Plasmodium falciparum Mutant Haplotype Infection during Pregnancy Associated with Reduced Birthweight, Tanzania
Intermittent preventive treatment during pregnancy with sulfadoxine–pyrimethamine (IPTp-SP) is a key strategy in the control of pregnancy-associated malaria. However, this strategy is compromised by widespread drug resistance from single-nucleotide polymorphisms in the Plasmodium falciparum dihydrof...
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doaj-1af23e82293e48669c33c48229ba17a82020-11-25T00:33:25ZengCenters for Disease Control and PreventionEmerging Infectious Diseases1080-60401080-60592013-09-011991446145410.3201/eid1909.130133Plasmodium falciparum Mutant Haplotype Infection during Pregnancy Associated with Reduced Birthweight, TanzaniaDaniel T. R. MinjaChristentze SchmiegelowBruno MmbandoStéphanie BoströmMayke OesterholtPamela MagistradoCaroline PehrsonDavis JohnAli SalantiAdrian J.F. LutyMartha LemngeThor TheanderJohn LusinguMichael AlifrangisIntermittent preventive treatment during pregnancy with sulfadoxine–pyrimethamine (IPTp-SP) is a key strategy in the control of pregnancy-associated malaria. However, this strategy is compromised by widespread drug resistance from single-nucleotide polymorphisms in the Plasmodium falciparum dihydrofolate reductase and dihydropteroate synthetase genes. During September 2008–October 2010, we monitored a cohort of 924 pregnant women in an area of Tanzania with declining malaria transmission. P. falciparum parasites were genotyped, and the effect of infecting haplotypes on birthweight was assessed. Of the genotyped parasites, 9.3%, 46.3%, and 44.4% had quadruple or less, quintuple, and sextuple mutated haplotypes, respectively. Mutant haplotypes were unrelated to SP doses. Compared with infections with the less-mutated haplotypes, infections with the sextuple haplotype mutation were associated with lower (359 g) birthweights. Continued use of the suboptimal IPTp-SP regimen should be reevaluated, and alternative strategies (e.g., intermittent screening and treatment or intermittent treatment with safe and effective alternative drugs) should be evaluated.https://wwwnc.cdc.gov/eid/article/19/9/13-0133_articlePlasmodium falciparummalariamutationshaplotypepregnancydrug resistance |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Daniel T. R. Minja Christentze Schmiegelow Bruno Mmbando Stéphanie Boström Mayke Oesterholt Pamela Magistrado Caroline Pehrson Davis John Ali Salanti Adrian J.F. Luty Martha Lemnge Thor Theander John Lusingu Michael Alifrangis |
spellingShingle |
Daniel T. R. Minja Christentze Schmiegelow Bruno Mmbando Stéphanie Boström Mayke Oesterholt Pamela Magistrado Caroline Pehrson Davis John Ali Salanti Adrian J.F. Luty Martha Lemnge Thor Theander John Lusingu Michael Alifrangis Plasmodium falciparum Mutant Haplotype Infection during Pregnancy Associated with Reduced Birthweight, Tanzania Emerging Infectious Diseases Plasmodium falciparum malaria mutations haplotype pregnancy drug resistance |
author_facet |
Daniel T. R. Minja Christentze Schmiegelow Bruno Mmbando Stéphanie Boström Mayke Oesterholt Pamela Magistrado Caroline Pehrson Davis John Ali Salanti Adrian J.F. Luty Martha Lemnge Thor Theander John Lusingu Michael Alifrangis |
author_sort |
Daniel T. R. Minja |
title |
Plasmodium falciparum Mutant Haplotype Infection during Pregnancy Associated with Reduced Birthweight, Tanzania |
title_short |
Plasmodium falciparum Mutant Haplotype Infection during Pregnancy Associated with Reduced Birthweight, Tanzania |
title_full |
Plasmodium falciparum Mutant Haplotype Infection during Pregnancy Associated with Reduced Birthweight, Tanzania |
title_fullStr |
Plasmodium falciparum Mutant Haplotype Infection during Pregnancy Associated with Reduced Birthweight, Tanzania |
title_full_unstemmed |
Plasmodium falciparum Mutant Haplotype Infection during Pregnancy Associated with Reduced Birthweight, Tanzania |
title_sort |
plasmodium falciparum mutant haplotype infection during pregnancy associated with reduced birthweight, tanzania |
publisher |
Centers for Disease Control and Prevention |
series |
Emerging Infectious Diseases |
issn |
1080-6040 1080-6059 |
publishDate |
2013-09-01 |
description |
Intermittent preventive treatment during pregnancy with sulfadoxine–pyrimethamine (IPTp-SP) is a key strategy in the control of pregnancy-associated malaria. However, this strategy is compromised by widespread drug resistance from single-nucleotide polymorphisms in the Plasmodium falciparum dihydrofolate reductase and dihydropteroate synthetase genes. During September 2008–October 2010, we monitored a cohort of 924 pregnant women in an area of Tanzania with declining malaria transmission. P. falciparum parasites were genotyped, and the effect of infecting haplotypes on birthweight was assessed. Of the genotyped parasites, 9.3%, 46.3%, and 44.4% had quadruple or less, quintuple, and sextuple mutated haplotypes, respectively. Mutant haplotypes were unrelated to SP doses. Compared with infections with the less-mutated haplotypes, infections with the sextuple haplotype mutation were associated with lower (359 g) birthweights. Continued use of the suboptimal IPTp-SP regimen should be reevaluated, and alternative strategies (e.g., intermittent screening and treatment or intermittent treatment with safe and effective alternative drugs) should be evaluated. |
topic |
Plasmodium falciparum malaria mutations haplotype pregnancy drug resistance |
url |
https://wwwnc.cdc.gov/eid/article/19/9/13-0133_article |
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