Trial reportTropical medicine & international health : TM & IH2008
dhfr and dhps genotype and sulfadoxine-pyrimethamine treatment failure in children with falciparum malaria in the Democratic Republic of Congo.
Trial report in Tropical medicine & international health : TM & IH, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
28 citing papers in PubMed, 4 syntheses or guidelines pooled it, 48 citations in OpenAlex.
- Risk of drug resistance in Plasmodium falciparum malaria therapy-a systematic review and meta-analysis.Parasitology research · 2017Pooled it
- Falciparum malaria molecular drug resistance in the Democratic Republic of Congo: a systematic review.Malaria journal · 2015Pooled it
- Pooled it
- A systematic review and meta-analysis of evidence for correlation between molecular markers of parasite resistance and treatment outcome in falciparum malaria.Malaria journal · 2009Pooled it
- Randomized comparison of the efficacies and tolerabilities of three artemisinin-based combination treatments for children with acute Plasmodium falciparum malaria in the Democratic Republic of the Congo.Antimicrobial agents and chemotherapy · 2014Trial
- Trial
- Trial
- Pharmacokinetics and pharmacodynamics of a new ACT formulation: Artesunate/Amodiaquine (TRIMALACT) following oral administration in African malaria patients.European journal of drug metabolism and pharmacokineticsTrial
- Emerging Molecular Mechanisms in Malaria Pathogenesis and Novel Therapeutic Approaches: A Focus onBiomolecules · 2025Review
- Exploring the relationship betweenThe Pan African medical journal · 2024Article
- Computational Studies on 6-Pyruvoyl Tetrahydropterin Synthase (6-PTPS) ofBioinformatics and biology insights · 2024Article
- The landscape of drug resistance in Plasmodium falciparum malaria in the Democratic Republic of Congo: a mapping systematic review.Tropical medicine and health · 2023Review
- Molecular Determinants of Sulfadoxine-Pyrimethamine Resistance in Plasmodium falciparum Isolates from Central Africa between 2016 and 2021: Wide Geographic Spread of Highly MutatedMicrobiology spectrum · 2022Article
- It Is Time to Strengthen the Malaria Control Policy of the Democratic Republic of Congo and Include Schools and School-Age Children in Malaria Control Measures.Pathogens (Basel, Switzerland) · 2022Review
- Probing the Structural Dynamics of theFrontiers in molecular biosciences · 2020Article
- The changing landscape of Plasmodium falciparum drug resistance in the Democratic Republic of Congo.BMC infectious diseases · 2019Article
- Article
- Molecular identification of sulfadoxine-pyrimethamine resistance in malaria infected women who received intermittent preventive treatment in the Democratic Republic of Congo.Malaria journal · 2018Article
- Prevalence ofInfection and drug resistance · 2018Article
- The Impact of Artesunate-Amodiaquine on Schistosoma mansoni Infection among Children Infected by Plasmodium in Rural Area of Lemfu, Kongo Central, Democratic Republic of the Congo.BioMed research international · 2018Article
Corrections and comments
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Authors and funding
6 authors at 5 institutions in 2 countries.
Funding
Abstract
objectiveTo determine the relationship between mutations in dhfr and dhps and SP treatment failure in Plasmodium falciparum malaria in the Democratic Republic of the Congo (DRC).
methodsTherapeutic efficacy trial was conducted in Rutshuru, Eastern DRC, between June and September 2002, comparing sulfadoxine-pyrimethamine (SP), SP plus amodiaquine (AQSP) and artesunate plus SP (ASSP) regimens for treating malaria in children under 5 years old. We genotyped 212 samples for mutations associated with SP resistance and investigated their association with treatment failure.
resultsIn the SP arm, 61% of the subjects experienced treatment failure after 14 days. The failure rate was lower in the combination arms (AQSP: 32%, ASSP: 21%). The dhfr-108 and dhfr-51 mutations were nearly universal while 89% of the samples had at least one additional mutation at dhfr-59, dhps-437 or dhps-540. Dhps mutations had a bigger impact on treatment failure in children with high parasite density: for children with a parasite density <45 000 parasites/microl, the risk of treatment failure was 37% for mutations at dhps-437 and dhps-540 mutation and 21% for neither mutation [risk difference (RD) = 17%, 95% CI: -3%, 36%]. In children with a parasite density >45 000 parasites/microl, the treatment failure risk was 58% and 8% for children with both mutations or neither mutation, respectively (RD = 51%, 95% CI: 34%, 67%).
conclusionsDhps-437 and dhps-540 are strongly associated with SP treatment failure and should be evaluated further as a method for surveillance of SP-based therapy in DRC.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.