Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK; Malaria Research Unit, Medical Research Council, PO Box 70380 Overport 4067, South Africa.
Trends Parasitol. 2013 Oct;29(10):505-15. doi: 10.1016/j.pt.2013.08.002. Epub 2013 Sep 9.
Sulfadoxine-pyrimethamine (SP) is used throughout Africa for intermittent preventive treatment (IPT) of malaria, but resistance threatens its efficacy. We found marked regional differences in the genotypes responsible for SP resistance when mapping recent surveys of dihydrofolate reductase (dhfr) and dihydropteroate synthase (dhps) mutations. In West Africa, a 'partially resistant' combination of dhfr N51I, N59R, and S108N with dhps A437G predominates, whereas in East Africa the 'fully resistant' combination of dhfr N51I, N59R, and S108N with dhps A437G+K540E is found. There are three East African foci where 'fully resistant' populations have additionally acquired dhps 581G and/or dhfr 164L to become 'super resistant'. SP-IPT in infants and pregnant women is reported to have failed in super resistant areas prompting review of SP-IPT use in affected areas.
磺胺多辛-乙胺嘧啶（SP）在整个非洲被用于间歇性预防治疗（IPT）疟疾，但耐药性威胁到其疗效。在对二氢叶酸还原酶（dhfr）和二氢蝶酸合成酶（dhps）突变的近期调查进行绘图时，我们发现了导致 SP 耐药性的基因型存在明显的区域差异。在西非，以 dhfr N51I、N59R 和 S108N 与 dhps A437G 为主的“部分耐药”组合占主导地位，而在东非，发现了 dhfr N51I、N59R 和 S108N 与 dhps A437G+K540E 的“完全耐药”组合。在三个东非焦点地区，“完全耐药”人群还获得了 dhps 581G 和/或 dhfr 164L，从而成为“超级耐药”。据报道，在超级耐药地区，婴儿和孕妇的 SP-IPT 已经失败，这促使人们对受影响地区的 SP-IPT 使用进行了审查。
