Intensity of transmission and spread of gene mutations linked to chloroquine and sulphadoxine-pyrimethamine resistance in falciparum malaria

Mutabingwa, Theonest K.

Intensity of transmission and spread of gene mutations linked to chloroquine and sulphadoxine-pyrimethamine resistance in falciparum malaria

dc.contributor.author	Mutabingwa, Theonest K.
dc.date.accessioned	2020-10-13T07:14:02Z
dc.date.available	2020-10-13T07:14:02Z
dc.date.issued	2003
dc.description.abstract	The number of malaria parasite clones per infection-multiplicity of parasite clones-is affected by the transmission intensity, multiplicity increases with increasing transmission. This affects the frequency of parasites’ sexual recombination and, if several mutations in different genes are involved, can break down drug resistant genotypes. Therefore, the effects of malaria transmission intensity on the spread of drug resistance could vary depending on the number of genes involved. Here we show that, compared to low transmission, intermediate-high transmission is associated with a 20–100-fold lower risk for the mutations linked to chloroquine resistance and a 6–17 times higher risk for those linked to sulphadoxine-pyrimethamine resistance. This is consistent with the hypothesis of a multigenic basis for chloroquine resistance and a monogenic basis for that of sulphadoxine-pyrimethamine. Reducing transmission intensity could slow the spread of resistance. However, a reduction below a critical threshold (e.g. when parasite prevalence in children 2–9 years old is around 60–80%) could, paradoxically, accelerate the spread of resistance to chloroquine and possibly to other drug combinations whose basis is multigenic. Our findings have important implications for malaria control because increasing drug resistance has a substantial impact on mortality.	en_US
dc.identifier.citation	Talisuna, A.O., Langi, P., Mutabingwa, T.K., Van Marck, E., Speybroeck, N., Egwang, T.G., Watkins, W.W., Hastings, I.M. and D'Alessandro, U., 2003. Intensity of transmission and spread of gene mutations linked to chloroquine and sulphadoxine-pyrimethamine resistance in falciparum malaria. International journal for parasitology, 33(10), pp.1051-1058.	en_US
dc.identifier.other	https://doi.org/10.1016/S0020-7519(03)00156-5
dc.identifier.uri	http://hdl.handle.net/123456789/645
dc.language.iso	en	en_US
dc.publisher	International journal for parasitology	en_US
dc.subject	Plasmodium falciparum	en_US
dc.subject	Drug resistance	en_US
dc.subject	Malaria	en_US
dc.title	Intensity of transmission and spread of gene mutations linked to chloroquine and sulphadoxine-pyrimethamine resistance in falciparum malaria	en_US
dc.type	Article	en_US