Rapid increase of Plasmodium falciparum dhfr/dhps resistant haplotypes, after the adoption of sulphadoxine-pyrimethamine as first line treatment in 2002, in southern Mozambique
2008

Increase of Malaria Drug Resistance in Mozambique

Sample size: 344 publication Evidence: high

Author Information

Author(s): Enosse Sonia, Magnussen Pascal, Abacassamo Fatima, Gómez-Olivé Xavier, Rønn Anita M, Thompson Ricardo, Alifrangis Michael

Primary Institution: Instituto Nacional de Saúde, Ministério de Saúde, Maputo, Mozambique

Hypothesis

What is the impact of changing first-line malaria treatment to sulphadoxine-pyrimethamine on drug resistance in Plasmodium falciparum?

Conclusion

The study found a significant increase in drug resistance-related haplotypes in malaria parasites after changing the first-line treatment to sulphadoxine-pyrimethamine.

Supporting Evidence

  • The frequency of the Pfdhps double mutant haplotype increased from 14% to 35%.
  • The triple mutant Pfdhfr haplotype changed marginally from 46% to 53%.
  • The quintuple mutant haplotype increased from 8% to 26%.

Takeaway

When Mozambique switched to a new malaria treatment, the number of drug-resistant parasites increased a lot in just one year.

Methodology

The study involved two cross-sectional surveys with random sampling of children and adults to analyze resistance-related haplotypes in malaria parasites.

Potential Biases

Potential bias due to unmeasured consumption of other antifolate drugs and migration changes.

Limitations

The study did not measure actual SP use outside health services, which could affect the results.

Participant Demographics

Participants included children one year or older and adults from Maciana, a malaria-endemic area in Mozambique.

Statistical Information

P-Value

p<0.001

Statistical Significance

p<0.001

Digital Object Identifier (DOI)

10.1186/1475-2875-7-115

Want to read the original?

Access the complete publication on the publisher's website

View Original Publication