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  1 / 2045 MEDLINE  
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[PMID]:28454537
[Au] Autor:Ruizendaal E; Tahita MC; Geskus RB; Versteeg I; Scott S; d'Alessandro U; Lompo P; Derra K; Traore-Coulibaly M; de Jong MD; Schallig HDFH; Tinto H; Mens PF
[Ad] Endereço:Department of Medical Microbiology, Academic Medical Centre, Amsterdam, The Netherlands. esmee.ruizendaal@gmail.com.
[Ti] Título:Increase in the prevalence of mutations associated with sulfadoxine-pyrimethamine resistance in Plasmodium falciparum isolates collected from early to late pregnancy in Nanoro, Burkina Faso.
[So] Source:Malar J;16(1):179, 2017 04 28.
[Is] ISSN:1475-2875
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Pregnant women are a high-risk group for Plasmodium falciparum infections, which may result in maternal anaemia and low birth weight newborns, among other adverse birth outcomes. Intermittent preventive treatment with sulfadoxine-pyrimethamine during pregnancy (IPTp-SP) is widely implemented to prevent these negative effects of malaria. However, resistance against SP by P. falciparum may decrease efficacy of IPTp-SP. Combinations of point mutations in the dhps (codons A437, K540) and dhfr genes (codons N51, C59, S108) of P. falciparum are associated with SP resistance. In this study the prevalence of SP resistance mutations was determined among P. falciparum found in pregnant women and the general population (GP) from Nanoro, Burkina Faso and the association of IPTp-SP dosing and other variables with mutations was studied. METHODS: Blood spots on filter papers were collected from pregnant women at their first antenatal care visit (ANC booking) and at delivery, from an ongoing trial and from the GP in a cross-sectional survey. The dhps and dhfr genes were amplified by nested PCR and products were sequenced to identify mutations conferring resistance (ANC booking, n = 400; delivery, n = 223; GP, n = 400). Prevalence was estimated with generalized estimating equations and for multivariate analyses mixed effects logistic regression was used. RESULTS: The prevalence of the triple dhfr mutation was high, and significantly higher in the GP and at delivery than at ANC booking, but it did not affect birth weight. Furthermore, quintuple mutations (triple dhfr and double dhps mutations) were found for the first time in Burkina Faso. IPTp-SP did not significantly affect the occurrence of any of the mutations, but high transmission season was associated with increased mutation prevalence in delivery samples. It is unclear why the prevalence of mutations was higher in the GP than in pregnant women at ANC booking. CONCLUSION: The high number of mutants and the presence of quintuple mutants in Burkina Faso confirm concerns about the efficacy of IPTp-SP in the near future. Other drug combinations to tackle malaria in pregnancy should, therefore, be explored. An increase in mutation prevalence due to IPTp-SP dosing could not be confirmed.
[Mh] Termos MeSH primário: Antimaláricos/farmacologia
Resistência a Medicamentos
Malária Falciparum/tratamento farmacológico
Mutação
Plasmodium falciparum/genética
Pirimetamina/farmacologia
Sulfadoxina/farmacologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Burkina Faso/epidemiologia
Criança
Pré-Escolar
Estudos Transversais
Combinação de Medicamentos
Feminino
Seres Humanos
Estudos Longitudinais
Malária Falciparum/epidemiologia
Masculino
Gravidez
Prevalência
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Antimalarials); 0 (Drug Combinations); 37338-39-9 (fanasil, pyrimethamine drug combination); 88463U4SM5 (Sulfadoxine); Z3614QOX8W (Pyrimethamine)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180223
[Lr] Data última revisão:
180223
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170430
[St] Status:MEDLINE
[do] DOI:10.1186/s12936-017-1831-y


  2 / 2045 MEDLINE  
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[PMID]:28934438
[Au] Autor:Boudová S; Divala T; Mungwira R; Mawindo P; Tomoka T; Laufer MK
[Ad] Endereço:Division of Malaria Research, Institute for Global Health, University of Maryland School of Medicine, Baltimore.
[Ti] Título:Placental but Not Peripheral Plasmodium falciparum Infection During Pregnancy Is Associated With Increased Risk of Malaria in Infancy.
[So] Source:J Infect Dis;216(6):732-735, 2017 Sep 15.
