We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Seasonal Malaria Chemoprevention Drug Levels and Drug Resistance Markers in Children With or Without Malaria in Burkina Faso: A Case-Control Study.
- Authors
Roh, Michelle E; Zongo, Issaka; Haro, Alassane; Huang, Liusheng; Somé, Anyirékun Fabrice; Yerbanga, Rakiswendé Serge; Conrad, Melissa D; Wallender, Erika; Legac, Jennifer; Aweeka, Francesca; Ouédraogo, Jean-Bosco; Rosenthal, Philip J
- Abstract
Background Despite scale-up of seasonal malaria chemoprevention (SMC) with sulfadoxine-pyrimethamine and amodiaquine (SP-AQ) in children 3–59 months of age in Burkina Faso, malaria incidence remains high, raising concerns regarding SMC effectiveness and selection of drug resistance. Using a case-control design, we determined associations between SMC drug levels, drug resistance markers, and presentation with malaria. Methods We enrolled 310 children presenting at health facilities in Bobo-Dioulasso. Cases were SMC-eligible children 6–59 months of age diagnosed with malaria. Two controls were enrolled per case: SMC-eligible children without malaria; and older (5–10 years old), SMC-ineligible children with malaria. We measured SP-AQ drug levels among SMC-eligible children and SP-AQ resistance markers among parasitemic children. Conditional logistic regression was used to compute odds ratios (ORs) comparing drug levels between cases and controls. Results Compared to SMC-eligible controls, children with malaria were less likely to have any detectable SP or AQ (OR, 0.33 [95% confidence interval,.16–.67]; P =.002) and have lower drug levels (P <.05). Prevalences of mutations mediating high-level SP resistance were rare (0%–1%) and similar between cases and SMC-ineligible controls (P >.05). Conclusions Incident malaria among SMC-eligible children was likely due to suboptimal levels of SP-AQ, resulting from missed cycles rather than increased antimalarial resistance to SP-AQ.
- Subjects
BURKINA Faso; DRUG resistance; CHEMOPREVENTION; MALARIA; CASE-control method; HEALTH facilities; SEASONAL variations of diseases
- Publication
Journal of Infectious Diseases, 2023, Vol 228, Issue 7, p926
- ISSN
0022-1899
- Publication type
Article
- DOI
10.1093/infdis/jiad172