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Plasmodium falciparum resistance to sulfadoxine-pyrimethamine in Africa

A systematic analysis of national trends

Bibliographic Data

ID21881352
AuthorsFloriano Amimo (0000-0003-1460-9522, Eduardo Mondlane University, corresponding author), Bernd Lambert (0000-0003-4274-4158, Imperial College London), Anthony Magit (University of California System), Jahit Sacarlal (0000-0003-1059-217X, Eduardo Mondlane University), Masahiro Hashizume (0000-0003-4720-1750, The University of Tokyo), Kenichi Shibuya (0000-0003-2528-7530, King's College London), Kenji Shibuya
Year2020
Volume5
Issue11
Pagese003217
Publication date2020-11-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueBMJ Global Health (JOURNAL)
Journal identifiersISSN: 2059-7908 • E-ISSN: 2059-7908
PublisherBMJ (PUBLISHER • GB)
DOI10.1136/bmjgh-2020-003217
PMID33214174
OpenAlexW3106470515
LanguageEN
Citations received2
References cited40

INTRODUCTION: resistance to sulfadoxine-pyrimethamine (SP) across Africa, from 2000 to 2020. METHODS: We assembled molecular, clinical and endemicity data covering malaria-endemic African countries up to December 2018. Subsequently, we reconstructed georeferenced patient data, using pfdhps540E and pfdhps581G to measure mid-level and high-level SP resistance. Gaussian process regression was applied to model spatiotemporal standardised prevalence. RESULTS: In eastern Africa, mid-level SP resistance increased by 64.0% (95% uncertainty interval, 30.7%-69.8%) in Tanzania, 55.4% (31.3%-65.2%) in Sudan, 45.7% (16.8%-54.3%) in Mozambique, 29.7% (10.0%-45.2%) in Kenya and 8.7% (1.4%-36.8%) in Malawi from 2000 to 2010. This was followed by a steady decline of 76.0% (39.6%-92.6%) in Sudan, 65.7% (25.5%-85.6%) in Kenya and 17.4% (2.6%-37.5%) in Tanzania from 2010 to 2020. In central Africa, the levels increased by 28.9% (7.2%-62.5%) in Equatorial Guinea and 85.3% (54.0%-95.9%) in the Congo from 2000 to 2020, while in the other countries remained largely unchanged. In western Africa, the levels have remained low from 2000 to 2020, except for Nigeria, with a reduction of 14.4% (0.7%-67.5%) and Mali, with an increase of 7.0% (0.8%-25.6%). High-level SP resistance increased by 5.5% (1.0%-20.0%) in Malawi, 4.7% (0.5%-25.4%) in Kenya and 2.0% (0.1%-39.2%) in Tanzania, from 2000 to 2020. CONCLUSION: Under the WHO protocols, SP is no longer effective for intermittent preventive treatment in pregnancy and infancy in most of eastern Africa and parts of central Africa. Strengthening health systems capacity to monitor drug resistance at subnational levels across the endemicity spectrum is critical to achieve the global target to end the epidemic

Biology · Drug resistance · Geography · Malaria · Plasmodium falciparum · Pyrimethamine · Sulfadoxine · Sulfadoxine/pyrimethamine · Tanzania · Veterinary medicine · Demography · Malaria Research and Control · Medicine · Mosquito-borne diseases and control · Trypanosoma species research and implications · Immunology

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Unique citing works2
Citations per year0,4
Citation span2021 - 2025 (5)
Citation velocityrecent
Highly citedNo
Citation typesNeutral: 2
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