National Malaria Control Program, Ministry of Health, 2000. Malaria Treatment Guidelines. Dar es Salaam, Tanzania: Ministry of Health.
The East African Network for Monitoring Antimalaria Treatment (EANMAT), 2003. The efficacy of antimalarial monotherapies, sulfadoxine-pyrimethamine and amodiaquine in east Africa: implication for sub-regional policy. Trop Med Int Health 8 :860–867.
Wakibara JV, Mboera LE, Ndawi BT, 1997. Malaria in Mvumi, central Tanzania and the in vivo response of Plasmodium falciparum to chloroquine and sulfadoxine pyrimethamine. East Afr Med J 74 :69–71.
Nwanyanwu OC, Ziba C, MacHeso A, Kazembe P, 2000. Efficacy of sulfadoxine-pyrimethamine for acute uncomplicated malaria due to Plasmodium falciparum in Malawi children under five years of age. Trop Med Int Health 5 :355–358.
Gorissen E, Ashruf G, Lamboo M, Bennebroek J, Gikunda S, Mbaruku G, Kager PA, 2000. In vivo efficacy study of amodiaquine and sulfadoxine/pyrimethamine in Kibwezi, Kenya and Kigoma, Tanzania. Trop Med Int Health 5 :459–463.
Ndyomugyenyi R, Magnussen P, 2000. In vivo sensitivity of Plasmodium falciparum to chloroquine and sulfadoxine-pyrimethamine among school children in rural Uganda: a comparison between 1995 and 1998. Acta Trop 76 :265–270.
Mabuza A, Govere J, Durrheim D, Mngomezulu N, Bredenkamp B, Barnes K, Sharp B, 2001. Therapeutic efficacy of sulfadoxine-pyrimethamine in uncomplicated Plasmodium falciparum malaria 3 years after introduction in Mpumalanga. South Afr Med J 91 :975–978.
Warsame M, Abdillahi A, Duale ON, Ismail AN, Hassan AM, Mohamed A, Warsame A, 2002. Therapeutic efficacy of chloroquine and sulfadoxine/pyrimethamine against Plasmodium falciparum infection in Somalia. Bull World Health Organ 80 :704–708.
White NJ, 1992. Antimalarial drug resistance: the pace quickens. J Antimicrob Chemother 30 :571–585.
Clyde DF, 1954. Observations on monthly pyrimethamine (Daraprim) prophylaxis in an east African village. East Afr Med J 3 :41–46.
Clyde DF, Shute GT, 1957. Resistance of Plasmodium falciparum in Tanganyika to pyrimethamine administered at weekly intervals. Trans R Soc Trop Med Hyg 51 :505–513.
Rønn AM, Msangeni HA, Mhina J, Wernsdorfer WH, Bygbjerg IC, 1996. High level of resistance of Plasmodium falciparum to sulfadoxine-pyrimethamine in children in Tanzania. Trans R Soc Trop Med Hyg 90 :179–181.
Mutabingwa T, Nzila A, Mberu E, Nduati E, Winstanley P, Hills E, Watkins W, 2001. Chlorproguanildapsone for the treatment of drug resistant falciparum malaria. Lancet 358 :1218–1223.
Schellenberg D, Kahigwa E, Drackeley C, Malende A, Wigayi J, Msokame C, Aponte JJ, Tanner M, Mshinda H, Menendez C, Alonso P, 2002. The safety and efficacy of sulfadoxine pyrimethamine, amodiaquine, and their combination in the treatment of uncomplicated Plasmodium falciparum malaria. Am J Trop Med Hyg 67 :17–23.
Jelinek T, Kllian AH, Kabagambe G, Sonnenburg F, 1999. Plasmodium falciparum resistance to sulfadoxine/pyrimethamine in Uganda: correlation with polymorphisms in dihydrofolate reductase and dihydropteroate synthase genes. Am J Trop Med Hyg 61 :463–466.
