@article{fdi:010037908,
  title = {{S}ulfadoxine-pyrimethamine susceptibilities and analysis of the dihydrofolate reductase and dihydropteroate synthase of {P}lasmodium falciparum isolates from {C}ote d'{I}voire},
  author = {{D}jaman, {J}. {A}. and {M}azabraud, {A}. and {B}asco, {L}eonardo},
  editor = {},
  language = {{ENG}},
  abstract = {{O}ver a 2-year study period, three methods [a test of therapeutic efficacy, an in-vitro assay, and sequencing of the parasites' dihydrofolate-reductase (dhfr) and dihydropteroate-synthase (dhps) genes] were used to monitor sulfadoxine-pyrimethamine ({SP}) resistance in the {P}lasmodium falciparum strains infecting young children near {A}bidjan, the largest city in {C}ote d'{I}voire. {O}verall, 118 children aged < 5 years and infected with {P}. falcipartan were treated with {SP}. {T}wenty-one (23.5%) of the 89 children who completed the 14 days of follow-up were categorized as therapeutic failures. {W}hen {P}. falcipartan isolates from the 61 children with adequate parasitaemias were investigated in the in-vitro assay, 24 (39.5%) were found to be highly resistant to pyrimethamine, each having a median inhibitory concentration ({IC}50) of at least 2000 nm. {P}olymorphism analysis of gene fragments of 118 {P}. falciparum isolates (one from each child enrolled in the study) revealed that 46 (39%) of the isolates had mutant dhfr and 111 (94%) had mutant dhps. {T}he mutations mainly affected {DHFR} codon 108 (39% of the isolates) and {DHPS} codons 436 (65%), 437 (52%) and 613 (27%). {O}f the 37 {DHFR} mutant isolates from children who completed follow-up, 21 were from children with therapeutic failure, indicating that mutant {DHFR} was associated with resistance to pyrimethamine in vivo (kappa=0.61). {A} mutant dhfr genotype was also found to be strongly associated with resistance to pyrimethamine in vitro (kappa=0.79). {T}here was, however, little evidence of an association between {SP} efficacy and dhps genotype (kappa=0.04). {R}esistance to {SP} appears to be an increasing problem in southern {C}ote d'{I}voire and one which may now justify a change away from this drug combination as the first- or second-line treatment for {P}. falciparum malaria in this area.},
  keywords = {},
  booktitle = {},
  journal = {{A}nnals of {T}ropical {M}edicine and {P}arasitology},
  volume = {101},
  numero = {2},
  pages = {103--112},
  ISSN = {0003-4983},
  year = {2007},
  DOI = {10.1179/136485907{X}154584},
  URL = {https://www.documentation.ird.fr/hor/fdi:010037908},
}