Treatment failure of pyrimethamine-sulphadoxine and induction of Plasmodium falciparum gametocytaemia in children in western Kenya

J. T. Bousema, L. C. Gouagna, A. M. Meutstege, B. E. Okech, N. I J Akim, J. I. Githure, John C Beier, R. W. Sauerwein

Research output: Contribution to journalArticle

38 Citations (Scopus)

Abstract

Sub-Saharan Africa faces increasing levels of resistance of Plasmodium falciparum parasites to the first-line drug pyrimethamine-sulphadoxine (SP). Successful treatment with SP is reported to induce gametocytes and drug resistance may further increase gametocytaemia after treatment. Treatment success, gametocyte prevalence and gametocyte density were determined in 224 asymptomatic children in western Kenya on day 7 after treatment with SP. Treatment failure (R2 or R3 resistance) was observed in 22% of the children. The relative risk to show gametocytes on day 7 after treatment in children with treatment failure was 4.1 (95% CI 1.4-11.6) times higher compared to children with a sensitive infection, after adjustment for age and trophozoite density at the start of treatment. In addition, the gametocyte density was also higher upon SP treatment failure. These findings are reason for concern, as the increased gametocyte prevalence and density after SP treatment failure may increase the spread of SP-resistant strains in the population.

Original languageEnglish
Pages (from-to)427-430
Number of pages4
JournalTropical Medicine and International Health
Volume8
Issue number5
DOIs
StatePublished - May 1 2003
Externally publishedYes

Fingerprint

Kenya
Plasmodium falciparum
Treatment Failure
Therapeutics
Trophozoites
Africa South of the Sahara
Drug Resistance
pyrimethamine drug combination fanasil
Parasites
Infection
Pharmaceutical Preparations
Population

Keywords

  • Gametocyte
  • Kenya
  • Malaria
  • Plasmodium falciparum
  • Pyrimethamine
  • Resistance
  • Sulfadoxine

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Infectious Diseases
  • Parasitology
  • Immunology

Cite this

Treatment failure of pyrimethamine-sulphadoxine and induction of Plasmodium falciparum gametocytaemia in children in western Kenya. / Bousema, J. T.; Gouagna, L. C.; Meutstege, A. M.; Okech, B. E.; Akim, N. I J; Githure, J. I.; Beier, John C; Sauerwein, R. W.

In: Tropical Medicine and International Health, Vol. 8, No. 5, 01.05.2003, p. 427-430.

Research output: Contribution to journalArticle

Bousema, J. T. ; Gouagna, L. C. ; Meutstege, A. M. ; Okech, B. E. ; Akim, N. I J ; Githure, J. I. ; Beier, John C ; Sauerwein, R. W. / Treatment failure of pyrimethamine-sulphadoxine and induction of Plasmodium falciparum gametocytaemia in children in western Kenya. In: Tropical Medicine and International Health. 2003 ; Vol. 8, No. 5. pp. 427-430.
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