Kublin JG, Witzig RS, Shakar AH, Zurita JO, Gilman RH, Guarda JA, Cortese J, Plowe CV, 1998. Molecular assays for surveillance of antifolate-resistant malaria. Lancet 351 :1629–1630.
Plowe CV, Kublin JG, Doumbo OK, 1998. P. falciparum dihydrofolate reductase and dihydropteroate synthase mutations: epidemiology and role in clinical resistance to antifolates. Drug Resist Updates 1 :389–396.
Nzila AM, Mberu EK, Sulo J, Dayo H, Winstanley PA, Sibley CH, Watkins WM, 2000. Towards an understanding of the mechanism of pyrimethamine-sulfadoxine resistance in Plasmodium falciparum: genotyping of dihydrofolate reductase and dihydropteroate synthase of Kenyan parasites. Antimicrob Agents Chemother 44 :991–996.
Basco LK, Tahar R, Ringwald P, 1998. Molecular basis for in vivo resistance to sulfadoxine-pyrimethamine in African adult patients infected with Plasmodium falciparum malaria parasites. Antimicrob Agents Chemother 42 :1811–1814.
Basco LK, Tahar R, Keundjian A, Ringwald P, 2000. Sequence variations in the genes encoding dihydropteroate synthase and dihydrofolate reductase and clinical response to sulfadoxine-pyrimethamine in patients with acute uncomplicated falciparum malaria. J Infect Dis 182 :624–628.
Nyamwange CI, Nyamogoba H, 2002. Molecular markers in epidemiological monitoring of the spread of resistance to antimalarials: a review. East Afr Med J 79 :480–484.
Omar SA, Adagu IS, Warhurst DC, 2001. Can pretreatment screening for dhps and dhfr point mutations in Plasmodium falciparum infections be used to predict sulfadoxine-pyrimethamine treatment failure? Trans R Soc Trop Med Hyg 95 :315–319.
Kyabayinze D, Cattamanchi A, Kamya MR, Rosenthal PJ, Dorsey G, 2003. Validation of a simplified method for using molecular markers to predict sulfadoxine-pyrimethamine treatment failure in African children with falciparum malaria. Am J Trop Med Hyg 69 :247–252.
Kublin J, Dzinjalamala FK, Kamwendo DD, Malkin EM, Cortese JF, Martino LM, Mukadam RAG, Rogerson SJ, Lescano AG, Molyneux ME, Winstanley PA, Chimpeni P, Taylor TE, Plowe CV, 2002. Molecular markers for failure of sulfadoxine-pyrimethamine and chlorproguanil-dapsone treatment of Plasmodium falciparum malaria. J Infect Dis 185 :380–388.
Rallon NI, Osorio LE, Giraldo LE, 1999. Lack of association between ASN-108 mutation in the dihydrofolate reductase gene and in vivo resistance to sulfadoxine/pyrimethamine in Plasmodium falciparum. Am J Trop Med Hyg 61 :245–248.
Jelinek T, Ronn AM, Curtis J, Duraisingh MT, Lemnge MM, Bygbjerg IC, Warhurst DC, 1997. High prevalence of mutations in the dihydrofolate reductase gene of Plasmodium falciparum in isolates from Tanzania without evidence of association to clinical sulfadoxine/pyrimethamine resistance. Trop Med Int Health 2 :1075–1079.
Hankins EG, Warhurst DC, Sibley CH, 2001. Novel alleles of the Plasmodium falciparum dhfr highly resistant to pyrimethamine and chlorcycloguanil, but not WR99210. Mol Biochem Parasitol 117 :91–102.
Djimde A, Doumbo OK, Steketee RW, Plowe CV, 2001. Application of a molecular marker for surveillance of chloroquine-resistant falciparum malaria. Lancet 358 :890–891.
Talisuna AO, Kyosiimire-Lugemwa J, Langi P, Mutabingwa TK, Watkins W, Van Marck E, Egwang T, D’Alessandro U, 2002. Role of the pfcrt codon 76 mutation as a molecular marker for population-based surveillance of chloroquine (CQ)-resistant Plasmodium falciparum malaria in Ugandan sentinel sites with high CQ resistance. Trans R Soc Trop Med Hyg 96 :551–556.
