High Resistance of Plasmodium falciparum to Sulphadoxine/Pyrimethamine in Northern Tanzania and the Emergence of dhps Resistance Mutation at Codon 581
2009

High Resistance of Plasmodium falciparum to Sulphadoxine/Pyrimethamine in Northern Tanzania

Sample size: 112 publication 10 minutes Evidence: high

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)

10.1371/journal.pone.0004569

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