Volume 77, Issue 3
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645


Resistance-conferring mutations in dihydrofolate reductase (DHFR) and dihydropteroate synthase (DHPS) in are selected by treatment with sulfadoxine pyrimethamine (SP). We assessed the association between these mutations and transmission capacity of parasites to mosquitoes on the Pacific coast of Colombia. Patients with uncomplicated malaria received SP treatment and were followed-up to compare the prevalence of DHFR and DHPS mutations before and after SP treatment. Membrane feeding assays were used to measure infectivity to mosquitoes of post-treatment gametocytes with and without these mutations. Per-protocol treatment efficacy was 95.0% (132 of 139). Gametocytes carrying resistance-conferring mutations were selected after SP treatment and were infective to mosquitoes. Seven days after treatment, infections with two DHFR mutations had a 10-fold higher probability of infecting mosquitoes than infections with no DHFR mutations (odds ratio = 10.23, < 0.05). Low-level drug resistance mutations have the potential to enhance transmission of and spread resistant parasites.


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  • Received : 11 Apr 2007
  • Accepted : 13 Jun 2007

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