[Is] ISSN:1537-6613
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Pregnancy-associated Plasmodium falciparum infection impacts the health of mothers and newborns, but little is known about the effects of these infections on infant susceptibility to malaria. We followed 473 mother-infant pairs during pregnancy and through 2 years of age. We observed that children born to mothers with placental malaria, but not those born to mothers with peripheral infection without evidence of placental sequestration, had increased risk of malaria during the first year of life compared with children born to mothers with no malaria during pregnancy. Malaria infections with placental sequestration have long-lasting impact on infant susceptibility to malaria infection.
[Mh] Termos MeSH primário: Malária Falciparum/diagnóstico
Doenças Placentárias/diagnóstico
Doenças Placentárias/parasitologia
Placenta/parasitologia
Plasmodium falciparum/isolamento & purificação
Complicações Parasitárias na Gravidez/diagnóstico
[Mh] Termos MeSH secundário: Cloroquina/uso terapêutico
Combinação de Medicamentos
Feminino
Seguimentos
Seres Humanos
Lactente
Modelos Logísticos
Estudos Longitudinais
Malária Falciparum/sangue
Análise Multivariada
Doenças Placentárias/sangue
Gravidez
Complicações Parasitárias na Gravidez/sangue
Pirimetamina/uso terapêutico
Fatores de Risco
Sulfadoxina/uso terapêutico
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Drug Combinations); 37338-39-9 (fanasil, pyrimethamine drug combination); 88463U4SM5 (Sulfadoxine); 886U3H6UFF (Chloroquine); Z3614QOX8W (Pyrimethamine)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170929
[Lr] Data última revisão:
170929
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170922
[St] Status:MEDLINE
[do] DOI:10.1093/infdis/jix372


  3 / 2045 MEDLINE  
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[PMID]:28427409
[Au] Autor:Mohamed AO; Abdel Hamid MM; Mohamed OS; Elkando NS; Suliman A; Adam MA; Elnour FAA; Malik EM
[Ad] Endereço:Department of Biochemistry, Faculty of Medicine, University of Khartoum, Khartoum, Sudan. abdelrahim_osman@yahoo.com.
[Ti] Título:Efficacies of DHA-PPQ and AS/SP in patients with uncomplicated Plasmodium falciparum malaria in an area of an unstable seasonal transmission in Sudan.
[So] Source:Malar J;16(1):163, 2017 Apr 20.
[Is] ISSN:1475-2875
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Artemisinin-based combination therapy (ACT), together with other control measures, have reduced the burden of falciparum malaria in sub-Saharan countries, including Sudan. Sudan adopted ACT in 2004 with a remarkable reduction in mortality due to falciparum malaria. However, emergence of resistance to the first-line treatment artesunate and sulfadoxine/pyrimethamine (AS/SP) has created new challenges to the control of malaria in Sudan. A search for an alternative drug of choice for treating uncomplicated malaria has become inevitable. The objective of this study was to evaluate the therapeutic efficacies of dihydroartemisinin/piperaquine (DHA-PPQ) and AS/SP in an area of unstable transmission in Blue Nile State, Sudan in 2015-16. METHODS: A total of 148 patients with uncomplicated malaria were recruited in the study from November 2015 to end of January 2016. Seventy-five patients received DHA-PPQ while 73 received AS/SP. Patients were monitored for clinical and parasitological outcomes following the standard WHO protocol for a period of 42 days for DHA-PPQ and 28 days for AS/SP; nested PCR (nPCR) was performed to confirm parasite re-appearance from day 7 onwards. RESULTS: Fifty-five patients completed the DHA-PPQ arm protocol with success cure rate of 98.2% (95% CI 90.3-100%) and one late clinical failure 1.8% (95% CI 0.0-9.7%). The AS/SP showed adequate clinical and parasitological response (ACPR) of 83.6% (95% CI 71.9-91.8%), early treatment failure was 1.6% (95% CI 0.0-8.8%) and late parasitological failure (LPF) was 14.8% (95% CI 7-26.2%). The respective PCR uncorrected LPF was 20%. CONCLUSION: DHA-PPQ is an efficacious ACT and candidate for replacement of first-line treatment in Sudan while AS/SP showed high treatment failure rate and must be replaced.
