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Background   Plasmodium falciparum  is the predominant human malaria species in Mozambique and a lead cause of mortality among children and pregnant women nationwide. Sulphadoxine/pyrimethamine (S/P) is used as first line antimalarial treatment as a partner drug in combination with artesunate.    Methods  A total of 92  P. falciparum -infected blood samples, from children with uncomplicated malaria attending the Centro de Saude de Bagamoyo in the Province of Maputo-Mozambique, were screened for S/P resistance-conferring mutations in the  pfdhfr  and  pfdhps  genes using a nested mutation-specific polymerase chain reaction and restriction digestion (PCR-RFLP). The panel of genetic polymorphisms analysed included the  pfdhfr  164L mutation, previously reported to be absent or rare in Africa.    Results  The frequency of the S/P resistance-associated  pfdhfr  triple mutants (51I/59R/108N) and of  pfdhfr/pfdhps  quintuple mutants (51I/59R/108N  +  437G/540E) was 93% and 47%, respectively. However, no  pfdhfr  164L mutants were detected.    Conclusion  The observation that a considerably high percentage of  P. falciparum  parasites contained S/P resistance-associated mutations raises concerns about the validity of this drug as first-choice treatment in Mozambique. On the other hand, no  pfdhfr  164L mutant was disclosed, corroborating the view that that this allele is still rare in Africa.

malaria journal

Analysis of sulphadoxine/pyrimethamine resistance-conferring mutations of Plasmodium falciparum from Mozambique reveals the absence of the dihydrofolate reductase 164L mutant