4.1 Article

Antifolate resistance in Africa and the 164-dollar question

Publisher

ELSEVIER SCIENCE INC
DOI: 10.1016/j.trstmh.2008.01.003

Keywords

malaria; Plasmodium falciparum; dihydrofolate reductase; quadruple mutants; drug treatment; sulfadoxine-pyrimethamine

Funding

  1. Wellcome Trust [073896] Funding Source: Medline

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The spread of Plasmodium falciparum carrying a quadruply mutated dhfr gene to Africa has been widely predicted to have profoundly adverse consequences, as such parasites in vitro are highly resistant to antifolate inhibitiors, still a mainstay of antimalarial drug regimes in this region. Studies of parasites from Southeast Asia demonstrate a strong connection between the I164L-bearing quadruple mutant form and failure of sulfadoxine-pyrimethamine (SP) treatment. However, a recent study reported in this issue of Transactions documents the low-level incidence in an area of Kenya of quadruply mutant parasites which, in the majority of cases, appear to have been cleared by a standard SP treatment regime, contrary to expectations. (c) 2008 Royal Society of Tropical Medicine and Hygiene. Published by Elsevier Ltd. All rights reserved.

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