed in 12% of children in both groups. No double mutations in the dhps gene were observed. Similar results were observed in asymptomatic children. In this setting, ITC use was not associated with increased circulation of parasites resistant to standard antimalarial drugs, or with a greater risk of treatment failure among children less than 5 years of age.
- Subjects :
- Animals
Burkina Faso epidemiology
Child, Preschool
Cross-Sectional Studies
DNA, Protozoan chemistry
DNA, Protozoan genetics
Drug Combinations
Drug Resistance
Humans
Infant
Insect Vectors parasitology
Malaria, Falciparum drug therapy
Malaria, Falciparum epidemiology
Malaria, Falciparum parasitology
Membrane Transport Proteins chemistry
Membrane Transport Proteins genetics
Multidrug Resistance-Associated Proteins chemistry
Multidrug Resistance-Associated Proteins genetics
Plasmodium falciparum genetics
Point Mutation
Polymerase Chain Reaction
Protozoan Proteins chemistry
Protozoan Proteins genetics
Pyrimethamine therapeutic use
Rural Population
Sulfadoxine therapeutic use
Tetrahydrofolate Dehydrogenase chemistry
Tetrahydrofolate Dehydrogenase genetics
Antimalarials therapeutic use
Bedding and Linens
Chloroquine therapeutic use
Insecticides
Malaria, Falciparum prevention & control
Mosquito Control methods
Plasmodium falciparum growth & development
Subjects
Details
- Language :
- English
- ISSN :
- 0002-9637
- Volume :
- 76
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- The American journal of tropical medicine and hygiene
- Publication Type :
- Academic Journal
- Accession number :
- 17297030