@article{fdi:010053396,
  title = {{S}ubmicroscopic gametocytes and the transmission of antifolate-resistant {P}lasmodium falciparum in {W}estern {K}enya},
  author = {{O}esterholt, {M}jam and {A}lifrangis, {M}. and {S}utherland, {C}. {J}. and {O}mar, {S}. {A}. and {S}awa, {P}. and {H}owitt, {C}. and {G}ouagna, {L}ouis-{C}l{\'e}ment and {S}auerwein, {R}. {W}. and {B}ousema, {T}.},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground: {S}ingle nucleotide polymorphisms ({SNP}s) in the dhfr and dhps genes are associated with sulphadoxine-pyrimethamine ({SP}) treatment failure and gametocyte carriage. {T}his may result in enhanced transmission of mutant malaria parasites, as previously shown for chloroquine resistant parasites. {I}n the present study, we determine the association between parasite mutations, submicroscopic {P}. falciparum gametocytemia and malaria transmission to mosquitoes. {M}ethodology/{P}rincipal {F}indings: {S}amples from children treated with {SP} alone or in combination with artesunate ({AS}) or amodiaquine were genotyped for {SNP}s in the dhfr and dhps genes. {G}ametocytemia was determined by microscopy and {P}fs25 {RNA}-based quantitative nucleic acid sequence-based amplification ({P}fs25 {QT}-{NASBA}). {T}ransmission was determined by membrane-feeding assays. {W}e observed no wild type infections, 66.5% (127/191) of the infections expressed mutations at all three dhfr codons prior to treatment. {T}he presence of all three mutations was not related to higher {P}fs25 {QT}-{NASBA} gametocyte prevalence or density during follow-up, compared to double mutant infections. {T}he proportion of infected mosquitoes or oocyst burden was also not related to the number of mutations. {A}ddition of {AS} to {SP} reduced gametocytemia and malaria transmission during follow-up. {C}onclusions/{S}ignificance: {I}n our study population where all infections had at least a double mutation in the dhfr gene, additional mutations were not related to increased submicroscopic gametocytemia or enhanced malaria transmission. {T}he absence of wild-type infections is likely to have reduced our power to detect differences. {O}ur data further support the use of {ACT} to reduce the transmission of drug-resistant malaria parasites.},
  keywords = {},
  booktitle = {},
  journal = {{P}los {O}ne},
  volume = {4},
  numero = {2},
  pages = {e4364},
  ISSN = {1932-6203},
  year = {2009},
  DOI = {10.1371/journal.pone.0004364},
  URL = {https://www.documentation.ird.fr/hor/fdi:010053396},
}