[Mh] Termos MeSH primário: Antimaláricos/uso terapêutico
Artemisininas/uso terapêutico
Pirimetamina/uso terapêutico
Quinolinas/uso terapêutico
Sulfadoxina/uso terapêutico
[Mh] Termos MeSH secundário: Adolescente
Criança
Pré-Escolar
Quimioterapia Combinada/métodos
Feminino
Seres Humanos
Lactente
Malária Falciparum/tratamento farmacológico
Malária Falciparum/parasitologia
Malária Falciparum/patologia
Masculino
Parasitemia
Plasmodium falciparum/isolamento & purificação
Sudão
Fatores de Tempo
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:CLINICAL TRIAL; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antimalarials); 0 (Artemisinins); 0 (Quinolines); 0 (sulfadoxine-pyrimethamine-artesunate); 6A9O50735X (dihydroartemisinin); 88463U4SM5 (Sulfadoxine); A0HV2Q956Y (piperaquine); Z3614QOX8W (Pyrimethamine)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170608
[Lr] Data última revisão:
170608
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170422
[St] Status:MEDLINE
[do] DOI:10.1186/s12936-017-1817-9


  4 / 2045 MEDLINE  
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[PMID]:28329383
[Au] Autor:Chico RM; Chaponda EB; Ariti C; Chandramohan D
[Ad] Endereço:Department of Disease Control, London School of Hygiene & Tropical Medicine, United Kingdom.
[Ti] Título:Sulfadoxine-Pyrimethamine Exhibits Dose-Response Protection Against Adverse Birth Outcomes Related to Malaria and Sexually Transmitted and Reproductive Tract Infections.
[So] Source:Clin Infect Dis;64(8):1043-1051, 2017 04 15.
[Is] ISSN:1537-6591
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Background: We conducted a prospective cohort study in Zambia among pregnant women who received intermittent preventive treatment using sulfadoxine-pyrimethamine (IPTp-SP). Methods: We calculated the odds ratios (ORs) of adverse birth outcomes by IPTp-SP exposure, 0-1 dose (n = 126) vs ≥2 doses (n = 590) and ≥2 doses (n = 310) vs ≥3 doses (n = 280) in 7 categories of malaria infection and sexually transmitted and reproductive tract infections (STIs/RTIs). Results: We found no significant differences in baseline prevalence of infection across IPTp-SP exposure groups. However, among women given 2 doses compared to 0-1 dose, the odds of any adverse birth outcome were reduced 45% (OR, 0.55; 95% confidence interval [CI], 0.36, 0.86) and 13% further with ≥3 doses (OR, 0.43; 95% CI, 0.27, 0.68). Two or more doses compared to 0-1 dose reduced preterm delivery by 58% (OR, 0.42; 95% CI, 0.27, 0.67) and 21% further with ≥3 doses (OR, 0.21; 95% CI, 0.13, 0.35). Women with malaria at enrollment who received ≥2 doses vs 0-1 had 76% lower odds of any adverse birth outcome (OR, 0.24; 95% 0.09, 0.66), and Neisseria gonorrhoeae and/or Chlamydia trachomatis had 92% lower odds of any adverse birth outcome (OR, 0.08; 95% CI, 0.01, 0.64). Women with neither a malaria infection nor STIs/RTIs who received ≥2 doses had 73% fewer adverse birth outcomes (OR, 0.27; 95% CI, 0.11, 0.68). Conclusions: IPTp-SP appears to protect against malaria, STIs/RTIs, and other unspecified causes of adverse birth outcome.
[Mh] Termos MeSH primário: Anti-Infecciosos/uso terapêutico
Quimioprevenção/métodos
Malária/prevenção & controle
Complicações Infecciosas na Gravidez/prevenção & controle
Resultado da Gravidez
Pirimetamina/uso terapêutico
Doenças Sexualmente Transmissíveis/prevenção & controle
Sulfadoxina/uso terapêutico
[Mh] Termos MeSH secundário: Adulto
Combinação de Medicamentos
Feminino
Seres Humanos
Gravidez
Estudos Prospectivos
Resultado do Tratamento
Adulto Jovem
Zâmbia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Infective Agents); 0 (Drug Combinations); 37338-39-9 (fanasil, pyrimethamine drug combination); 88463U4SM5 (Sulfadoxine); Z3614QOX8W (Pyrimethamine)
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170712
[Lr] Data última revisão:
170712
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170323
[St] Status:MEDLINE
[do] DOI:10.1093/cid/cix026


  5 / 2045 MEDLINE  
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[PMID]:28279875
[Au] Autor:Nong C; Niu Z; Li P; Wang C; Li W; Wen Y
[Ad] Endereço:Laboratory of Environmental Monitoring, School of Tropical and Laboratory Medicine, Hainan Medical University, Haikou 571199, China.
