Decline in sulfadoxine-pyrimethamine-resistant alleles after change in drug policy in the Amazon region of Peru - PubMed (original) (raw)

Decline in sulfadoxine-pyrimethamine-resistant alleles after change in drug policy in the Amazon region of Peru

Zhiyong Zhou et al. Antimicrob Agents Chemother. 2008 Feb.

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Abstract

The frequency of alleles with triple mutations conferring sulfadoxine-pyrimethamine (SP) resistance in the Peruvian Amazon Basin has declined (16.9% for dhfr and 0% for dhps compared to 47% for both alleles in 1997) 5 years after SP was replaced as the first-line treatment for Plasmodium falciparum malaria. Microsatellite analysis showed that the dhfr and dhps alleles are of common origin.

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Figures

FIG. 1.

FIG. 1.

Frequency of dhfr (A) and dhps (B) mutant alleles at two time points from the Iquitos region of Peru. The data for 2005 and 2006 came from this study; the data for 1997 were taken from the work of Kublin et al. (4). The difference in the frequencies of the dhfr and dhps alleles with triple mutations between the two points was highly significant (P < 0.0001), based on Fisher's exact test. The numbers of isolates were 141, 2, 5, and 30 for mutant dhfr alleles 108, 51/108, 108/164, and 51/108/164, respectively (a total of 178 samples were genotyped for dhfr). The numbers of isolates were 2, 1, 24, and 0 for mutant dhps alleles 437, 581, 437/581, and 437/540/581, respectively. The wild-type allele was present in 140 samples (a total of 167 samples were genotyped for dhps). One of the S108N/I164L allele isolates and all of the N51I/S108N/I164L allele isolates carried the Bolivia repeat.

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