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Archived Comments for: Island-wide diversity in single nucleotide polymorphisms of the Plasmodium vivax dihydrofolate reductase and dihydropteroate synthetase genes in Sri Lanka

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  1. Correction on treatment guidelines in Sri Lanka

    Michael Alifrangis, Centre for Medical Parasitology, University of Copenhagen

    14 April 2007

    We have been made aware of some serious flaws in the text regarding the drug treatment guidelines in Sri Lanka that we feel we have to correct. We claim that SP is used as second line drug against both P. falciparum and P. vivax infections, this is not correct: SP is only used against P. falciparum treatment failures.

    In abstract, should be read as:

    “In Sri Lanka, chloroquine (CQ) with primaquine (PQ) and SP with PQ is used as first and second line treatment, respectively, against uncomplicated Plasmodium falciparum and resistant P. falciparum infections. CQ/PQ is still efficacious against P. falciparum infections, thus SP is rarely used and it is assumed that the prevalence of SNPs related to P. vivax SP resistance is low.”

    In the discussion, should be read as:

    “The present descriptive study analysed sulphadoxine/pyrimethamine (SP) resistance-related SNPs in the P. vivax dhfr and Pvdhps genes in samples originating from nine districts in Sri Lanka, a country were both CQ and SP (in combination with primaquine) is still regarded as efficient treatment against uncomplicated P. falciparum and resistant forms of P. falciparum infections, respectively.“

    This does however not influence the conclusions of this study, on the contrary: when SP is not used at all against P. vivax infections then it is intriguing that we find quite a high frequency of SP-resistance related mutations.

    Competing interests

    None declared