{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T13:18:59Z","timestamp":1791206339467,"version":"4.1.0"},"reference-count":43,"publisher":"American Society for Microbiology","issue":"9","license":[{"start":{"date-parts":[[2015,9,1]],"date-time":"2015-09-01T00:00:00Z","timestamp":1441065600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Antimicrob Agents Chemother"],"published-print":{"date-parts":[[2015,9]]},"abstract":"ABSTRACT<\/jats:title>\n \n The aim of this study was to assess the prevalence of mutations in\n Plasmodium falciparum<\/jats:named-content>\n dihydrofolate reductase (\n Pfdhfr<\/jats:italic>\n ) and dihydropteroate synthase (\n Pfdhps<\/jats:italic>\n ) genes among pregnant women using sulfadoxine-pyrimethamine (SP) as an intermittent preventive treatment (IPTp). A molecular epidemiological study of\n P. falciparum<\/jats:named-content>\n parasite resistance markers to SP was conducted from August 2010 to February 2012 in Mukono district in central Uganda. DNA was extracted from 413\n P. falciparum<\/jats:named-content>\n -positive samples. Real-time PCR, followed by melting curve analysis, was used to characterize point mutations in the\n Pfdhfr<\/jats:italic>\n and\n Pfdhps<\/jats:italic>\n genes that are associated with SP resistance. The prevalence of the single-nucleotide mutations in\n Pfdhfr<\/jats:italic>\n at codons 51I, 59R, and 108N and in\n Pfdhps<\/jats:italic>\n at codons 437G and 540E was high (>98%), reaching 100% fixation after one dose of SP, while the prevalence of 581G was 3.3% at baseline, reaching 12.5% after one dose of SP. At baseline, the prevalence of\n Pfdhfr<\/jats:italic>\n and\n Pfdhps<\/jats:italic>\n quintuple mutations was 89%, whereas the sextuple mutations (including 581G) were not prevalent (3.9%), reaching 16.7% after one dose of SP. However, the numbers of infections at follow-up visits were small, and hence there was insufficient statistical power to test whether there was a true rise in the prevalence of this allele. The overall high frequency of\n Pfdhfr<\/jats:italic>\n and\n Pfdhps<\/jats:italic>\n quintuple mutations throughout pregnancy excluded further analyses of possible associations between certain haplotypes and the risk of lower birth weight and anemia. However, women infected with\n P. falciparum<\/jats:named-content>\n had 1.3-g\/dl-lower hemoglobin levels (\n P<\/jats:italic>\n = 0.001) and delivered babies with a 400-g-lower birth weight (\n P<\/jats:italic>\n = 0.001) compared to nonparasitemic women. Despite this, 44 women who were\n P. falciparum<\/jats:named-content>\n positive at baseline became negative after one or two doses of SP (i.e., 50.5%), implying that SP-IPTp still has some efficacy.\n P. falciparum<\/jats:named-content>\n resistance markers to SP are high in this population, whereas\n P. falciparum<\/jats:named-content>\n infection was associated with poor birth outcomes.\n <\/jats:p>","DOI":"10.1128\/aac.00507-15","type":"journal-article","created":{"date-parts":[[2015,6,30]],"date-time":"2015-06-30T02:44:58Z","timestamp":1435632298000},"page":"5475-5482","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":38,"title":["Prevalence of Plasmodium falciparum Resistance Markers to Sulfadoxine-Pyrimethamine among Pregnant Women Receiving Intermittent Preventive Treatment for Malaria in Uganda"],"prefix":"10.1128","volume":"59","author":[{"given":"Anthony K.","family":"Mbonye","sequence":"first","affiliation":[{"name":"Ministry of Health, Kampala, Uganda, and School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josephine","family":"Birungi","sequence":"additional","affiliation":[{"name":"Division of Entomology, Uganda Virus Research Institute, Entebbe, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie K.","family":"Yanow","sequence":"additional","affiliation":[{"name":"Provincial Laboratory for Public Health, Edmonton, Alberta, Canada"},{"name":"School of Public Health, University of Alberta, Edmonton, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra","family":"Shokoples","sequence":"additional","affiliation":[{"name":"Provincial Laboratory for Public Health, Edmonton, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"Malamba","sequence":"additional","affiliation":[{"name":"Uganda Virus Research Institute, Entebbe, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Alifrangis","sequence":"additional","affiliation":[{"name":"Centre for Medical Parasitology, Institute of International Health, Immunology, and Microbiology, University of Copenhagen, and Department of Infectious Diseases, Copenhagen University Hospital, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pascal","family":"Magnussen","sequence":"additional","affiliation":[{"name":"Centre for Medical Parasitology, Institute of International Health, Immunology, and Microbiology, University of Copenhagen, and Department of Infectious Diseases, Copenhagen University Hospital, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","first-page":"1005","article-title":"An analysis of malaria in pregnancy in Africa","volume":"61","author":"Brabin BJ","year":"1983","unstructured":"Brabin BJ. 1983. An analysis of malaria in pregnancy in Africa. Bull World Health Organ 61:1005\u20131016.","journal-title":"Bull World Health Organ"},{"key":"e_1_3_2_3_2","first-page":"529","article-title":"Malaria infection of the placenta in The Gambia, West Africa, its incidence and relationship to birth weight and placenta weight","volume":"93","author":"McGregor IA","year":"1983","unstructured":"McGregor IA, Wilson ME, Bilewicz WZ. 1983. Malaria infection of the placenta in The Gambia, West Africa, its incidence and relationship to birth weight and placenta weight. Trans R Soc Trop Med Hyg 93:529\u2013534.","journal-title":"Trans R Soc Trop Med Hyg"},{"key":"e_1_3_2_4_2","volume-title":"Uganda clinical guidelines","author":"Uganda Ministry of Health","year":"2010","unstructured":"Uganda Ministry of Health. 2010. Uganda clinical guidelines. 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Principal role of dihydropteroate synthetase mutations in mediating resistance to sulfadoxine-pyrimethamine in single-drug and combination therapy of uncomplicated malaria in Uganda. 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Two mutations in dihydrofolate reductase combined with one in the dihydropteroate synthase gene predict sulphadoxine-pyrimethamine parasitological failure in Ugandan children with uncomplicated falciparum malaria. Infect Genet Evol 4:321\u2013327.","journal-title":"Infect Genet Evol"},{"key":"e_1_3_2_27_2","doi-asserted-by":"crossref","first-page":"375","DOI":"10.4269\/ajtmh.2006.75.375","article-title":"Effect of cotrimoxazole prophylaxis taken by human immunodeficiency virus (HIV)-infected persons on the selection of sulfadoxine-pyrimethamine-resistant malaria parasites among HIV-uninfected household members","volume":"75","author":"Malamba SS","year":"2006","unstructured":"Malamba SS, Mermin J, Reingold A, Lule JR, Downing R, Ransom R, Kigozi A, Hunt BM, Hubbard A, Rosenthal PJ, Dorsey G. 2006. 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