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Increased prevalence of dhfr and dhps mutants at delivery in Malawian pregnant women receiving intermittent preventive treatment for malaria
Author(s) -
Lin Jessica T.,
Mbewe Bernard,
Taylor Steve M.,
Luntamo Mari,
Meshnick Steven R.,
Ashorn Per
Publication year - 2013
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/tmi.12028
Subject(s) - dhps , sulfadoxine/pyrimethamine , malaria , sulfadoxine , medicine , dihydropteroate synthase , plasmodium falciparum , context (archaeology) , dihydrofolate reductase , parasitemia , pregnancy , population , drug resistance , obstetrics , pyrimethamine , immunology , biology , environmental health , genetics , methotrexate , paleontology
In the context of an Intermittent preventive treatment ( IPT p) trial for pregnant women in Malawi, Plasmodium falciparum samples from 85 women at enrolment and 35 women at delivery were genotyped for mutations associated with sulfadoxine–pyrimethamine resistance. The prevalence of the highly resistant haplotype with mutations at codons 51 and 108 of dihydrofolate reductase ( dhfr ) and codons 437 and 540 of dihydropteroate synthase ( dhps ) increased from 81% at enrolment to 100% at delivery ( P = 0.01). Pregnant women who were smear‐positive at enrolment were more likely to have P. falciparum parasitemia at delivery. These results lend support to concerns that IPT p use may lead to increased drug resistance in pregnant women during pregnancy and emphasise the importance of screening pregnant women for malaria parasites in areas with prevalent SP resistance even when they are already on IPT p.