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EFFICACY OF SULFADOXINE-PYRIMETHAMINE IN THE TREATMENT OF UNCOMPLICATED PLASMODIUM FALCIPARUM MALARIA IN EAST TIMOR

MATTHEW BURNSMedical Emergency Relief International, London, United Kingdom; Australian Army Malaria Institute, Brisbane, Queensland, Australia; Division of Infectious Diseases and Immunology, Queensland Institute of Medical Research, Brisbane, Queensland, Australia; Australian Centre for International and Tropical Health and Nutrition, University of Queensland, Brisbane, Queensland, Australia

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JOANNE BAKERMedical Emergency Relief International, London, United Kingdom; Australian Army Malaria Institute, Brisbane, Queensland, Australia; Division of Infectious Diseases and Immunology, Queensland Institute of Medical Research, Brisbane, Queensland, Australia; Australian Centre for International and Tropical Health and Nutrition, University of Queensland, Brisbane, Queensland, Australia

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ALYSON M. AULIFFMedical Emergency Relief International, London, United Kingdom; Australian Army Malaria Institute, Brisbane, Queensland, Australia; Division of Infectious Diseases and Immunology, Queensland Institute of Medical Research, Brisbane, Queensland, Australia; Australian Centre for International and Tropical Health and Nutrition, University of Queensland, Brisbane, Queensland, Australia

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MICHELLE L. GATTONMedical Emergency Relief International, London, United Kingdom; Australian Army Malaria Institute, Brisbane, Queensland, Australia; Division of Infectious Diseases and Immunology, Queensland Institute of Medical Research, Brisbane, Queensland, Australia; Australian Centre for International and Tropical Health and Nutrition, University of Queensland, Brisbane, Queensland, Australia

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MICHAEL D. EDSTEINMedical Emergency Relief International, London, United Kingdom; Australian Army Malaria Institute, Brisbane, Queensland, Australia; Division of Infectious Diseases and Immunology, Queensland Institute of Medical Research, Brisbane, Queensland, Australia; Australian Centre for International and Tropical Health and Nutrition, University of Queensland, Brisbane, Queensland, Australia

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QIN CHENGMedical Emergency Relief International, London, United Kingdom; Australian Army Malaria Institute, Brisbane, Queensland, Australia; Division of Infectious Diseases and Immunology, Queensland Institute of Medical Research, Brisbane, Queensland, Australia; Australian Centre for International and Tropical Health and Nutrition, University of Queensland, Brisbane, Queensland, Australia

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The efficacy of sulfadoxine-pyrimethamine (SP) in East Timor is unknown. We treated 38 individuals with uncomplicated Plasmodium falciparum malaria with SP and monitored the outcome for 28 days. Recrudescent parasitemia, confirmed by genotyping, were detected in three individuals resulting in a late treatment failure rate of 7.9% (95% confidence interval = 1.7–21.4%). The results suggest that SP is still efficacious in treating uncomplicated P. falciparum malaria in East Timor. However, the useful life of SP in East Timor may be limited because 80% of the parasites in our samples were found to already carry double mutations in P. falciparum dihydrofolate reductase (S108N/C59R). The data from this study also highlights that the presence of gametocytes may significantly influence the estimate of SP efficacy determined by genotyping.

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