title: Decline in sulfadoxine-pyrimethamine-resistant alleles after change in drug policy in the Amazon region of Peru.
abstract: The frequency of alleles with triple mutations conferring sulfadoxine-pyrimethamine (SP) resistance in the Peruvian Amazon Basin has declined (16.9% for dhfr and 0% for dhps compared to 47% for both alleles in 1997) 5 years after SP was replaced as the first-line treatment for Plasmodium falciparum malaria. Microsatellite analysis showed that the dhfr and dhps alleles are of common origin.
authors.affiliation: Division of Parasitic Diseases, National Center for Zoonotic, Vector-Borne and Enteric Diseases, Coordinating Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA.
authors.forename: Zhiyong
authors.initials: Z
authors.lastname: Zhou
authors.forename: Sean M
authors.initials: SM
authors.lastname: Griffing
authors.forename: Alexandre Macedo
authors.initials: AM
authors.lastname: de Oliveira
authors.forename: Andrea M
authors.initials: AM
authors.lastname: McCollum
authors.forename: Wilmer Marquino
authors.initials: WM
authors.lastname: Quezada
authors.forename: Nancy
authors.initials: N
authors.lastname: Arrospide
authors.forename: Ananias A
authors.initials: AA
authors.lastname: Escalante
authors.forename: Venkatachalam
authors.initials: V
authors.lastname: Udhayakumar
mesh_terms: D000483:Alleles; D000818:Animals; D000962:Antimalarials / Q000494:pharmacology* / Q000627:therapeutic use; D004094:Dihydropteroate Synthase / Q000235:genetics; D004338:Drug Combinations; D004351:Drug Resistance / Q000235:genetics*; D006291:Health Policy; D006801:Humans; D016778:Malaria, Falciparum / Q000188:drug therapy* / Q000453:epidemiology*; D009154:Mutation; D010568:Peru; D010963:Plasmodium falciparum / Q000187:drug effects / Q000201:enzymology / Q000235:genetics; D011739:Pyrimethamine / Q000494:pharmacology* / Q000627:therapeutic use; D013413:Sulfadoxine / Q000494:pharmacology* / Q000627:therapeutic use; D013762:Tetrahydrofolate Dehydrogenase / Q000235:genetics
chemical_list: D000962:Antimalarials; D004338:Drug Combinations; C001205:fanasil, pyrimethamine drug combination; D013413:Sulfadoxine; D013762:Tetrahydrofolate Dehydrogenase; D004094:Dihydropteroate Synthase; D011739:Pyrimethamine