World Health Organization, 1996. Assessment of Therapeutic Efficacy of Antimalarial Drugs for Uncomplicated Falciparum Malaria in Areas with Intense Transmission. Geneva: World Health Organization. MAL/96–1077.
Plowe CV, Djimde A, Bouare M, Doumbo O, Wellems TE, 1995. Pyrimethamine and proguanil resistance-conferring mutations in Plasmodium falciparum dihydrofolate reductase: polymerase chain reaction methods for surveillance in Africa. Am J Trop Med Hyg 52 :565–568.
Duraisingh MT, Curtis J, Warhurst D, 1998. Plasmodium falciparum: Detection of polymorphism in the dihydrofalate reductase and dihydropteroate synthase genes by PCR and restriction digestion. Exp Parasitol 89 :1–8.
World Health Organization, 2001. The Use of Antimalarial Drugs: Report of a WHO Informal Consultation, November 7–13, 2000. Geneva: World Health Organization. WHO/CDS/RBM/2001.33.
World Health Organization, 2001. Antimalarial Drug Combination Therapy: Report of a WHO Informal Consultation, April 4–5, 2000. Geneva: World Health Organization. WHO/CDS/RBM/2001.35.
World Health Organization, 2002. Monitoring Antimalarial Drug Resistance. Report of a WHO Consultation, December 3–5, 2001. Geneva: World Health Organization.
Alifrangis M, Enosse S, Khalil IF, Tarimo DS, Lemnge MM, Thompson R, Bygbjerg IC, Rønn AM, 2003. Prediction of Plasmodium falciparum resistance to sulfadoxine/pyrimethamine in vivo by mutations in the dihydrofolate reductase and dihydropteroate synthase genes: a comparative study between sites of differing endemicities. Am J Trop Med Hyg 69 :601–606.
Pearce RJ, Drakeley C, Chandramohan D, Mosha F, Roper C, 2003. Molecular determination of point mutation haplotypes in the dihydrofolate reductase and dihydropteroate synthase of Plasmodium falciparum in three districts of northern Tanzania. Antimicrob Agents Chemother 47 :1347–1354.
Hastings MD, Bates SJ, Blackstone EA, Monks SM, Mutabingwa TK, Sibley CH, 2002. Highly pyrimethamine-resistant alleles of dihydrofolate reductase in isolates of Plasmodium falciparum from Tanzania. Trans R Soc Trop Med Hyg 96 :674–676.
Ochong E, Nzila A, Serah K, Kokwaro G, Mutabingwa T, Watkins W, Marsh K, 2003. Molecular monitoring of the Leu-164 mutation of dihydrofolate reductase in a highly sulfadoxine/pyrimethamine-resistant area in Africa. Malar J 2 :46–48.
Wichmann O, Jelinek T, Peyerl-Hoffmann G, Mühlberger N, Grobusch M, Gascon J, Matteelli A, Hatz C, Laferl H, Schulze M, Burchard G, da Cunha S, Beran J, McWhinney P, Kollaritsch H, Kern P, Caudros J, Alifrangis M, Gjørup I, European Network on Surveillance of Imported Infectious Diseases, 2003. Molecular surveillance of the antifolate-resistant mutation I164L in imported African isolates of Plasmodium falciparum in Europe: Sentinel data from Trop Net Europ. Malar J 2 :17–21.
Bwijo B, Kaneko A, Takechi M, Zungu IL, Moriyama Y, Lum JK, Tsukahara T, Mita T, Takahashi N, Bergqvist Y, Bjorkman A, Kobayakawa T, 2003. High Prevalence of quintuple mutant dhps/dhfr genes in Plasmodium falciparum infections seven years after introduction of sulfadoxine and pyrimethamine as the first line treatment in Malawi. Acta Trop 85 :363–373.
