Malarone treatment failure and in vitro confirmation of resistance of Plasmodium falciparum isolate from Lagos, Nigeria

We report the first in vitro and genetic confirmation of Malarone(®) (GlaxoSmithKline; atovaquone and proguanil hydrochloride) resistance in Plasmodium falciparum acquired in Africa. On presenting with malaria two weeks after returning from a 4-week visit to Lagos, Nigeria without prophylaxis, a mal...

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Detalles Bibliográficos
Autores principales: Fivelman, Quinton L, Butcher, Geoffrey A, Adagu, Ipemida S, Warhurst, David C, Pasvol, Geoffrey
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2002
Materias:
Case Report
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC111499/
https://www.ncbi.nlm.nih.gov/pubmed/12057021
http://dx.doi.org/10.1186/1475-2875-1-1
Descripción
Sumario:We report the first in vitro and genetic confirmation of Malarone(®) (GlaxoSmithKline; atovaquone and proguanil hydrochloride) resistance in Plasmodium falciparum acquired in Africa. On presenting with malaria two weeks after returning from a 4-week visit to Lagos, Nigeria without prophylaxis, a male patient was given a standard 3-day treatment course of Malarone(®). Twenty-eight days later the parasitaemia recrudesced. Parasites were cultured from the blood and the isolate (NGATV01) was shown to be resistant to atovaquone and the antifolate pyrimethamine. The cytochrome b gene of isolate NGATV01 showed a single mutation, Tyr268Asn which has not been seen previously.

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