High Resistance of Plasmodium falciparum to Sulphadoxine/Pyrimethamine in Northern Tanzania
Author Information
Author(s): Gesase Samwel, Gosling Roly D., Hashim Ramadhan, Ord Rosalynn, Naidoo Inbarani, Madebe Rashid, Mosha Jacklin F., Joho Angel, Mandia Victor, Mrema Hedwiga, Mapunda Ephraim, Savael Zacharia, Lemnge Martha, Mosha Frank W., Greenwood Brian, Roper Cally, Chandramohan Daniel
Primary Institution: National Institute for Medical Research, Tanga Centre, Tanga, Tanzania
Hypothesis
Is Sulphadoxine/Pyrimethamine effective in treating malaria in symptomatic children and asymptomatic infants in Northern Tanzania?
Conclusion
In northern Tanzania, Sulphadoxine/Pyrimethamine is ineffective for treating malaria, showing high failure rates.
Supporting Evidence
- 82.2% of symptomatic children experienced treatment failure by day 28.
- 38.8% of symptomatic children had early treatment failures.
- 96% of samples carried mutations in the dhfr gene.
- 63% of samples had double mutations in the dhps gene.
- 55% of samples carried a mutation at codon 581 in the dhps gene.
- High failure rates were observed in both symptomatic and asymptomatic groups.
- The study was stopped early due to high failure rates.
- SP is no longer an effective treatment for malaria in the study area.
Takeaway
The medicine used to treat malaria isn't working well anymore in Tanzania, especially for young children.
Methodology
An open label single arm study comparing the efficacy of Sulphadoxine/Pyrimethamine in symptomatic children and asymptomatic infants.
Potential Biases
Potential bias due to early termination of the study and limited sample size in the asymptomatic group.
Limitations
The study was stopped early due to high failure rates, limiting the power to detect differences between groups.
Participant Demographics
Symptomatic children aged 6-59 months and asymptomatic infants aged 2-10 months.
Statistical Information
P-Value
0.012
Confidence Interval
95% CI 26.8–50.8
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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