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Eriksen J 1,2 , Mwankusye S 3 , Mduma S 3 , Kitua A 3 , Swedberg G 4 , Tomson G 2,5 ,

P atterns of R esistance and DHFR/DHPS G enotypes of P . F alciparum in Rural T anzania Prior To SP Adoption As First Line Treatment. Results High c linical but low parasitological recovery was achieved in the SP and CQ groups:

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Eriksen J 1,2 , Mwankusye S 3 , Mduma S 3 , Kitua A 3 , Swedberg G 4 , Tomson G 2,5 ,

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  1. Patternsof Resistance and DHFR/DHPS Genotypes ofP. FalciparuminRural Tanzania Prior To SP Adoption As First Line Treatment ResultsHigh clinical but low parasitological recovery was achieved in the SP and CQ groups: No relationships could be detected between number of parasite mutations and clinical or parasitological outcome. Study population 117 underfives with uncomplicated malaria in Tindiga village, Kilosa district, Tanzania. Methods underfives with uncomplicated malaria were treated with either CQ or SP. Patients were monitored for 28 days concerning parasitological and clinical resistance, parasite mutations and haemoglobin levels. High parasitological dug resistance but low clinical resistance to both Sulfadoxine/ Pyrimethamine (SP) and Chloroquine (CQ) was seen two years prior to the Tanzanian policy change. Eriksen J1,2, Mwankusye S3, Mduma S3, Kitua A3, Swedberg G4, Tomson G2,5, Gustafsson LL1 and Warsame M2 Malaria Treatment Policy Due to spreading CQ resistance many African countries have been forced to change treatment policies. In 1999, CQ resistance in Tanzania averaged 42%. The WHO recommends a policy change when the resistance levels surpass 25%. In 2001, Tanzania changed its 1st line treatment to Sulfadoxine/Pyrimethamine (SP). SP resistance known to develop rapidly. • Division of Clinical Pharmacology, Karolinska University Hospital Huddinge, Sweden • Division of International Health (IHCAR), Karolinska Institute, Sweden • National Institute for Medical Research (NIMR), Tanzania • Department of Medical Biochemistry and Microbiology, Uppsala University, Sweden • Medical Management Centre (MMC), Karolinska Institute, Sweden ConclusionsThe high degree of RII/RIII resistance observed already two years prior to the introduction of SP as first-line treatment is of concern. Mechanisms must be in place ensuring rational use of SP in order to prolong the lifespan of the drug after the policy change. Objectives To assess the patterns of resistance and occurrence of DHFR/DHPS genotypes of P. falciparum prior to SP adoption as first-line treatment for malaria in Tanzania.

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