Counter-Selection of Antimalarial Resistance Polymorphisms by Intermittent Preventive Treatment in Pregnancy
J. infect. dis
; 221(2): 293-203, Jan 2. 2020. tab, graf, mapas
Artigo
em Inglês
| AIM (África), RDSM
| ID: biblio-1530922
Biblioteca responsável:
MZ1.1
ABSTRACT
Background:
Innovative approaches are needed to limit antimalarial resistance evolution. Understanding the role of intermittent preventive treatment in pregnancy (IPTp) on the selection for resistance and the impact such selection has on pregnancy outcomes can guide future interventions.Methods:
Plasmodium falciparum isolates (n = 914) from 2 randomized clinical trials were screened for pfmdr1 copy number variation and pfcrt, pfmdr1, pfdhfr, and pfdhps resistance markers. The trials were conducted between 2010 and 2013 in Benin, Gabon, Kenya, and Mozambique to establish the efficacy of IPTp-mefloquine (MQ) compared with IPTp-sulphadoxine-pyrimethamine (SP) in human immunodeficiency virus (HIV)-uninfected and to IPTp-placebo in HIV-infected women.Results:
In HIV-uninfected women, the prevalence of pfcrt mutants, pfdhfr/pfdhps quintuple mutants, and pfmdr1 copy number was similar between women receiving IPT-SP and IPTp-MQ. However, prevalence of pfmdr1 polymorphism 86Y was lower in the IPTp-MQ group than in the IPTp-SP group, and within the IPTp-MQ group it was lower at delivery compared with recruitment. No effect of IPTp-MQ on resistance markers was observed among HIV-infected women. The carriage of resistance markers was not associated with pregnancy outcomes.
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Assuntos
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Coleções:
Bases de dados nacionais
/
Moçambique
Base de dados:
AIM (África)
/
RDSM
Assunto principal:
Malária Falciparum
/
Resistência a Múltiplos Medicamentos
/
Antimaláricos
Limite:
Adulto
/
Feminino
/
Humanos
/
Gravidez
Idioma:
Inglês
Revista:
J. infect. dis
Ano de publicação:
2020
Tipo de documento:
Artigo
Instituição/País de afiliação:
Center for Global Health/US
/
Centre de Recherches Médicales de Lambaréné/GA
/
Centro de Investigação em Saúde da Manhiça/MZ
/
Faculté des Sciences de la Santé/BJ
/
Ifakara Health Institute/TZ
/
Kenya Medical Research Institute/KE
/
Universitat de Barcelona/ES
/
University of Barcelona/ES
/
Université de Paris/FR