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Higher gametocyte prevalence following failure of treatment of Plasmodium falciparum malaria with sulfadoxine-pyrimethamine and the combination of chloroquine plus sulfadoxine-pyrimethamine: implications for progression of anti-folate resistance

Tjitra, E., Suprianto, S. and Anstey, Nicholas M. (2002). Higher gametocyte prevalence following failure of treatment of Plasmodium falciparum malaria with sulfadoxine-pyrimethamine and the combination of chloroquine plus sulfadoxine-pyrimethamine: implications for progression of anti-folate resistance. Transactions of the Royal Society of Tropical Medicine and Hygiene,96(4):434-437.

Document type: Journal Article
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Title Higher gametocyte prevalence following failure of treatment of Plasmodium falciparum malaria with sulfadoxine-pyrimethamine and the combination of chloroquine plus sulfadoxine-pyrimethamine: implications for progression of anti-folate resistance
Author Tjitra, E.
Suprianto, S.
Anstey, Nicholas M.
Journal Name Transactions of the Royal Society of Tropical Medicine and Hygiene
Publication Date 2002
Volume Number 96
Issue Number 4
ISSN 0035-9203   (check CDU catalogue open catalogue search in new window)
Start Page 434
End Page 437
Total Pages 4
Place of Publication Oxford, UK
Publisher Elsevier
Language English
Field of Research 320000 Medical and Health Sciences
Abstract Chloroquine (CQ) treatment of CQ-resistant Plasmodium falciparum is associated with a significantly higher prevalence of post-treatment gametocytaemia which has been linked to the preferential transmission of CQ-resistant parasites. It is not known whether treatment failure (TF) with sulfadoxine-pyrimethamine (SP) is associated with the same higher prevalence of gametocytaemia as that seen with CQ TF. Using 1997 WHO in-vivo drug efficacy protocols for malaria, we therefore compared (in a study in 1999) the frequency of gametocytaemia in those with TF to the frequency seen in those with an adequate clinical and parasitological response (ACPR) following treatment with one of 3 regimens in Papua, Indonesia: SP monotherapy (n = 87; TF 20.7%), CQ monotherapy (n = 48; TF 83.3%), and the combination of CQ plus SP (n = 34; TF 38.2%). Following SP, day 7 prevalence was significantly higher in those with TF (67%) than with ACPR (38%, P = 0.03). Following combination treatment with CQ + SP, the day 14 gametocyte prevalence was significantly higher in those with TF (100% vs 38%, P = 0.016). The higher prevalence of SP TF-associated gametocytaemia may contribute to increased transmission of antifolate-resistant strains, and further cautions against the use of SP as monotherapy. Adding SP to CQ, after significant resistance has emerged to both drugs, may not prevent enhanced transmission of dual-resistant strains and progression of anti-folate resistance.
Keywords anti-folate
chloroquine
falciparum
gametocyte
malaria
Plasmodium
sulfadoxine-pyrimethamine
DOI http://dx.doi.org/10.1016/S0035-9203(02)90385-8   (check subscription with CDU E-Gateway service for CDU Staff and Students  check subscription with CDU E-Gateway in new window)
Additional Notes 3700 (Journal) DA - 20021224IS - 0035-9203 (Print)LA - engPT - Journal ArticlePT - Research Support, Non-U.S. Gov'tRN - 0 (Antimalarials)RN - 0 (Drug Combinations)RN - 2447-57-6 (Sulfadoxine)RN - 37338-39-9 (sulfadoxine-pyrimethamine)RN - 54-05-7 (Chloroquine)RN - 58-14-0 (Pyrimethamine)SB - IM
 
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