ArticleMalaria journal2014
High levels of sulphadoxine-pyrimethamine resistance Pfdhfr-Pfdhps quintuple mutations: a cross sectional survey of six regions in Tanzania.
Article in Malaria journal, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 2 of them syntheses that pooled it.
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Who cites it
38 citing papers in PubMed, 2 syntheses or guidelines pooled it, 65 citations in OpenAlex.
- Prevalence of antimalaria drug resistance-conferring mutations associated with sulphadoxine-pyrimethamineine-resistant Plasmodium falciparum in East Africa: a systematic review and meta-analysis.Annals of clinical microbiology and antimicrobials · 2025Pooled it
- Drug resistance markers within an evolving efficacy of anti-malarial drugs in Cameroon: a systematic review and meta-analysis (1998-2020).Malaria journal · 2021Pooled it
- Intermittent Preventive Treatment With Dihydroartemisinin-Piperaquine for the Prevention of Malaria Among HIV-Infected Pregnant Women.The Journal of infectious diseases · 2017Trial
- Dihydroartemisinin-Piperaquine for the Prevention of Malaria in Pregnancy.The New England journal of medicine · 2016Trial
- Evolving patterns of antimalarial drug resistance markers in symptomatic infections in Kenya, 2013-2022.Parasites & vectors · 2026Article
- Trends in Plasmodium falciparum resistance markers to sulfadoxine-pyrimethamine and amodiaquine over ten years of seasonal malaria chemoprevention in Moissala Health District, Chad.Malaria journal · 2025Article
- A scoping review of antimalarial drug resistance markers in Kenya (1987-2022): toward a National Surveillance Framework and Data Repository.Malaria journal · 2025Article
- Prevalence of resistance markers of artemisinin, partner drugs, and sulfadoxine-pyrimethamine in Nanyumbu and Masasi Districts, Tanzania between 2020 and 2021.Antimicrobial agents and chemotherapy · 2025Article
- A NovelmedRxiv : the preprint server for health sciences · 2025Article
- A Narrative Review on the Prevalence ofTropical medicine and infectious disease · 2025Review
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- Exploring the relationship betweenThe Pan African medical journal · 2024Article
- Peripheral and Placental Prevalence of Sulfadoxine-Pyrimethamine Resistance Markers in Plasmodium falciparum among Pregnant Women in Southern Province, Rwanda.The American journal of tropical medicine and hygiene · 2023Article
- Evolution of Plasmodium falciparum antimalarial drug resistance markers post-adoption of artemisinin-based combination therapies in Yaounde, Cameroon.International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2023Article
- A snapshot of the prevalence of dihydropteroate synthase-431V mutation and other sulfadoxine-pyrimethamine resistance markers in Plasmodium falciparum isolates in Nigeria.Malaria journal · 2023Article
- Resistance to Antimalarial Monotherapy Is Cyclic.Journal of clinical medicine · 2022Article
- Review of the Current Landscape of the Potential of Nanotechnology for Future Malaria Diagnosis, Treatment, and Vaccination Strategies.Pharmaceutics · 2021Review
- Temporal evolution of sulfadoxine-pyrimethamine resistance genotypes and genetic diversity in response to a decade of increased interventions against Plasmodium falciparum in northern Ghana.Malaria journal · 2021Article
- Article
- Molecular surveillance of anti-malarial resistance Pfdhfr and Pfdhps polymorphisms in African and Southeast Asia Plasmodium falciparum imported parasites to Wuhan, China.Malaria journal · 2020Article
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Authors and funding
8 authors at 2 institutions in 2 countries.
Funding
Abstract
backgroundIn 2006, the first-line anti-malarial drug treatment in Tanzania was changed from sulphadoxine-pyrimethamine (SP) to artemether-lumefantrine (ALu), an artemisinin-based combination (ACT), since when the use of SP has been restricted for intermittent preventive treatment in pregnancy (IPTp). A number of Plasmodium falciparum mutations are known to be associated with resistance to SP, but it is not known if the prevalence of these mutations is increasing or decreasing under the conditions of reduced levels of SP use. This study reports on the current SP resistant quintuple Pfdhfr-Pfdhps mutations in six regions of Tanzania.
methodsFinger-prick blood on filter paper and rapid diagnostic test strips from P. falciparum-positive individuals of all age groups attending health facilities in six regions of Tanzania between June 2010 and August 2011 were obtained. Using chelex-100 extracted DNA, genotyping was done for mutations on codons 51, 59 and 108 of Pfdhfr and 437 and 540 of Pfdhps genes using PCR-RFLP technique.
resultsA total of 802 malaria-positive samples were screened and genotyped. The prevalence of Pfdhfr 51I, Pfdhps 437G and 540E varied between the regions (p < 0.001) whereas Pfdhfr 59R (FE 10.79, p = 0.225) and 108 N (FE 10.61, p = 0.239) did not vary between the regions. The Pfdhfr triple mutant was above 84% and close to fixation levels in all regions, whereas the Pfdhps double mutation ranged from 43.8 to 97% between the regions. The quintuple mutant (IRNGE) was the most prevalent in all regions and it varied significantly from 37.5 to 90.2% (χ(2) = 1.11, p <0.001).
conclusionsThere is evidence of persistent high levels of SP resistance markers in Tanzania with evidence of quintuple mutations that are likely to become fixed in the population. This threatens the future of SP not only in IPTp programmes, but as a combination drug for ACT. Continuous monitoring of SP-IPTp efficacy should be encouraged subsequent to searching for alternative drugs for IPTp in East Africa.
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