Sokoine University of Agriculture

The genetic change in P. falciparum populations of rural Tanzania resulting from national policy on firstline malaria treatment and pilot Sulfadoxine/pyrimethamine and Artesunate combination

Show simple item record

dc.contributor.author Malisa, Allen L
dc.contributor.author Pearce, Richard J
dc.contributor.author Abdullah, Salim
dc.contributor.author Mshinda, Hassan
dc.contributor.author Kachur, Patrick
dc.contributor.author Bloland, Peter
dc.contributor.author Roper, Cally
dc.date.accessioned 2016-12-15T14:08:13Z
dc.date.available 2016-12-15T14:08:13Z
dc.date.issued 2010-10
dc.identifier.uri http://hdl.handle.net/123456789/1108
dc.description Malaria Journal 2010, 9(Suppl 2):P20 en_US
dc.description.abstract Theory predicts that we can protect the efficacy of future antimalarials by changing treatment practice or drug formulation, but the potential success of such interventions rests upon their impact on drug pressure in the field. So far, gathering field data on the relationship between policy, drug pressure, recombination and the evolution of resistance has been entirely challenging. To test these predictions, dhfr and dhps frequency changes were measured in two rural districts of Rufiji and Kilombero/Ulanga during 2000-2006, and the frequencies of the two genes compared prior, during and after antimalarial policy change from first line CQ to first line SP in 2001. Furthermore, while SP first line was maintained in Kilombero/Ulanga, pilot combination therapy of SP+Artesunate (ART) was introduced in Rufiji in 2002 to replace SP and dhfr and dhps frequency changes compared between the two districts. Size polymorphisms at three sets of microsatellite loci linked to dhfr and three other sets of unlinked microsatellite loci were analysed. Genetic analysis of SP resistance genes was carried out on 9,662 Plasmodium falciparum infections identified in a series of annual cross sectional surveys conducted in the two districts between 2000-2006. The frequency of dhfr and dhps resistance alleles did not change significantly while SP was the recommended second-line treatment, but highly significant changes occurred during the subsequent year after the switch to first line SP. The frequency of the triple mutant dhfr allele increased by 37% -63% and that of double mutant dhps allele increased 200%-300%. A strong association between these unlinked alleles also emerged; confirming that they are co-selected by SP. Distribution of major lineages indicates that there is extensive genetic exchange among the geographic regions. Combination therapy had visible effect on the frequencies of dhfr and dhps resistance alleles. The findings of this study provide insight on the interplay between policy, drug pressure, recombination and the evolution of resistance. en_US
dc.language.iso en en_US
dc.publisher Malaria Journal en_US
dc.subject Malaria treatment en_US
dc.subject Sulfadoxine-pyrimethamine en_US
dc.subject Ant-malaria en_US
dc.subject Artesunate combination en_US
dc.subject Rufiji en_US
dc.subject Kilombero-Ulanga en_US
dc.title The genetic change in P. falciparum populations of rural Tanzania resulting from national policy on firstline malaria treatment and pilot Sulfadoxine/pyrimethamine and Artesunate combination en_US
dc.type Article en_US
dc.url http://www.malariajournal.com/content/9/S2/P20 en_US


Files in this item

This item appears in the following Collection(s)

Show simple item record

Search SUA IR


Advanced Search

Browse

My Account

Statistics