title: Parasitological rebound effect and emergence of pyrimethamine resistance in Plasmodium falciparum after single-dose sulfadoxine-pyrimethamine.
abstract: Intermittent preventive treatment for malaria in infants (IPTi) is a promising malaria control strategy. However, mass preventive treatment for malaria inherently bears the risk of increasing drug resistance. Here, the effect of single-dose sulfadoxine-pyrimethamine (S-P) versus placebo on Plasmodium falciparum infection rates was assessed in 63 selected infants who were aparasitemic at enrollment. An increase in the proportion of infants with isolates exhibiting drug resistance-associated mutations was detected 3 weeks after drug application in the treatment group. S-P, in the setting of IPTi, appears to cause a parasitological rebound effect in which there is selection of drug-resistant parasites for a short period after drug clearance.
authors.affiliation: Infection Epidemiology Group, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany.
authors.forename: Florian
authors.initials: F
authors.lastname: Marks
authors.forename: Vera
authors.initials: V
authors.lastname: von Kalckreuth
authors.forename: Robin
authors.initials: R
authors.lastname: Kobbe
authors.forename: Samuel
authors.initials: S
authors.lastname: Adjei
authors.forename: Ohene
authors.initials: O
authors.lastname: Adjei
authors.forename: Rolf D
authors.initials: RD
authors.lastname: Horstmann
authors.forename: Christian G
authors.initials: CG
authors.lastname: Meyer
authors.forename: Jurgen
authors.initials: J
authors.lastname: May
mesh_terms: D000818:Animals; D000962:Antimalarials / Q000008:administration & dosage* / Q000627:therapeutic use; D004338:Drug Combinations; D004351:Drug Resistance / Q000235:genetics; D006801:Humans; D007223:Infant; D016778:Malaria, Falciparum / Q000188:drug therapy* / Q000469:parasitology; D010963:Plasmodium falciparum / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification; D011739:Pyrimethamine / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use; D013413:Sulfadoxine / Q000008:administration & dosage* / Q000627:therapeutic use
chemical_list: D000962:Antimalarials; D004338:Drug Combinations; C001205:fanasil, pyrimethamine drug combination; D013413:Sulfadoxine; D011739:Pyrimethamine