1921
Volume 91, Issue 1
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

Abstract.

Standard therapy for malaria in Uganda changed from chloroquine to chloroquine + sulfadoxine-pyrimethamine in 2000, and artemether-lumefantrine in 2004, although implementation of each change was slow. genetic polymorphisms are associated with alterations in drug sensitivity. We followed the prevalence of drug resistance-mediating polymorphisms in 982 samples from Tororo, a region of high transmission intensity, collected from three successive treatment trials conducted during 2003–2012, excluding samples with known recent prior treatment. Considering transporter mutations, prevalence of the mutant 76T, 86Y, and 1246Y alleles decreased over time. Considering antifolate mutations, the prevalence of 51I, 59R, and 108N, and 437G and 540E were consistently high; 164L and 581G were uncommon, but most prevalent during 2008–2010. Our data suggest sequential selective pressures as different treatments were implemented, and they highlight the importance of genetic surveillance as treatment policies change over time.

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2014-07-02
2017-10-17
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  • Received : 05 Nov 2013
  • Accepted : 26 Feb 2014

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