[Ti] Título:Dual-cloud point extraction coupled to high performance liquid chromatography for simultaneous determination of trace sulfonamide antimicrobials in urine and water samples.
[So] Source:J Chromatogr B Analyt Technol Biomed Life Sci;1051:9-16, 2017 Apr 15.
[Is] ISSN:1873-376X
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:Dual-cloud point extraction (dCPE) was successfully developed for simultaneous extraction of trace sulfonamides (SAs) including sulfamerazine (SMZ), sulfadoxin (SDX), sulfathiazole (STZ) in urine and water samples. Several parameters affecting the extraction were optimized, such as sample pH, concentration of Triton X-114, extraction temperature and time, centrifugation rate and time, back-extraction solution pH, back-extraction temperature and time, back-extraction centrifugation rate and time. High performance liquid chromatography (HPLC) was applied for the SAs analysis. Under the optimum extraction and detection conditions, successful separation of the SAs was achieved within 9min, and excellent analytical performances were attained. Good linear relationships (R ≥0.9990) between peak area and concentration for SMZ and STZ were optimized from 0.02 to 10µg/mL, for SDX from 0.01 to 10µg/mL. Detection limits of 3.0-6.2ng/mL were achieved. Satisfactory recoveries ranging from 85 to 108% were determined with urine, lake and tap water spiked at 0.2, 0.5 and 1µg/mL, respectively, with relative standard deviations (RSDs, n=6) of 1.5-7.7%. This method was demonstrated to be convenient, rapid, cost-effective and environmentally benign, and could be used as an alternative tool to existing methods for analysing trace residues of SAs in urine and water samples.
[Mh] Termos MeSH primário: Anti-Infecciosos/análise
Anti-Infecciosos/urina
Cromatografia Líquida de Alta Pressão/métodos
Sulfonamidas/análise
Sulfonamidas/urina
Poluentes Químicos da Água/análise
Poluentes Químicos da Água/urina
[Mh] Termos MeSH secundário: Fracionamento Químico/métodos
Água Potável/análise
Seres Humanos
Lagos/análise
Limite de Detecção
Polietilenoglicóis/química
Sulfadoxina/análise
Sulfadoxina/urina
Sulfamerazina/análise
Sulfamerazina/urina
Sulfatiazóis/análise
Sulfatiazóis/urina
Água/análise
[Pt] Tipo de publicação:JOURNAL ARTICLE; VALIDATION STUDIES
[Nm] Nome de substância:
0 (Anti-Infective Agents); 0 (Drinking Water); 0 (Sulfathiazoles); 0 (Sulfonamides); 0 (Water Pollutants, Chemical); 059QF0KO0R (Water); 30IQX730WE (Polyethylene Glycols); 88463U4SM5 (Sulfadoxine); 9036-19-5 (Nonidet P-40); UR1SAB295F (Sulfamerazine); Y7FKS2XWQH (sulfathiazole)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170601
[Lr] Data última revisão:
170601
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170311
[St] Status:MEDLINE


  6 / 2045 MEDLINE  
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[PMID]:28245259
[Au] Autor:Walker PG; Floyd J; Ter Kuile F; Cairns M
[Ad] Endereço:MRC Centre for Outbreak Analysis and Modelling, Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom.
[Ti] Título:Estimated impact on birth weight of scaling up intermittent preventive treatment of malaria in pregnancy given sulphadoxine-pyrimethamine resistance in Africa: A mathematical model.
[So] Source:PLoS Med;14(2):e1002243, 2017 Feb.
