@article{Cisse2017-td,

title = {Recent uptake of intermittent preventive treatment during  pregnancy with sulfadoxine-pyrimethamine is associated with  increased prevalence of Pfdhfr mutations in Bobo-Dioulasso, Burkina Faso},

author = {Mamoudou Cisse and Gordon A Awandare and Alamissa Soulama and Halidou Tinto and Marie-Pierre Hayette and Robert T Guiguemd\'{e}},

doi = {10.1186/s12936-017-1695-1},

issn = {1475-2875},

year  = {2017},

date = {2017-01-01},

urldate = {2017-01-01},

journal = {Malar. J.},

volume = {16},

number = {1},

pages = {38},

abstract = {BACKGROUND: The impact of sulfadoxine-pyrimethamine (SP) used as 

 intermittent preventive treatment during pregnancy (IPTp-SP) on 

 mutant parasite selection has been poorly documented in Burkina 

 Faso. This study sought first to explore the relationship between 

 IPTp-SP and the presence of mutant parasites. Second, to assess 

 the relationship between the mutant parasites and adverse 

 pregnancy outcomes. METHODS: From September to December 2010, 

 dried blood spots (DBS) were collected during antenatal care 

 visits and at delivery from 109 pregnant women with 

 microscopically confirmed falciparum malaria infection. DBS were 

 analysed by PCR-restriction fragment length polymorphism 

 (PCR-RFLP) for the polymorphisms at codons 51, 59, 108, and 164 

 of the Pfdhfr gene and codons 437 and 540 in the Pfdhps gene. 

 RESULTS: Both the Pfdhfr and Pfdhps genes were successfully 

 genotyped in 92.7% (101/109) of the samples. The prevalence of 

 Pfdhfr mutations N51I, C59R and S108N was 71.3, 42.6 and 64.4%, 

 respectively. Overall, 80.2% (81/101) of samples carried the 

 Pfdhps A437G mutation. None of the samples had the Pfdhfr I164L 

 and the Pfdhps K540E mutations. The prevalence of the triple 

 mutation N51I + C59R + S108N was 25.7% (26/101). The use of 

 IPTp-SP was associated with a threefold increased odds of Pfdhfr 

 C59R mutation [crude OR 3.29; 95% CI (1.44-7.50)]. Pregnant 

 women with recent uptake of IPTp-SP were at higher odds of both 

 the Pfdhfr C59R mutation [adjusted OR 4.26; 95% CI (1.64-11.07)] 

 and the Pfdhfr intermediate-to-high resistance, i.e., $geq$ 2 

 Pfdhfr mutations [adjusted OR 3.45; 95% CI (1.18-10.07)]. There 

 was no statistically significant association between the presence 

 of the Pfdhfr intermediate-to-high resistance and parasite 

 densities or both maternal haemoglobin level and anaemia. 

 CONCLUSION: The data indicate that despite the possibility that 

 IPTp-SP contributes to the selection of resistant parasites, it 

 did not potentiate pregnancy-associated malaria morbidity, 

 suggesting the continuation of SP use as IPTp in Burkina Faso.},

keywords = {Burkina Faso; Drug resistance; Malaria; Pregnancy;   Sulfadoxine-pyrimethamine},

pubstate = {published},

tppubtype = {article}

}