Wang PL, Bayoumi R, Djimde A, Doumbo O, Swedberg G, Dao LD, Mshinda H, Tanner M, Watkins WM, Sims PF, Hyde E, 1997. Resistance to antifolate in plasmodium falciparum monitored by sequence analysis of dihydropteroate synthase and dihydrofolate reductase alleles in a large number of field samples of diverse origins. Mol Biochem Parasitol 89 :161–177.
Roper C, Pearce R, Bredenkamp B, Gumede J, Drackeley C, Mosha F, Chandramohan D, Sharp B, 2003. Antifolate anti-malarial resistance in southern Africa: a population-based analysis. Lancet 361 :1174–1181.
Nair S, Williams JT, Brockman A, Paiphun L, Mayxay M, Newton PN, Guthmann J-P, Smithuis FM, Hein TT, White NJ, Nosten F, Anderson TJC, 2003. A selective sweep driven by pyrimethamine treatment in southeast Asian malaria parasites. Mol Biol Evol 20 :1526–1536.
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Prior to the 2001 malarial treatment policy change in Tanzania, we conducted trials to assess the efficacy of sulfadoxine-pyrimethamine (SP) and the usefulness of molecular markers in monitoring resistance. A total of 383 uncomplicated Plasmodium falciparum malaria patients (between 6 and 59 months old) were treated with SP and their responses were assessed. Mutations in the P. falciparum dihydrofolate reductase (pfdhfr) and dihydropteroate synthase (pfdhps) genes in admission day blood samples were analyzed. Results indicated that 85.6% of the patients showed an adequate clinical response, 9.7% an early treatment failure, and 4.7% a late treatment failure. The quintuple mutant genotype (pfdhfr 51 Ile, 59 Arg, and 108 Asn and pfdhps 437 Gly and 540 Glu) showed an association with treatment outcome (odds ratio = 2.1; 95% confidence interval = 0.94–4.48, P = 0.045). The prevalence of the triple pfdhfr mutant genotype (51 Ile, 59 Arg, and 108 Asn) at a site of high SP resistance (23.6%) was four times higher compared with that observed at sites of moderate SP resistance (6.8–14.4%) (P = 0.000001). The genotype failure index calculated by using this marker was invariable (1.96–2.1) at sites with moderate SP resistance, but varied (3.4) at a site of high SP resistance. In conclusion, our clinical and molecular findings suggest that SP may have a short useful therapeutic life in Tanzania; thus, its adoption as an interim first-line antimalarial drug. The findings also point to the potential of the triple pfdhfr mutant genotype as an early warning tool for increasing SP resistance. These data form the baseline SP efficacy and molecular markers profile in Tanzania prior to the policy change.
National Malaria Control Program, Ministry of Health, 2000. Malaria Treatment Guidelines. Dar es Salaam, Tanzania: Ministry of Health.
The East African Network for Monitoring Antimalaria Treatment (EANMAT), 2003. The efficacy of antimalarial monotherapies, sulfadoxine-pyrimethamine and amodiaquine in east Africa: implication for sub-regional policy. Trop Med Int Health 8 :860–867.
Wakibara JV, Mboera LE, Ndawi BT, 1997. Malaria in Mvumi, central Tanzania and the in vivo response of Plasmodium falciparum to chloroquine and sulfadoxine pyrimethamine. East Afr Med J 74 :69–71.
Nwanyanwu OC, Ziba C, MacHeso A, Kazembe P, 2000. Efficacy of sulfadoxine-pyrimethamine for acute uncomplicated malaria due to Plasmodium falciparum in Malawi children under five years of age. Trop Med Int Health 5 :355–358.
Gorissen E, Ashruf G, Lamboo M, Bennebroek J, Gikunda S, Mbaruku G, Kager PA, 2000. In vivo efficacy study of amodiaquine and sulfadoxine/pyrimethamine in Kibwezi, Kenya and Kigoma, Tanzania. Trop Med Int Health 5 :459–463.