[Is] ISSN:1549-1676
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Malaria transmission has declined substantially in the 21st century, but pregnant women in areas of sustained transmission still require protection to prevent the adverse pregnancy and birth outcomes associated with malaria in pregnancy (MiP). A recent call to action has been issued to address the continuing low coverage of intermittent preventive treatment of malaria in pregnancy (IPTp). This call has, however, been questioned by some, in part due to concerns about resistance to sulphadoxine-pyrimethamine (SP), the only drug currently recommended for IPTp. METHODS AND FINDINGS: Using an existing mathematical model of MiP, we combined estimates of the changing endemicity of malaria across Africa with maps of SP resistance mutations and current coverage of antenatal access and IPTp with SP (IPTp-SP) across Africa. Using estimates of the relationship between SP resistance mutations and the parasitological efficacy of SP during pregnancy, we estimated the varying impact of IPTp-SP across Africa and the incremental value of enhancing IPTp-SP uptake to match current antenatal care (ANC) coverage. The risks of MiP and malaria-attributable low birthweight (mLBW) in unprotected pregnancies (i.e., those not using insecticide-treated nets [ITNs]) leading to live births fell by 37% (33%-41% 95% credible interval [crI]) and 31% (27%-34% 95% crI), respectively, from 2000 to 2015 across endemic areas in sub-Saharan Africa. However, these gains are fragile, and coverage is far from optimal. In 2015, 9.5 million (8.3 million-10.4 million 95% crI) of 30.6 million pregnancies in these areas would still have been infected with Plasmodium falciparum without intervention, leading to 750,000 (390,000-1.1 million 95% crI) mLBW deliveries. In all, 6.6 million (5.6 million-7.3 million 95% crI) of these 9.5 million (69.3%) pregnancies at risk of infection (and 53.4% [16.3 million/30.6 million] of all pregnancies) occurred in settings with near-perfect SP curative efficacy (>99%) based on the most recent estimates of resistance. Forty-four percent of these pregnancies (23% of all pregnancies) were not receiving any IPTp-SP despite making ≥3 ANC visits, representing 160,000 (94,000-236,000 95% crI) preventable low birthweight (LBW) deliveries. Only 4% (1.4 million) of pregnancies occurred in settings with >10% prevalence of the sextuple haplotype associated with compromised SP effectiveness. Forty-two percent of all pregnancies occurred in settings where the quintuple dhfr/dhps haplotype had become established but where in vivo efficacy data suggest SP maintains the majority of its effectiveness in clearing infections. Not accounting for protection from the use of ITNs during pregnancy, expanding IPTp-SP to all women with ≥3 ANC visits in Africa could prevent an additional 215,000 (128,000-318,000 95% crI) LBW deliveries. In 26 countries with sufficient recent data to estimate ITN impact (population-based ITN usage data that can be stratified by gravidity), we estimate that, due primarily to low ITN use by primigravidae, only 16.5% of the potential LBW births prevented by scaling up IPTp-SP would in fact have already have been prevented through ITN use. Our analysis also highlights the difficulties associated with estimating the relationship between the effectiveness of interventions against parasitological endpoints such as placental infection at delivery and health outcomes including birthweight, which is also determined by a wide range of unrelated factors. We also did not capture other aspects of malaria burden such as clinical malaria, maternal and neonatal anaemia, and miscarriage, all of which increase the overall importance of effective preventative strategies but have their own relationship with transmission intensity, parity, and SP resistance. CONCLUSIONS: Despite recent declines in malaria transmission in Africa, the burden of MiP in the absence of adequate prevention remains substantial. Even accounting for SP resistance, extending IPTp-SP to all women attending ANC, as well as long-lasting insecticidal net distribution targeted towards first-time mothers, would have a sizeable impact upon maternal and infant health in almost all malaria-endemic settings in sub-Saharan Africa.
[Mh] Termos MeSH primário: Antimaláricos/uso terapêutico
Peso ao Nascer
Resistência a Múltiplos Medicamentos
Malária/prevenção & controle
Modelos Teóricos
Pirimetamina/uso terapêutico
Sulfadoxina/uso terapêutico
[Mh] Termos MeSH secundário: África ao Sul do Saara
Criança
Pré-Escolar
Combinação de Medicamentos
Feminino
Seres Humanos
Gravidez
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antimalarials); 0 (Drug Combinations); 37338-39-9 (fanasil, pyrimethamine drug combination); 88463U4SM5 (Sulfadoxine); Z3614QOX8W (Pyrimethamine)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170922
[Lr] Data última revisão:
170922
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170301
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pmed.1002243


  7 / 2045 MEDLINE  
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[PMID]:28237831
[Au] Autor:Baraka V; Delgado-Ratto C; Nag S; Ishengoma DS; Madebe RA; Mavoko HM; Nabasumba C; Lutumba P; Alifrangis M; Van Geertruyden JP
[Ad] Endereço:National Institute for Medical Research, Tanga Research Centre, P.O. Box 5004, Tanga, United Republic of Tanzania; Global Health Institute, University of Antwerp, Antwerp, Belgium. Electronic address: vitobaraka@gmail.com.
[Ti] Título:Different origin and dispersal of sulfadoxine-resistant Plasmodium falciparum haplotypes between Eastern Africa and Democratic Republic of Congo.
[So] Source:Int J Antimicrob Agents;49(4):456-464, 2017 Apr.
