Intermittent preventive treatment in infants (IPTi) is the delivery of a treatment dose of an antimalarial at the time of routine vaccinations in the first year of a child's life. Studies have shown that IPTi may reduce the incidence of clinical malaria by about 30% in infants up to 12 months of age (Aponte JJ et al 2009,The Lancet 374,9700, 1533-1542). WHO policy recommendations.

IPTi using sulphadoxine-pyrimethamine (SP) is effective in areas of high malaria transmission provided thresholds of drug resistance are not exceeded. The WHO Technical Consultation on Intermittent Preventive Treatment of Infants (2009, WHO Geneva, Switzerland) noted that key mutations are indicative of high level SP resistance and the presence of dhps 540E above a 50% prevalence should preclude the use of SP for IPTi. Read the WHO policy recommendations. Download the static map of where the 50% resistance threshold is exceeded (Naidoo and Roper 2011, Parasitology in press).

In the map below we have summarised recent data on the prevalence of the dhps 540E. Sites where the? 50% cut-off is exceeded are indicated by brown (51-75%) or red (76-100%) map pins. Sites within the prevalence criteria are indicated by white (0%) blue (1-25%) and green (26-50%). Click on the map pins to reach details on individual studies.

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The prevalence of the 540E mutation of the dhps gene in Africa since 2004

We identified 35 publications describing 90 surveys of 540E in 70 unique study sites in 29 countries. Of the total 12,167 samples tested 4,243 were positive for 540E.?

  1. Aponte JJ et al? 2009 Intermittent Preventive Treatment for malaria control in African infants: Pooled analysis of safety and efficacy in six randomised controlled trials. The Lancet 374,9700, 1533-1542.
  2. The WHO technical Consultation on Intermittent Preventive Treatment of Infants (IPTi) (2009)(WHO Geneva, Switzerland)
  3. Read the WHO policy recommendations

 Samples tested

 of which positive


Sites studied are shown as markers on the map beneath. Use the controls on the left of the map to pan, zoom and centre. Click on a marker to view study details and links to journals.

Map key: percentage of data set found to exhibit mutation

You can view more detailed information on this study at the foot of this page.

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