In vivo assessment of the sensitivity of Plasmodium falciparum to sulphadoxine/pyrimethamine combination (Fansidar) in six localities in Tanzania where chloroquine-resistant P. falciparum has been detected

Abstract

The sensitivity of Plasmodium falciparum strains to Fansidar (500 mg sulphadoxine/25 mg pyrimethamine) was tested in vivo in six localities in the United Republic of Tanzania where chloroquine-resistant P. falciparum strains have been demonstrated by both in vivo and in vitro tests. Single doses as recommended by the manufacturers achieved 100% clearance of parasitaemia in five localities with mean clearance period of between 2.2 and 2.9 days. In one locality (Gonja) the recommended dose failed to clear parasitaemia in two of the 38 cases (5.3%) within seven days. The possibility of using this drug combination for the treatment of chloroquine-resistant P. falciparum strains in the United Republic of Tanzania is discussed.

Malaria Control at the District Level in Africa: The Case of the Muheza District in Northeastern Tanzania

“…The po- (1985)(1986)(1987)(1988)(1989)(1990)(1991)(1992)(1993)(1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003). The sources reviewed were Kilmali and Mkufya, 49,50 Mutabingwa and Malle, 51 Irare and others, 52 Mutabingwa and others, 32 Fowler and others, 53 Kilimali and others, 54 Rønn, 33 Trigg and others, 55 Msangeni and others, 56 Warsame and others, 23 Mutabingwa and others, 38,39 Magesa and others, 57 and Lemnge and others. 58 tential alternative sources of care for those not reached by DHS include traditional medicines, self treatment, and private dispensaries.…”

Prevalence of mutations associated with antimalarial drugs in Plasmodium falciparum isolates prior to the introduction of sulphadoxine-pyrimethamine as first-line treatment in Iran

“…The antimalarial compounds sulphadoxine (S) and pyrimethamine (P) are usually given together as a synergistic combination, known commercially as Fansidar ® [ 3 ], and represent an effective agent against chloroquine-resistant P. falciparum . However, resistance to this drug has also been reported from parts of South East Asia, Latin America and Africa [ 4 - 6 ].…”

Drug-resistant Malaria: Laboratory and Field Investigations

“…Resistance to these drugs apparently depends largely on point mutations in the DHPS and DHFR genes (Peterson et a1 1990;Brooks et a1 1994). Combinations of type I and type I1 antifolates have been generally effective against pyrimethamine resistance, and at first resistance to SDX/PYR was not a significant problem (Kilimali & Mkufya 1985). Now it seems, particularly in East Africa and South East Asia, that resistance to SDX/PYR is becoming more widespread.…”