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Prevalence of molecular markers of drug resistance in an area of seasonal malaria chemoprevention in children in Senegal
- Source :
- Malaria Journal
- Publication Year :
- 2013
- Publisher :
- Springer Science and Business Media LLC, 2013.
-
Abstract
- BACKGROUND: In sub-Saharan Africa, malaria is the leading cause of morbidity and mortality especially in children. In Senegal, seasonal malaria chemoprevention (SMC) previously referred to as intermittent preventive treatment in children (IPTc) is a new strategy for malaria control in areas of high seasonal transmission. An effectiveness study of SMC, using sulphadoxine-pyrimethamine (SP) plus amodiaquine (AQ), was conducted in central Senegal from 2008 to 2010 to obtain information about safety, feasibility of delivery, and cost effectiveness of SMC. Here are report the effect of SMC delivery on the prevalence of markers of resistance to SP and AQ. METHODS: This study was conducted in three health districts in Senegal with 54 health posts with a gradual introduction of SMC. Three administrations of the combination AQ + SP were made during the months of September, October and November of each year in children aged less than 10 years living in the area. Children were surveyed in December of each year and samples (filter paper and thick films) were made in 2008, 2009 and 2010. The prevalence of mutations in the pfdhfr, pfdhps, pfmdr1 and pfcrt genes was investigated by sequencing and RTPCR in samples positive by microscopy for Plasmodium falciparum. RESULTS: Mutations at codon 540 of pfdhps and codon 164 of pfdhfr were not detected in the study. Among children with parasitaemia at the end of the transmission seasons, the CVIET haplotypes of pfcrt and the 86Y polymorphism of pfmdr1 were more common among those that had received SMC, but the number of infections detected was very low and confidence intervals were wide. The overall prevalence of these mutations was lower in SMC areas than in control areas, reflecting the lower prevalence of parasitaemia in areas where SMC was delivered. CONCLUSION: The sensitivity of P. falciparum to SMC drugs should be regularly monitored in areas deploying this intervention. Overall the prevalence of genotypes associated with resistance to either SP or AQ was lower in SMC areas due to the reduced number of parasitaemia individuals.
- Subjects :
- Male
Pfdhps
Cost effectiveness
medicine.medical_treatment
Drug Resistance
Drug resistance
Mutation Rate
Prevalence
Malaria, Falciparum
Child
Pfcrt
biology
SMC
musculoskeletal system
Senegal
Drug Combinations
Pyrimethamine
Infectious Diseases
Child, Preschool
cardiovascular system
Drug Therapy, Combination
Female
medicine.drug
Genetic Markers
medicine.medical_specialty
Sulfadoxine
Plasmodium falciparum
Pfdhfr
Amodiaquine
Chemoprevention
Antimalarials
Environmental health
parasitic diseases
medicine
Humans
Pfmdr1
business.industry
Research
Infant
biology.organism_classification
medicine.disease
Biotechnology
Tropical medicine
Sulphadoxine-pyrimethamine
Parasitology
business
Malaria
Subjects
Details
- ISSN :
- 14752875
- Volume :
- 12
- Database :
- OpenAIRE
- Journal :
- Malaria Journal
- Accession number :
- edsair.doi.dedup.....4178ea7b073bc30c39993424aff65bdb