Associations between malaria preventive regimens and Plasmodium falciparum drug resistance mediating polymorphisms in Ugandan pregnant women.

Associations between malaria preventive regimens and Plasmodium falciparum drug resistance mediating polymorphisms in Ugandan pregnant women. Antimicrob Agents Chemother. 2020 Oct 05;: Authors: Nayebare P, Asua V, Conrad MD, Kajubi R, Kakuru A, Nankabirwa JI, Muhanguzi D, Dorsey G, Kamya MR, Nsobya S, Rosenthal PJ Abstract Intermittent preventive treatment in pregnancy (IPTp) with monthly sulfadoxine-pyrimethamine (SP) is recommended for malaria-endemic parts of Africa, but efficacy is compromised by resistance and, in recent trials, dihydroartemisinin-piperaquine (DP) has shown better antimalarial protective efficacy. We utilized blood samples from a recent trial to evaluate selection by IPTp with DP or SP of Plasmodium falciparum genetic polymorphisms that alter susceptibility to these drugs. The prevalence of known genetic polymorphisms associated with altered drug susceptibility was determined in parasitemic samples, including 375 collected before IPTp drugs were administered, 125 randomly selected from those receiving SP, and 80 from those receiving DP. For women receiving DP, the prevalence of mixed/mutant sequences was greater in samples collected during IPTp compared to that in samples collected prior to the intervention for PfMDR1 N86Y (19.7% vs. 4.1%, p<0.001), PfMDR1 Y184F (73.7% vs. 53.6%, p=0.002), and PfCRT K76T (45.6% vs. 24.4%, p=0.002). Considering SP, prior to IPTp the prevalence of all 5 common antifolate mutati...
Source: Antimicrobial Agents and Chemotherapy - Category: Microbiology Authors: Tags: Antimicrob Agents Chemother Source Type: research