Ndyomugyenyi R, Magnussen P, 2000. In vivo sensitivity of Plasmodium falciparum to chloroquine and sulfadoxine-pyrimethamine among school children in rural Uganda: a comparison between 1995 and 1998. Acta Trop 76 :265–270.
Mabuza A, Govere J, Durrheim D, Mngomezulu N, Bredenkamp B, Barnes K, Sharp B, 2001. Therapeutic efficacy of sulfadoxine-pyrimethamine in uncomplicated Plasmodium falciparum malaria 3 years after introduction in Mpumalanga. South Afr Med J 91 :975–978.
Warsame M, Abdillahi A, Duale ON, Ismail AN, Hassan AM, Mohamed A, Warsame A, 2002. Therapeutic efficacy of chloroquine and sulfadoxine/pyrimethamine against Plasmodium falciparum infection in Somalia. Bull World Health Organ 80 :704–708.
White NJ, 1992. Antimalarial drug resistance: the pace quickens. J Antimicrob Chemother 30 :571–585.
Clyde DF, 1954. Observations on monthly pyrimethamine (Daraprim) prophylaxis in an east African village. East Afr Med J 3 :41–46.
Clyde DF, Shute GT, 1957. Resistance of Plasmodium falciparum in Tanganyika to pyrimethamine administered at weekly intervals. Trans R Soc Trop Med Hyg 51 :505–513.
Rønn AM, Msangeni HA, Mhina J, Wernsdorfer WH, Bygbjerg IC, 1996. High level of resistance of Plasmodium falciparum to sulfadoxine-pyrimethamine in children in Tanzania. Trans R Soc Trop Med Hyg 90 :179–181.
Mutabingwa T, Nzila A, Mberu E, Nduati E, Winstanley P, Hills E, Watkins W, 2001. Chlorproguanildapsone for the treatment of drug resistant falciparum malaria. Lancet 358 :1218–1223.
Schellenberg D, Kahigwa E, Drackeley C, Malende A, Wigayi J, Msokame C, Aponte JJ, Tanner M, Mshinda H, Menendez C, Alonso P, 2002. The safety and efficacy of sulfadoxine pyrimethamine, amodiaquine, and their combination in the treatment of uncomplicated Plasmodium falciparum malaria. Am J Trop Med Hyg 67 :17–23.
Jelinek T, Kllian AH, Kabagambe G, Sonnenburg F, 1999. Plasmodium falciparum resistance to sulfadoxine/pyrimethamine in Uganda: correlation with polymorphisms in dihydrofolate reductase and dihydropteroate synthase genes. Am J Trop Med Hyg 61 :463–466.
Kublin JG, Witzig RS, Shakar AH, Zurita JO, Gilman RH, Guarda JA, Cortese J, Plowe CV, 1998. Molecular assays for surveillance of antifolate-resistant malaria. Lancet 351 :1629–1630.
Plowe CV, Kublin JG, Doumbo OK, 1998. P. falciparum dihydrofolate reductase and dihydropteroate synthase mutations: epidemiology and role in clinical resistance to antifolates. Drug Resist Updates 1 :389–396.
Nzila AM, Mberu EK, Sulo J, Dayo H, Winstanley PA, Sibley CH, Watkins WM, 2000. Towards an understanding of the mechanism of pyrimethamine-sulfadoxine resistance in Plasmodium falciparum: genotyping of dihydrofolate reductase and dihydropteroate synthase of Kenyan parasites. Antimicrob Agents Chemother 44 :991–996.
Basco LK, Tahar R, Ringwald P, 1998. Molecular basis for in vivo resistance to sulfadoxine-pyrimethamine in African adult patients infected with Plasmodium falciparum malaria parasites. Antimicrob Agents Chemother 42 :1811–1814.
Basco LK, Tahar R, Keundjian A, Ringwald P, 2000. Sequence variations in the genes encoding dihydropteroate synthase and dihydrofolate reductase and clinical response to sulfadoxine-pyrimethamine in patients with acute uncomplicated falciparum malaria. J Infect Dis 182 :624–628.
