{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T01:29:46Z","timestamp":1788830986562,"version":"build-2803163510"},"reference-count":65,"publisher":"Springer Science and Business Media LLC","issue":"1","content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Malar J"],"published-print":{"date-parts":[[2012,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Resistance to sulphadoxine-pyrimethamine (SP) in <jats:italic>Plasmodium falciparum<\/jats:italic> parasites is associated with mutations in the dihydrofolate reductase (<jats:italic>dhfr<\/jats:italic>) and dihydropteroate synthase (<jats:italic>dhps<\/jats:italic>) genes and has spread worldwide. SP remains the recommended drug for intermittent preventive treatment for malaria in pregnancy (IPTp) and information on population prevalence of the SP resistance molecular markers in pregnant women is limited.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>Temporal trends of SP resistance molecular markers were investigated in 489 parasite samples collected from pregnant women at delivery from three different observational studies between 1996 and 2009 in Kenya, where SP was adopted for both IPTp and case treatment policies in 1998. Using real-time polymerase chain reaction, pyrosequencing and direct sequencing, 10 single-nucleotide polymorphisms (SNPs) of SP resistance molecular markers were assayed.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>The prevalence of quintuple mutant (<jats:italic>dhfr<\/jats:italic> N51<jats:bold>I<\/jats:bold>\/C59<jats:bold>R<\/jats:bold>\/S108<jats:bold>N<\/jats:bold> and <jats:italic>dhps<\/jats:italic> A437<jats:bold>G<\/jats:bold>\/K540<jats:bold>E<\/jats:bold> combined genotype) increased from 7\u2009% in the first study (1996\u20132000) to 88\u2009% in the third study (2008\u20132009). When further stratified by sample collection year and adoption of IPTp policy, the prevalence of the quintuple mutant increased from 2.4\u2009% in 1998 to 44.4\u2009% three years after IPTp policy adoption, seemingly in parallel with the increase in percentage of SP use in pregnancy. However, in the 1996\u20132000 study, more mutations in the combined <jats:italic>dhfr<\/jats:italic>\/<jats:italic>dhps<\/jats:italic> genotype were associated with SP use during pregnancy only in univariable analysis and no associations were detected in the 2002\u20132008 and 2008\u20132009 studies. In addition, in the 2008\u20132009 study, 5.3\u2009% of the parasite samples carried the <jats:italic>dhps<\/jats:italic> triple mutant (A437<jats:bold>G<\/jats:bold>\/K540<jats:bold>E<\/jats:bold>\/A581<jats:bold>G<\/jats:bold>). There were no differences in the prevalence of SP mutant genotypes between the parasite samples from HIV\u2009+\u2009and HIV- women over time and between paired peripheral and placental samples.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>There was a significant increase in <jats:italic>dhfr\/dhps<\/jats:italic> quintuple mutant and the emergence of new genotype containing <jats:italic>dhps<\/jats:italic> 581 in the parasites from pregnant women in western Kenya over 13\u2009years. IPTp adoption and SP use in pregnancy only played a minor role in the increased drug-resistant parasites in the pregnant women over time. Most likely, other major factors, such as the high prevalence of resistant parasites selected by the use of SP for case management in large non-pregnant population, might have contributed to the temporally increased prevalence of SP resistant parasites in pregnant women. Further investigations are needed to determine the linkage between SP drug resistance markers and efficacy of IPTp-SP.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/1475-2875-11-134","type":"journal-article","created":{"date-parts":[[2012,4,27]],"date-time":"2012-04-27T10:14:35Z","timestamp":1335521675000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":65,"title":["Temporal trends of sulphadoxine-pyrimethamine (SP) drug-resistance molecular markers in Plasmodium falciparum parasites from pregnant women in western Kenya"],"prefix":"10.1186","volume":"11","author":[{"given":"Nnaemeka C","family":"Iriemenam","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica","family":"Shah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wangeci","family":"Gatei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna M","family":"van Eijk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Ayisi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Kariuki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jodi","family":"Vanden Eng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon O","family":"Owino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashima A","family":"Lal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yusuf O","family":"Omosun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kephas","family":"Otieno","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meghna","family":"Desai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feiko O","family":"ter Kuile","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernard","family":"Nahlen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Moore","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary J","family":"Hamel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Ouma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurence","family":"Slutsker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ya Ping","family":"Shi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2012,4,27]]},"reference":[{"key":"2106_CR1","doi-asserted-by":"publisher","first-page":"e1000221","DOI":"10.1371\/journal.pmed.1000221","volume":"7","author":"S Dellicour","year":"2010","unstructured":"Dellicour S, Tatem AJ, Guerra CA, Snow RW, ter Kuile FO: Quantifying the number of pregnancies at risk of malaria in 2007: a demographic study. 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