@article{fdi:010053812,
  title = {{M}olecular markers of resistance to sulphadoxine-pyrimethamine during intermittent preventive treatment of pregnant women in {B}enin},
  author = {{B}ertin, {G}wladys and {B}riand, {V}al{\'e}rie and {B}onaventure, {D}. and {C}arrieu, {A}. and {M}assougbodji, {A}. and {C}ot, {M}ichel and {D}eloron, {P}hilippe},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground: {T}he prevention of malaria faces with the repeated emergence of {P}lasmodium falciparum resistance to drugs, often involving point mutations of the target gene. {I}n the pregnant woman, currently the {WHO} recommendation is the administration of an intermittent preventive treatment ({IPT}p) with sulphadoxine-pyrimethamine. {S}ulphadoxine-pyrimethamine ({SP}) resistance has increased for several years in {A}frica, stressing the need for alternative molecules. {I}n this context, the first randomized clinical trial comparing the efficacy of {SP} and mefloquine for {IPT}p has been conducted recently in {B}enin. {U}sing samples from this trial, the current study evaluated and quantified the prevalence of mutations on the pfdhfr and pfdhps genes as well as the copy number of the pfmdr1 gene in parasites from {P}. falciparum-infected pregnant women before first and second {IPT}p administration, and at delivery. {M}ethods: {PCR}-restriction fragment length polymorphism of polymorphic codons of the pfdhfr gene (51, 59, 108, and 164) was performed. {T}he identification of mutations in three codons of the pfdhps gene (436, 437 and 540) was achieved by {PCR} and sequencing. {C}opy number quantification for pfmdr1 gene was performed using real-time {PCR}. {R}esults: {R}esults show a high prevalence rate of mutant parasites in women taking {IPT}p with sulphadoxine-pyrimethamine or mefloquine. {T}he prevalence of triple and quadruple mutants was high before first drug regimen administration (79/93, 85%), and remained similar until delivery. {I}nfection with mutant parasites was not correlated with low birth weight nor placental infection. {I}n all samples, the copy number of pfmdr1 gene was equal to one. {C}onclusions: {T}he clinical trial comparing {SP} and mefloquine efficacy during {IPT}p showed {SP} remained efficacious in preventing low birth weight. {T}he present study shows a high prevalence of triple and quadruple mutations implicated in {SP} resistance. {A}lthough the pfdhfr/pfdhps triple and quadruple mutations were frequent, there was no evidence of correlation between these genotypes and the lack of efficacy of {SP} in the context of {IPT}p. {N}evertheless, it is now obvious that {SP} will soon be compromised in whole {A}frica. {M}olecular markers have been recommended to monitor {SP} efficacy for {IPT}p, but given the current prevalence of mutant parasites their usefulness is questionable.},
  keywords = {{BENIN}},
  booktitle = {},
  journal = {{M}alaria {J}ournal},
  volume = {10},
  numero = {},
  pages = {196},
  ISSN = {1475-2875},
  year = {2011},
  DOI = {10.1186/1475-2875-10-196},
  URL = {https://www.documentation.ird.fr/hor/fdi:010053812},
}