Nyamwange CI, Nyamogoba H, 2002. Molecular markers in epidemiological monitoring of the spread of resistance to antimalarials: a review. East Afr Med J 79 :480–484.
Omar SA, Adagu IS, Warhurst DC, 2001. Can pretreatment screening for dhps and dhfr point mutations in Plasmodium falciparum infections be used to predict sulfadoxine-pyrimethamine treatment failure? Trans R Soc Trop Med Hyg 95 :315–319.
Kyabayinze D, Cattamanchi A, Kamya MR, Rosenthal PJ, Dorsey G, 2003. Validation of a simplified method for using molecular markers to predict sulfadoxine-pyrimethamine treatment failure in African children with falciparum malaria. Am J Trop Med Hyg 69 :247–252.
Kublin J, Dzinjalamala FK, Kamwendo DD, Malkin EM, Cortese JF, Martino LM, Mukadam RAG, Rogerson SJ, Lescano AG, Molyneux ME, Winstanley PA, Chimpeni P, Taylor TE, Plowe CV, 2002. Molecular markers for failure of sulfadoxine-pyrimethamine and chlorproguanil-dapsone treatment of Plasmodium falciparum malaria. J Infect Dis 185 :380–388.
Rallon NI, Osorio LE, Giraldo LE, 1999. Lack of association between ASN-108 mutation in the dihydrofolate reductase gene and in vivo resistance to sulfadoxine/pyrimethamine in Plasmodium falciparum. Am J Trop Med Hyg 61 :245–248.
Jelinek T, Ronn AM, Curtis J, Duraisingh MT, Lemnge MM, Bygbjerg IC, Warhurst DC, 1997. High prevalence of mutations in the dihydrofolate reductase gene of Plasmodium falciparum in isolates from Tanzania without evidence of association to clinical sulfadoxine/pyrimethamine resistance. Trop Med Int Health 2 :1075–1079.
Hankins EG, Warhurst DC, Sibley CH, 2001. Novel alleles of the Plasmodium falciparum dhfr highly resistant to pyrimethamine and chlorcycloguanil, but not WR99210. Mol Biochem Parasitol 117 :91–102.
Djimde A, Doumbo OK, Steketee RW, Plowe CV, 2001. Application of a molecular marker for surveillance of chloroquine-resistant falciparum malaria. Lancet 358 :890–891.
Talisuna AO, Kyosiimire-Lugemwa J, Langi P, Mutabingwa TK, Watkins W, Van Marck E, Egwang T, D’Alessandro U, 2002. Role of the pfcrt codon 76 mutation as a molecular marker for population-based surveillance of chloroquine (CQ)-resistant Plasmodium falciparum malaria in Ugandan sentinel sites with high CQ resistance. Trans R Soc Trop Med Hyg 96 :551–556.
World Health Organization, 1996. Assessment of Therapeutic Efficacy of Antimalarial Drugs for Uncomplicated Falciparum Malaria in Areas with Intense Transmission. Geneva: World Health Organization. MAL/96–1077.
Plowe CV, Djimde A, Bouare M, Doumbo O, Wellems TE, 1995. Pyrimethamine and proguanil resistance-conferring mutations in Plasmodium falciparum dihydrofolate reductase: polymerase chain reaction methods for surveillance in Africa. Am J Trop Med Hyg 52 :565–568.
Duraisingh MT, Curtis J, Warhurst D, 1998. Plasmodium falciparum: Detection of polymorphism in the dihydrofalate reductase and dihydropteroate synthase genes by PCR and restriction digestion. Exp Parasitol 89 :1–8.
World Health Organization, 2001. The Use of Antimalarial Drugs: Report of a WHO Informal Consultation, November 7–13, 2000. Geneva: World Health Organization. WHO/CDS/RBM/2001.33.
