Evidence map›Paper›PMID 33546703›Full record

ArticleMalaria journal2021

Low prevalence of highly sulfadoxine-resistant dihydropteroate synthase alleles in Plasmodium falciparum isolates in Benin.

Samaly Souza Svigel, Adicath Adeothy, Augustin Kpemasse, Ernest Houngbo, Antoine Sianou, Ramani Saliou, Monica E Patton, Fortune Dagnon, Eric S Halsey, Alexis Tchevoede and 2 more

Open access · goldAbstract read
In one paragraph

Article in Malaria journal, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed
2.6field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 16 citations in OpenAlex.

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  9. Prevalence of Mutations in theTropical medicine and infectious disease · 2022
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  11. Profiling antimalarial drug-resistant haplotypes inTherapeutic advances in infectious disease
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 5 institutions in 1 country.

Samaly Souza SvigelMalaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, USA. ynp4@cdc.gov.
Adicath AdeothyNational Malaria Control Programme, Ministry of Health, Cotonou, Benin.
Augustin KpemasseNational Malaria Control Programme, Ministry of Health, Cotonou, Benin.
Ernest HoungboNational Malaria Control Programme, Ministry of Health, Cotonou, Benin.
Antoine SianouNational Malaria Control Programme, Ministry of Health, Cotonou, Benin.
Ramani SaliouAccelerating the Reduction of Malaria Morbidity and Mortality Project (ARM3), Medical Care Development International, Cotonou, Benin.
Monica E PattonMalaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Fortune DagnonU.S. President's Malaria Initiative, USAID, Cotonou, Benin.
Eric S HalseyMalaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Alexis TchevoedeNational Malaria Control Programme, Ministry of Health, Cotonou, Benin.
Venkatachalam UdhayakumarMalaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Naomi W LucchiMalaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Division of Parasitic Diseases and Malaria · USCenters for Disease Control and Prevention · USJohn Snow (United States) · USMedical Care Development International · USU.S. President's Malaria Initiative · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn 2004, in response to high levels of treatment failure associated with sulfadoxine-pyrimethamine (SP) resistance, Benin changed its first-line malaria treatment from SP to artemisinin-based combination therapy for treatment of uncomplicated Plasmodium falciparum malaria. Resistance to SP is conferred by accumulation of single nucleotide polymorphisms (SNPs) in P. falciparum genes involved in folate metabolism, dihydrofolate reductase (Pfdhfr) and dihydropteroate synthase (Pfdhps), targeted by pyrimethamine and sulfadoxine, respectively. Because SP is still used for intermittent preventive treatment in pregnant women (IPTp) and seasonal malaria chemoprevention (SMCP) in Benin, the prevalence of Pfdhfr and Pfdhps SNPs in P. falciparum isolates collected in 2017 were investigated.

methodsThis study was carried out in two sites where the transmission of P. falciparum malaria is hyper-endemic: Klouékanmey and Djougou. Blood samples were collected from 178 febrile children 6-59 months old with confirmed uncomplicated P. falciparum malaria and were genotyped for SNPs associated with SP resistance.

resultsThe Pfdhfr triple mutant IRN (N51I, C59R, and S108N) was the most prevalent (84.6%) haplotype and was commonly found with the Pfdhps single mutant A437G (50.5%) or with the Pfdhps double mutant S436A and A437G (33.7%). The quintuple mutant, Pfdhfr IRN/Pfdhps GE (A437G and K540E), was rarely observed (0.8%). The A581G and A613S mutant alleles were found in 2.6 and 3.9% of isolates, respectively. Six isolates (3.9%) were shown to harbour a mutation at codon I431V, recently identified in West African parasites.

conclusionsThis study showed that Pfdhfr triple IRN mutants are near fixation in this population and that the highly sulfadoxine-resistant Pfdhps alleles are not widespread in Benin. These data support the continued use of SP for chemoprevention in these study sites, which should be complemented by periodic nationwide molecular surveillance to detect emergence of resistant genotypes.

Indexed as

AllelesAntimalarialsBeninChild, PreschoolDihydropteroate SynthaseDrug CombinationsDrug ResistanceFemaleHumansInfantMalaria, FalciparumMalePlasmodium falciparumPrevalencePyrimethamineSulfadoxineAntimalarialsDihydropteroate SynthaseDrug Combinationsfanasil, pyrimethamine drug combinationPyrimethamineSulfadoxineDrug resistanceIntermittent Preventive Treatment in PregnantMalariaPfdhfrPfdhpsPregnant womenSeasonal Malaria ChemopreventionSulfadoxine Pyrimethamine

Identifiers

PMID33546703
PMCPMC7866691
OpenAlexW3126279747

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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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.