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Plasmodium falciparum mutant haplotype infection during pregnancy associated with reduced birthweight, Tanzania.
- Source :
-
Emerging infectious diseases [Emerg Infect Dis] 2013; Vol. 19 (9). - Publication Year :
- 2013
-
Abstract
- Intermittent preventive treatment during pregnancy with sulfadoxine-pyrimethamine (IPTp-SP) is a key strategy in the control of pregnancy-associated malaria. However, this strategy is compromised by widespread drug resistance from single-nucleotide polymorphisms in the Plasmodium falciparum dihydrofolate reductase and dihydropteroate synthetase genes. During September 2008-October 2010, we monitored a cohort of 924 pregnant women in an area of Tanzania with declining malaria transmission. P. falciparum parasites were genotyped, and the effect of infecting haplotypes on birthweight was assessed. Of the genotyped parasites, 9.3%, 46.3%, and 44.4% had quadruple or less, quintuple, and sextuple mutated haplotypes, respectively. Mutant haplotypes were unrelated to SP doses. Compared with infections with the less-mutated haplotypes, infections with the sextuple haplotype mutation were associated with lower (359 g) birthweights. Continued use of the suboptimal IPTp-SP regimen should be reevaluated, and alternative strategies (e.g., intermittent screening and treatment or intermittent treatment with safe and effective alternative drugs) should be evaluated.
- Subjects :
- Adolescent
Adult
Alleles
Female
Gestational Age
Humans
Malaria, Falciparum diagnosis
Malaria, Falciparum drug therapy
Malaria, Falciparum prevention & control
Polymorphism, Single Nucleotide
Pregnancy
Prospective Studies
Tanzania
Tetrahydrofolate Dehydrogenase genetics
Young Adult
Haplotypes
Infant, Low Birth Weight
Malaria, Falciparum complications
Mutation
Plasmodium falciparum genetics
Pregnancy Complications, Parasitic diagnosis
Pregnancy Complications, Parasitic drug therapy
Pregnancy Complications, Parasitic prevention & control
Pregnancy Outcome
Subjects
Details
- Language :
- English
- ISSN :
- 1080-6059
- Volume :
- 19
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- Emerging infectious diseases
- Publication Type :
- Academic Journal
- Accession number :
- 23969132
- Full Text :
- https://doi.org/10.3201/eid1909.130133