World Health Organization, 2001. Antimalarial Drug Combination Therapy: Report of a WHO Informal Consultation, April 4–5, 2000. Geneva: World Health Organization. WHO/CDS/RBM/2001.35.
World Health Organization, 2002. Monitoring Antimalarial Drug Resistance. Report of a WHO Consultation, December 3–5, 2001. Geneva: World Health Organization.
Alifrangis M, Enosse S, Khalil IF, Tarimo DS, Lemnge MM, Thompson R, Bygbjerg IC, Rønn AM, 2003. Prediction of Plasmodium falciparum resistance to sulfadoxine/pyrimethamine in vivo by mutations in the dihydrofolate reductase and dihydropteroate synthase genes: a comparative study between sites of differing endemicities. Am J Trop Med Hyg 69 :601–606.
Pearce RJ, Drakeley C, Chandramohan D, Mosha F, Roper C, 2003. Molecular determination of point mutation haplotypes in the dihydrofolate reductase and dihydropteroate synthase of Plasmodium falciparum in three districts of northern Tanzania. Antimicrob Agents Chemother 47 :1347–1354.
Hastings MD, Bates SJ, Blackstone EA, Monks SM, Mutabingwa TK, Sibley CH, 2002. Highly pyrimethamine-resistant alleles of dihydrofolate reductase in isolates of Plasmodium falciparum from Tanzania. Trans R Soc Trop Med Hyg 96 :674–676.
Ochong E, Nzila A, Serah K, Kokwaro G, Mutabingwa T, Watkins W, Marsh K, 2003. Molecular monitoring of the Leu-164 mutation of dihydrofolate reductase in a highly sulfadoxine/pyrimethamine-resistant area in Africa. Malar J 2 :46–48.
Wichmann O, Jelinek T, Peyerl-Hoffmann G, Mühlberger N, Grobusch M, Gascon J, Matteelli A, Hatz C, Laferl H, Schulze M, Burchard G, da Cunha S, Beran J, McWhinney P, Kollaritsch H, Kern P, Caudros J, Alifrangis M, Gjørup I, European Network on Surveillance of Imported Infectious Diseases, 2003. Molecular surveillance of the antifolate-resistant mutation I164L in imported African isolates of Plasmodium falciparum in Europe: Sentinel data from Trop Net Europ. Malar J 2 :17–21.
Bwijo B, Kaneko A, Takechi M, Zungu IL, Moriyama Y, Lum JK, Tsukahara T, Mita T, Takahashi N, Bergqvist Y, Bjorkman A, Kobayakawa T, 2003. High Prevalence of quintuple mutant dhps/dhfr genes in Plasmodium falciparum infections seven years after introduction of sulfadoxine and pyrimethamine as the first line treatment in Malawi. Acta Trop 85 :363–373.
Wang PL, Bayoumi R, Djimde A, Doumbo O, Swedberg G, Dao LD, Mshinda H, Tanner M, Watkins WM, Sims PF, Hyde E, 1997. Resistance to antifolate in plasmodium falciparum monitored by sequence analysis of dihydropteroate synthase and dihydrofolate reductase alleles in a large number of field samples of diverse origins. Mol Biochem Parasitol 89 :161–177.
Roper C, Pearce R, Bredenkamp B, Gumede J, Drackeley C, Mosha F, Chandramohan D, Sharp B, 2003. Antifolate anti-malarial resistance in southern Africa: a population-based analysis. Lancet 361 :1174–1181.
Nair S, Williams JT, Brockman A, Paiphun L, Mayxay M, Newton PN, Guthmann J-P, Smithuis FM, Hein TT, White NJ, Nosten F, Anderson TJC, 2003. A selective sweep driven by pyrimethamine treatment in southeast Asian malaria parasites. Mol Biol Evol 20 :1526–1536.
Past two years | Past Year | Past 30 Days | |
---|---|---|---|
Abstract Views | 991 | 924 | 838 |
Full Text Views | 350 | 8 | 5 |
PDF Downloads | 72 | 8 | 4 |