Competitive facilitation of drug-resistant Plasmodium falciparum malaria parasites in pregnant women who receive preventive treatment

dc.contributor.authorMutabingwa, Theonest K.
dc.date.accessioned2020-10-08T06:22:11Z
dc.date.available2020-10-08T06:22:11Z
dc.date.issued2009
dc.description.abstractAbstract: Intermittent preventive treatment in pregnancy (IPTp) is used to prevent Plasmodium falciparum malaria. However, parasites resistant to the IPTp drug sulfadoxine-pyrimethamine (SP) have emerged worldwide, and infections with mixed resistant and susceptible parasites are exacerbated by pyrimethamine in mice. In a prospective delivery cohort in Muheza, Tanzania, we examined the effects of SP IPTp on parasite resistance alleles, parasite diversity, level of parasitemia, and inflammation in the placenta. IPTp use was associated with an increased fraction of parasites carrying the resistance allele at DHPS codon 581, an increase in the level of parasitemia, and more intense placental inflammation. The lowest mean level of parasite diversity and highest mean level of parasitemia occurred in women after recent IPTp use. These findings support a model of parasite release and facilitation, whereby the most highly resistant parasites out-compete less fit parasite populations and overgrow under drug pressure. Use of partially effective anti-malarial agents for IPTp may exacerbate malaria infections in the setting of widespread drug resistance.en_US
dc.identifier.citationHarrington, W.E., Mutabingwa, T.K., Muehlenbachs, A., Sorensen, B., Bolla, M.C., Fried, M. and Duffy, P.E., 2009. Competitive facilitation of drug-resistant Plasmodium falciparum malaria parasites in pregnant women who receive preventive treatment. Proceedings of the National Academy of Sciences, 106(22), pp.9027-9032.en_US
dc.identifier.otherhttps://doi.org/10.1073/pnas.0901415106
dc.identifier.urihttp://hdl.handle.net/123456789/616
dc.language.isoenen_US
dc.publisherProceedings of the National Academy of Sciencesen_US
dc.subjectDrug resistanceen_US
dc.subjectPregnancyen_US
dc.subjectMalariaen_US
dc.titleCompetitive facilitation of drug-resistant Plasmodium falciparum malaria parasites in pregnant women who receive preventive treatmenten_US
dc.typeArticleen_US

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