Resistance to chloroquine and sulfadoxine-pyrimethamine in Plasmodium falciparum in Muheza district, Tanzania

Warsame, Marian; Kilimali, V.A.E.B.; Wernsdorfer, W. H.; Lebbad, Marianne; Rutta, Acleus S. M.; Ericsson, Örjan

doi:10.1016/s0035-9203(99)90034-2

Cited by 23 publications

(16 citation statements)

References 3 publications

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“…In our study, SAM children were significantly younger, had low body temperature and less malaria parasitemia density compared to those without SAM. Warsame et al [24] observed also that patients who experienced clinical failure had significantly higher initial parasitaemia than those in whom there was an adequate clinical response.…”

Section: Discussionmentioning

confidence: 95%

“…By using, usually the drug efficacy steadily declined. In Rwanda, in the neighborhood of South Kivu province, using the combination amodiaquine + sulfadoxine/ pyrimethamine (AQ + SP), the total rates failures at day 28 was estimated as 17% in 2003 [24]. Two years after its adoption as the first-line antimalarial the total rates failures at day 28 raised up 25% [30].…”

Section: Discussionmentioning

confidence: 99%

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Efficacy of Artesunate Plus Amodiaquine for Treatment of Uncomplicated Clinical Falciparum Malaria in Severely Malnourished Children Aged 6–59 Months, Democratic Republic of Congo

Mitangala-Ndeba¹,

D’Alessandro

Hennart³

et al. 2013

J Clin Exp Pathol

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Efficacy of Artesunate Plus Amodiaquine for Treatment of Uncomplicated Clinical Falciparum Malaria in Severely Malnourished Children Aged 6–59 Months, Democratic Republic of Congo

Mitangala-Ndeba¹,

D’Alessandro

Hennart³

et al. 2013

J Clin Exp Pathol

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“…44 All children whose malaria was diagnosed at baseline were given treatment according to the standard of care in Tanzania; however, there is evidence of widespread resistance of P falciparum to chloroquine in Tanzania. 45,46 In vitro experiments show that retinol and quinine act synergistically in improving indices of parasite clearance 47 ; thus, vitamin A could constitute a low-cost, effective adjuvant of pharmacological treatment against adverse outcomes associated with malaria infection in infants.…”

Section: Figmentioning

confidence: 99%

Vitamin A Supplements Ameliorate the Adverse Effect of HIV-1, Malaria, and Diarrheal Infections on Child Growth

et al. 2002

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ABSTRACT. Objective. Evidence from animal experiments and observational studies in humans suggests that vitamin A plays a fundamental role in physical growth. However, results from vitamin A supplementation trials in children are inconsistent; whereas some did not find an overall effect on growth, others found benefits only among specific groups, including children with low concentrations of serum retinol or short duration of breastfeeding. The apparent lack of an overall effect of vitamin A on growth could be attributed to context-specific distribution of conditions that affect both growth and the response to supplementation, eg, baseline vitamin A status, deficiency of other nutrients (fat, zinc), and the presence of infectious diseases. Human immunodeficiency virus (HIV) infection, malaria, and diarrheal disease adversely affect growth and are associated with increased prevalence of vitamin A deficiency. We hypothesize that vitamin A supplementation could ameliorate the adverse effect of these infections on child growth.Methods. We conducted a randomized, clinical trial among 687 Tanzanian children who were 6 to 60 months of age and admitted to the hospital with pneumonia. Children were assigned to oral doses of 200 000 IU vitamin A (half that dose if <12 months) or placebo on the day of admission, a second dose on the following day, and third and fourth doses at 4 and 8 months after discharge from the hospital, respectively. Anthropometric measurements were obtained at baseline and at monthly visits to the study clinics during 12 months after the initial hospitalization. Surveillance on the incidence and severity of diarrhea and respiratory infections was conducted during biweekly visits, alternately at a study clinic and the child's home, using a pictorial diary that the mothers were trained to use. A blood specimen was drawn at baseline for determination of HIV status, malaria infection, and hemoglobin levels. We used mixed effects models to compare estimated total weight and height increases after 1 year of follow-up between treatment arms, overall and within levels of HIV status, malaria, and other possible baseline effect modifiers. We also assessed the potential modulating effect of vitamin A on the risk of stunting (height-for-age <؊2 standard deviations of the gender-specific National Center for Health Statistics median reference) attributable to diarrheal and respiratory infections during follow-up, in the subset of children who were not stunted at baseline. A similar approach was followed for wasting (weight-forheight <؊2 standard deviations of the reference median). Cox regression models were used to estimate relative risks and 95% confidence intervals (CI), treating episodes of infection as time-dependent covariates.Results. A total of 554 children had at least 2 follow-up measurements of height or weight and constituted the study base. Baseline characteristics did not differ significantly by treatment arm. Seventy-three percent of the children were <2 years of age, and 37% were <12 months; 31% w...

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“…The antifolate drug combination pyrimethamine (PM)-sulfadoxine (SDX) is the first-line drug used in several countries in East and Southern Africa, but reports of resistance to PM-SDX in the area are increasing [1][2][3][4]. The novel antifolate drug combination chlorproguanil (CPG)-dapsone (DDS) will be registered for general use soon.…”

mentioning

confidence: 99%

Mutations indhfrinPlasmodium falciparumInfections Selected by Chlorproguanil‐Dapsone Treatment

et al. 2002

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Treatment with the novel antifolate drug combination chlorproguanil-dapsone effectively cleared asymptomatic Plasmodium falciparum infections in 246 (93.5%) of 263 children in the Usambara Mountains of Tanzania during the course of a 2-week follow-up. Samples from 71 recurrent infections, collected over a 9-week follow-up, showed selection for parasites with the triple mutant Ile(51)-Arg(59)-Asn(108) in dihydrofolate reductase. There was no selection for mutations in dihydropteroate synthetase, the target enzyme of dapsone. Search for complete identity in the highly polymorphic genes coding for merozoite surface proteins 1 and 2 in parasite samples collected before and after treatment indicated that the majority of recurrent parasitemias were new infections. These observations on selection in Tanzania and the lack of selection reported from a less endemic area suggest that the active metabolite of chlorproguanil, which has a short half-life in the blood, may persist in the liver, where it exerts selective pressure on growing preerythrocytic stages.

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Resistance to chloroquine and sulfadoxine-pyrimethamine in Plasmodium falciparum in Muheza district, Tanzania

Cited by 23 publications

References 3 publications

Efficacy of Artesunate Plus Amodiaquine for Treatment of Uncomplicated Clinical Falciparum Malaria in Severely Malnourished Children Aged 6–59 Months, Democratic Republic of Congo

Efficacy of Artesunate Plus Amodiaquine for Treatment of Uncomplicated Clinical Falciparum Malaria in Severely Malnourished Children Aged 6–59 Months, Democratic Republic of Congo

Vitamin A Supplements Ameliorate the Adverse Effect of HIV-1, Malaria, and Diarrheal Infections on Child Growth

Mutations indhfrinPlasmodium falciparumInfections Selected by Chlorproguanil‐Dapsone Treatment

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