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Trends Parasitol. 2001 Dec;17(12):582-8.

Pyrimethamine-sulfadoxine resistance in Plasmodium falciparum: what next?

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Department of Genetics, Box 357360, University of Washington, Seattle, WA 98195-7360, USA.


Chemotherapy remains the only practicable tool to control falciparum malaria in sub-Saharan Africa, where >90% of the world's burden of malaria mortality and morbidity occurs. Resistance is rapidly eroding the efficacy of chloroquine, and the combination pyrimethamine-sulfadoxine is the most commonly chosen alternative. Resistant populations of Plasmodium falciparum were selected extremely rapidly in Southeast Asia and South America. If this happens in sub-Saharan Africa, it will be a public health disaster because no inexpensive alternative is currently available. This article reviews the molecular mechanisms of this resistance and discusses how to extend the therapeutic life of antifolate drugs.

[Indexed for MEDLINE]

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