1921
Volume 69, Issue 6
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

resistance to sulfadoxine/pyrimethamine (S/P) is due to mutations in the dihydrofolate reductase () and dihydropteroate synthetase () genes. Large-scale screening of the prevalence of these mutations could facilitate the surveillance of the level of S/P resistance . The prevalence of mutations in and in relation to S/P efficacy was studied in four sites of differing endemicity in Sudan, Mozambique, and Tanzania. The sites were organized in order of increasing resistance and a significant increase in the prevalence of triple mutations in codons c51, c59, and c108 of was observed. A similar trend was observed when genotypes were combined with c437 of . Since the differences in S/P resistance between the sites were minor, but nevertheless revealed major differences in genotype prevalence, the role of as a general molecular marker seems debatable. The differences may reflect variation in the duration and magnitude of S/P usage (or other antifolate drugs) between the sites. Thus, triple mutations may prove suitable only as a general guideline for detecting emerging S/P resistance in areas where S/P has been introduced recently. However, changes in susceptibility within the same area with moderate levels of resistance may be possible by longitudinal surveillance of a subset of / mutations that has been associated with S/P resistance in a defined location.

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2003-12-01
2017-11-22
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  • Received : 17 Mar 2003
  • Accepted : 20 Aug 2003

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