High Level of Resistance of Plasmodium Falciparum to Sulfadoxine-Pyrimethamine in Children in Tanzania

Trans R Soc Trop Med Hyg. Mar-Apr 1996;90(2):179-81. doi: 10.1016/s0035-9203(96)90129-7.

Abstract

In many areas of tropical Africa affected by chloroquine-resistant Plasmodium falciparum, a combination of sulfadoxine and pyrimethamine (S-P) is used for alternative medication, especially in young children. In Magoda village in Muheza District, north-eastern Tanzania, 38 children 1-10 years of age were enrolled in a therapeutic study of S-P in July 1994. All had monoinfections of P. falciparum and an asexual parasite count of 1000-80,000/microL of blood. S-P was given as a single dose corresponding to 0.8-1.4 mg pyrimethamine/kg body weight. Of the 38 children followed up to day 7, 10 showed an S/RI response, 26 an RII response, and 2 an RIII response. Older children had lower pre-treatment parasitaemia and a better therapeutic response than younger children. Among the various contributory factors responsible for the poor therapeutic result, drug pressure from a prophylactic intervention with weekly dapsone-pyrimethamine between May 1993 and May 1994 seems to have been the most important.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Antimalarials / therapeutic use*
  • Child
  • Child, Preschool
  • Double-Blind Method
  • Drug Resistance
  • Drug Therapy, Combination
  • Humans
  • Infant
  • Malaria, Falciparum / prevention & control*
  • Plasmodium falciparum / drug effects*
  • Pyrimethamine / therapeutic use*
  • Sulfadoxine / therapeutic use*
  • Tanzania
  • Time Factors
  • Treatment Outcome

Substances

  • Antimalarials
  • Sulfadoxine
  • Pyrimethamine