[Is] ISSN:1872-7913
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:Sulfadoxine/pyrimethamine (SP) is still used for malaria control in sub-Saharan Africa; however, widespread resistance is a major concern. This study aimed to determine the dispersal and origin of sulfadoxine resistance lineages in the Democratic Republic of the Congo compared with East African Plasmodium falciparum dihydropteroate synthetase (Pfdhps) haplotypes. The analysis involved 264 isolates collected from patients with uncomplicated malaria from Tanzania, Uganda and DR Congo. Isolates were genotyped for Pfdhps mutations at codons 436, 437, 540, 581 and 613. Three microsatellite loci (0.8, 4.3 and 7.7 kb) flanking the Pfdhps gene were assayed. Evolutionary analysis revealed a shared origin of Pfdhps haplotypes in East Africa, with a distinct population clustering in DR Congo. Furthermore, in Tanzania there was an independent distinct origin of Pfdhps SGEGA resistant haplotype. In Uganda and Tanzania, gene flow patterns contribute to the dispersal and shared origin of parasites carrying double- and triple-mutant Pfdhps haplotypes associated with poor outcomes of intermittent preventive treatment during pregnancy using SP (IPTp-SP). However, the origins of the Pfdhps haplotypes in DR Congo and Eastern Africa sites are different. The genetic structure demonstrated a divergent and distinct population cluster predominated by single-mutant Pfdhps haplotypes at the DR Congo site. This reflects the limited dispersal of double- and triple-mutant Pfdhps haplotypes in DR Congo. This study highlights the current genetic structure and dispersal of high-grade Pfdhps resistant haplotypes, which is important to guide implementation of SP in malaria chemoprevention strategies in the region.
[Mh] Termos MeSH primário: Antimaláricos/farmacologia
Di-Hidropteroato Sintase/genética
Resistência a Medicamentos
Haplótipos
Plasmodium falciparum/efeitos dos fármacos
Plasmodium falciparum/enzimologia
Sulfadoxina/farmacologia
[Mh] Termos MeSH secundário: África Oriental/epidemiologia
Criança
Pré-Escolar
República Democrática do Congo/epidemiologia
Feminino
Variação Genética
Técnicas de Genotipagem
Seres Humanos
Lactente
Malária Falciparum/epidemiologia
Malária Falciparum/parasitologia
Masculino
Repetições de Microssatélites
Plasmodium falciparum/classificação
Plasmodium falciparum/genética
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antimalarials); 88463U4SM5 (Sulfadoxine); EC 2.5.1.15 (Dihydropteroate Synthase)
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170417
[Lr] Data última revisão:
170417
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170227
[St] Status:MEDLINE


  8 / 2045 MEDLINE  
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[PMID]:28219435
[Au] Autor:Mwendera CA; de Jager C; Longwe H; Phiri K; Hongoro C; Mutero CM
[Ad] Endereço:School of Health Systems and Public Health, Institute for Sustainable Malaria Control (UP ISMC), University of Pretoria, Private Bag X363, Pretoria, 0001, South Africa.
[Ti] Título:Changing the policy for intermittent preventive treatment with sulfadoxine-pyrimethamine during pregnancy in Malawi.
[So] Source:Malar J;16(1):84, 2017 Feb 20.
[Is] ISSN:1475-2875
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The growing resistance of Plasmodium falciparum to sulfadoxine-pyrimethamine (SP) treatment for uncomplicated malaria led to a recommendation by the World Health Organization for the use of artemisinin-based combination therapy. Inevitably, concerns were also raised surrounding the use of SP for intermittent prevention treatment of malaria during pregnancy (IPTp) amidst the lack of alternative drugs. Malawi was the first country to adopt intermittent prevention treatment with SP in 1993, and updated in 2013. This case study examines the policy updating process and the contribution of research and key stakeholders to this process. The findings support the development of a malaria research-to-policy framework in Malawi. METHODS: Documents and evidence published from 1993 to 2012 were systematically reviewed in addition to key informant interviews. RESULTS: The online search identified 170 potential publications, of which eight from Malawi met the inclusion criteria. Two published studies from Malawi were instrumental in the WHO policy recommendation which in turn led to the updating of national policies. The updated policy indicates that more than two SP doses, as informed by research, overcome the challenges of the first policy of two SP doses only because of ineffectiveness by P. falciparum resistance and the global lack of replacement drugs to SP for IPTp. CONCLUSION: International WHO recommendations facilitated a smooth policy change driven by motivated local leadership with technical and financial support from development partners. Policy development and implementation should include key stakeholders and use local malaria research in a research-to-policy framework.
