CROSS-RESISTANCE BETWEEN SULFADOXINE-PYRIMETHAMINE AND OTHER ANTIMALARIAL DRUGS: A STUDY OF PREGNANT WOMEN IN ILORIN KWARA STATE NIGERIA
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Date
2025-03
Journal Title
Journal ISSN
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Publisher
International Journal of Advanced Resource
Abstract
Antimalarial resistance remains a serious problem in malaria-endemic
regions, particularly in pregnant women, who are likely to suffer from
complications. The research evaluates the resistance to commonly
employed antimalarial medications—Chloroquine, Artesunate, and
Arthether—among pregnant women in Ilorin, Nigeria, at different
trimesters and during delivery. Cross-sectional study was conducted
among 253 pregnant women presenting at antenatal clinics within
Ilorin, Kwara State. Venous blood from study participants in different
pregnancy stages (first trimester, second trimester, third trimester, and
upon delivery) were drawn. Schizont maturation inhibition method was
used in the drug susceptibility test to establish resistance to
Chloroquine, Artesunate, and Arthether. Chloroquine resistance
prevalence was moderately low at varying levels of between 7.9% upon
delivery and 12.2% in the second trimester. Resistance against
Artesunate, however, rose progressively as pregnancy advanced up to
60.0% in the third trimester, suggesting loss of drug effectiveness
toward the end of pregnancy. Arthether resistance was variable, with
the highest prevalence in the first (43.0%) and second (33.8%)
trimesters, dropping to 0% during the third trimester, and then rising
again to 38.1% at delivery. Cross-resistance evaluation showed a high
positive correlation between SP resistance and Artesunate resistance
during the first (OR = 2.53, p = 0.007) and second trimesters (OR =
2.19, p = 0.043), which suggests shared resistance mechanisms. In
contrast, SP resistance was reversely associated with Chloroquine
resistance at the second trimester (OR = 0.43, p = 0.021) and at
delivery (OR = 0.27, p = 0.042), demonstrating that individuals
resistant to SP were less resistant to Chloroquine. The findings prove
evidence of enhanced resistance to Artesunate, particularly as gestation
age increases, making its usage among pregnant women challenging.
Cross-resistance between SP and Artesunate increases the need for
continued caution and possible alteration of treatment of malaria in
pregnant women. Other treatment regimens to manage malaria in
pregnancy effectively should be the focus of future research