dhfr N51, C59, S108 – dhps A437, K540 mutations in Plasmodium falciparum isolates from pregnant women and the general population in Nanoro, Burkina Faso]]>

摘要

Graphical abstract For the first time the combined quintuple mutation in the dhps and dhfr gene of Plasmodium falciparum associated with sulfadoxine-pyrimethamine resistance has been found in Burkina Faso. Display Omitted Highlights ? First finding of the quintuple dhfr - dhps mutant in Burkina Faso. ? Limitation of use of ITPp-SP as a preventive measure. ? Need for increased drug resistance monitoring and surveillance in West Africa. Abstract Sulphadoxine-pyrimethamine (SP) is only used for intermittent preventive treatment during pregnancy (IPTp) in most Sub-Saharan African countries. However, there are concerns about the efficacy of IPTp-SP because of increasing resistance. Combinations of point mutations in the dhps and dhfr genes of Plasmodium falciparum are associated with SP resistance, in particular the quintuple dhfr (N51, C59, S108) ? dhps (codons A437, K540) mutant. In Nanoro, Burkina Faso, filter paper samples from pregnant women at first antenatal care visit and at delivery plus samples from the general population (GP) were studied for dhfr and dhps mutations by sequencing. Quintuple mutants were present in 2 delivery and 4 GP samples. This is the first time the quintuple mutation is found in Burkina Faso and although the prevalence is still very low, emergence of the quintuple mutation could highly diminish the efficacy of IPTp-SP. Close surveillance of SP resistance mutations is therefore warranted. ]]>