[Mh] Termos MeSH primário: Antimaláricos/administração & dosagem
Quimioprevenção/métodos
Política de Saúde
Malária Falciparum/prevenção & controle
Complicações Infecciosas na Gravidez/prevenção & controle
Pirimetamina/administração & dosagem
Sulfadoxina/administração & dosagem
[Mh] Termos MeSH secundário: Combinação de Medicamentos
Feminino
Seres Humanos
Malaui
Gravidez
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Antimalarials); 0 (Drug Combinations); 37338-39-9 (fanasil, pyrimethamine drug combination); 88463U4SM5 (Sulfadoxine); Z3614QOX8W (Pyrimethamine)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170608
[Lr] Data última revisão:
170608
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170222
[St] Status:MEDLINE
[do] DOI:10.1186/s12936-017-1736-9


  9 / 2045 MEDLINE  
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[PMID]:28192434
[Au] Autor:Lee SJ; Ter Kuile FO; Price RN; Luxemburger C; Nosten F
[Ad] Endereço:Mahidol Oxford Research Unit, Mahidol University, Bangkok, Thailand.
[Ti] Título:Adverse effects of mefloquine for the treatment of uncomplicated malaria in Thailand: A pooled analysis of 19, 850 individual patients.
[So] Source:PLoS One;12(2):e0168780, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Mefloquine (MQ) has been used for the treatment of malaria since the mid-1980s, first as monotherapy or as fixed combination with sulfadoxine-pyrimethamine (MSP) and since the mid-1990s in combination with artesunate. There is a renewed interested in MQ as part of a triple therapy for the treatment of multi-drug resistance P. falciparum malaria. The widespread use of MQ beyond south-East Asia has been constrained by reports of poor tolerability. Here we present the side effect profile of MQ for the treatment of uncomplicated malaria on the Thai-Myanmar/Cambodia borders. In total 19,850 patients received seven different regimens containing either 15 or 24-25 mg/kg of MQ, the latter given either as a single dose, or split over two or three days. The analysis focused on (predominantly) gastrointestinal and neuropsychiatric events as compared to the new fixed dose combination of MQ plus artesunate given as equal doses of 8 mg/kg MQ per day over three days. Gastrointestinal side effects were dose-dependent and associated with the severity of malaria symptoms. Serious neuropsychiatric side effects associated with MQ use were rare: for a single 25 mg/kg dose it was 11.9 per 10,000 treatments (95% confidence interval, CI, 4-285) vs. 7.8 (3-15) for the 15 mg/kg dose. The risk with 25 mg/kg was much higher when it was given as repeat dosing in patients who had failed treatment with 15 mg/kg MQ in the preceding month; (RR 6.57 (95% CI 1.33 to 32.4), p = 0.0077). MQ was best tolerated as 15 mg/kg or as 24 mg/kg when given over three days in combination with artesunate. We conclude that the tolerance of a single dose of MQ in the treatment of uncomplicated malaria is moderate, but can be improved by administering it as a split dose over three days.
[Mh] Termos MeSH primário: Malária/tratamento farmacológico
Mefloquina/uso terapêutico
Plasmodium falciparum/efeitos dos fármacos
Plasmodium vivax/efeitos dos fármacos
[Mh] Termos MeSH secundário: Adolescente
Adulto
Anorexia/induzido quimicamente
Antimaláricos/efeitos adversos
Antimaláricos/uso terapêutico
Artemisininas/efeitos adversos
Artemisininas/uso terapêutico
Criança
Pré-Escolar
Tontura/induzido quimicamente
Relação Dose-Resposta a Droga
Combinação de Medicamentos
Quimioterapia Combinada
Feminino
Interações Hospedeiro-Parasita/efeitos dos fármacos
Seres Humanos
Malária/parasitologia
Masculino
Mefloquina/efeitos adversos
Náusea/induzido quimicamente
Avaliação de Resultados (Cuidados de Saúde)/métodos
Avaliação de Resultados (Cuidados de Saúde)/estatística & dados numéricos
Plasmodium falciparum/fisiologia
Plasmodium vivax/fisiologia
Transtornos Psicóticos/etiologia
Pirimetamina/efeitos adversos
Pirimetamina/uso terapêutico
Sulfadoxina/efeitos adversos
Sulfadoxina/uso terapêutico
Tailândia
Vômito/induzido quimicamente
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antimalarials); 0 (Artemisinins); 0 (Drug Combinations); 37338-39-9 (fanasil, pyrimethamine drug combination); 60W3249T9M (artesunate); 88463U4SM5 (Sulfadoxine); TML814419R (Mefloquine); Z3614QOX8W (Pyrimethamine)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170824
[Lr] Data última revisão:
170824
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170214
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0168780


  10 / 2045 MEDLINE  
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[PMID]:28151566
[Au] Autor:Warsame M; Hassan AH; Hassan AM; Arale AM; Jibril AM; Mohamud SA; Barrette A; Muse AY; Yusuf FE; Nada RA; Amran JG
[Ad] Endereço:World Health Organization, Global Malaria Programme, Geneva, Switzerland.
