Falciparum antifolate resistance, we believe that a high degree of antifolate resistance in Uganda before the widespread use of cotrimoxazole prophylaxis and uniform increase in Pr prevalence of resistant parasites in different populations of patients and do not deliver to antifolates take cotrimoxazole prophylaxis AMG 900 in Tororo evidence against this theory. Another hypothesis leads the etiology The increasing prevalence of resistant parasites antifolates sharing the SP in the region, either alone or in combination with other drugs as first-line treatment of clinical malaria and intermittent pr Preventive treatment for pregnant women .
A previous study showed that after the introduction of linked dhfr and DHPS mutations with antifolate resistance in East Africa and South Asia in the 1980s and 1990s, these mutations are spread throughout the continent after verst Markets using SP as they commonly used treatment for malaria in southern and eastern Africa. 35 In addition, some of these mutations an advantage antifolates transmission to Anopheles mosquitoes after treatment, infect MS patient. 36 The causal factors that give associated with the increasing prevalence of antifolate resistance mutations in P. falciparum remains controversial and may be multifactorial. To our knowledge, the Pr Prevalence of quintuple mutant and the pure pure and mixed quintuple mutant in Tororo the next hour Recorded in Africa. The prevalence Pr Of dhfr and DHPS mutations were found in other studies of the fight against HIV and HIV-infected patients unknown conducted simultaneously in Tororo nearly identical to those of our study.
24, 29, 30 Although these other studies are not directly comparable, they provide an indication that there is little difference in the prevalence Pr Of antifolate resistance mutations confer with Bev Lkerungsgruppen with HIV infected and uninfected in Tororo. Despite these high pr Prevalence of antifolate resistance mutations, we have already shown that cotrimoxazole prophylaxis t Reduce adjusted incidence of malaria and improved the mortality t infected patients with HIV in this region. 11 has the mechanism 15 can not prevent the associated by cotrimoxazole by malaria parasites with antifolate resistance mutations have been determined.
It is possible to change that these changes Not adversely Chtigen the protective effect of cotrimoxazole or perhaps drug levels for the pr Prevention of malaria are lower than those required for the treatment ben CONFIRMS. Cotrimoxazole or other sulfa drugs has not been studied biochemically. Therefore, k We can not rule S, the M Possibility misclassification bias infected if some use of cotrimoxazole more patients with HIV, the cotrimoxazole and / or the use of sulfonamides as SP was reported to take differnet Caustic of people infected with malaria are not subject to co-trimoxazole prophylaxis. Second were the quasi-S Saturation mutant alleles of HIV in the general Bev POPULATION infected at the time of the study, we limited to the observation of the selection of P. falciparum dhfr and DHPS mutations. In summary, co-trimoxazole prophylaxis is not an h Heren Pr Associated prevalence of P. falciparum dhfr and DHPS mutations below the S saturation Our Bev POPULATION. There was also no difference in the pr Prevalence of the dhfr / DHPS .