[Ti] Título:Efficacy of artesunate + sulphadoxine/pyrimethamine and artemether + lumefantrine and dhfr and dhps mutations in Somalia: evidence for updating the malaria treatment policy.
[So] Source:Trop Med Int Health;22(4):415-422, 2017 Apr.
[Is] ISSN:1365-3156
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To determine the therapeutic efficacy of artesunate + sulphadoxine/pyrimethamine (AS + SP) and artemether + lumefantrine (AL), and to investigate the presence of molecular mutations associated with resistance, to inform national malaria treatment policy. METHODS: One-arm prospective studies were conducted in three study sites in Somalia in 2013 and 2015 to evaluate the efficacy of AS + SP and AL among patients with uncomplicated falciparum malaria. Outcomes included clinical and parasitological response over 28 days, and the presence of dihydrofolate reductase (dfhr) and dihydropteroate synthase (dhps) and mutations. RESULTS: Among patients treated with AS + SP, the PCR-corrected treatment failure rate was 12.3%. The majority of patients (89%) carried either the quintuple mutations (51I/108N + 437G/540E/581G or 51I/59R/108N + 437G/540E) or the quadruple mutation (51I/108N + 437G/540E). All patients who failed treatment with AS + SP carried the quintuple mutation (51I/108N + 437G/540E/581G). In the studies of AL, the PCR-corrected treatment failure rate was <6%. All patients in both treatment groups cleared their parasitaemia by day 3. CONCLUSIONS: The findings demonstrate a failing first-line treatment (AS + SP), with a failure rate above the threshold (10%) for policy change, and a high prevalence of quintuple mutations. In contrast, AL was highly efficacious. Based on these findings and the results from a previous AS + SP study, AL was selected to replace AS + SP as the first-line treatment for uncomplicated malaria in Somalia in 2016. Dihydroartemisinin + piperaquine (DHA + PPQ) has been recommended as the second-line treatment. Routine monitoring of recommended ACTs should continue to inform treatment policy.
[Mh] Termos MeSH primário: Antimaláricos/farmacologia
Artemisininas/farmacologia
Resistência a Múltiplos Medicamentos
Etanolaminas/farmacologia
Fluorenos/farmacologia
Malária Falciparum
Mutação
Plasmodium falciparum/genética
[Mh] Termos MeSH secundário: Adolescente
Antimaláricos/uso terapêutico
Artemisininas/uso terapêutico
Criança
Pré-Escolar
Di-Hidropteroato Sintase/genética
Etanolaminas/uso terapêutico
Feminino
Fluorenos/uso terapêutico
Seres Humanos
Lactente
Malária Falciparum/tratamento farmacológico
Malária Falciparum/parasitologia
Masculino
Meia-Idade
Plasmodium falciparum/enzimologia
Estudos Prospectivos
Proteínas de Protozoários/genética
Pirimetamina/farmacologia
Pirimetamina/uso terapêutico
Somália
Sulfadoxina/farmacologia
Sulfadoxina/uso terapêutico
Tetra-Hidrofolato Desidrogenase/genética
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antimalarials); 0 (Artemisinins); 0 (Ethanolamines); 0 (Fluorenes); 0 (Protozoan Proteins); 0 (sulfadoxine-pyrimethamine-artesunate); 60W3249T9M (artesunate); 88463U4SM5 (Sulfadoxine); C7D6T3H22J (artemether); EC 1.5.1.3 (Tetrahydrofolate Dehydrogenase); EC 2.5.1.15 (Dihydropteroate Synthase); F38R0JR742 (lumefantrine); Z3614QOX8W (Pyrimethamine)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170705
[Lr] Data última revisão:
170705
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170203
[St] Status:MEDLINE
[do] DOI:10.1111/tmi.12847



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