Skip directly to site content Skip directly to page options Skip directly to A-Z link Skip directly to A-Z link Skip directly to A-Z link
Volume 16, Number 10—October 2010
Dispatch

Artesunate Misuse and Plasmodium falciparum Malaria in Traveler Returning from Africa

Dea Shahinas, Rachel Lau, Krishna Khairnar, David Hancock, and Dylan R. PillaiComments to Author 
Author affiliations: Author affiliations: University of Toronto, Toronto, Ontario, Canada (D. Shahinas, K. Khairnar, D.R. Pillai); Ontario Agency for Health Protection and Promotion, Toronto (R. Lau, D.R. Pillai); Ajax-Pickering Hospital, Ajax, Ontario, Canada (D. Hancock)

Main Article

Table

Results of sequencing single-nucleotide polymorphisms of Plasmodium falciparum isolate*

Strain
 Pfmdr1
PfATPase
 pfmdr1 copy no.
 CQ IC50, nmol/L
 MQ IC50, nmol/L
 ART IC50, nmol/L
86
 184
 1034
 1042
 1246
 623
 769
3D7 N Y S N D A S 1.00 6.1 2.1 6.1
W2 Y Y S N D A S 0.97 252 3.2 7.3
Cameroon Y F S N D E N 1.85 163 7.7 8.07
Congo Y F S N D E N 1.51 355 10.7 10.9
Kenya Y F S N D E N 1.75 282 11.7 10.1
Liberia N F S N D E N 1.65 109 16.2 16.5
Nigeria C Y F S N D E N 1.06 222 8.7 8.1
Nigeria A N F S N D E N 1.52 171 16.6 20.1
Nigeria B Y F S N D E N 1.09 188 5.6 10.0
Ghana N F S N D E N 0.96 24.0 11.6 14.2
Tanzania Y F S N Y E N 1.88 381 7.8 16.6
Angola Y F S N D E N 0.81 258 4.5 7.3

* At Pfmdr1 and PfATPase6 residues previously implicated in artemisinin resistance and gene copy number of pfmdr1 by quantitative real-time PCR in relation to mean IC50 (n = 3) data for key drugs (7,8,10). pfmdr1, P. falciparum multidrug resistance 1; CQ, chloroquine; MQ, mefloquine; ART, artemisinin; IC50., 50% minimum inhibitory concentration; N, asparagine; Y, tyrosine; S, serine; D, aspartic acid; A, alanine; E, glutamic acid; 3D7, chloroquine-sensitive laboratory strain; W2, chloroquine-resistant laboratory strain; Nigeria A, clinical isolate described in this report.

Main Article

References
  1. Centers for Disease Control and Prevention. Artesunate now available to treat severe malaria in the United States [cited 2010 Jun 10]. http://www.cdc.gov/malaria/diagnosis_treatment/artesunate.html
  2. Centers for Disease Control and Prevention. Coartem, new malaria treatment drug, now available [cited 2010 Jun 10]. http://www.cdc.gov/malaria/diagnosis_treatment/treatment.html
  3. Health Canada. Special Access Programme—drugs [cited 2010 Jun 10]. http://www.hc-sc.gc.ca/dhp-mps/acces/drugs-drogues/index-eng.php
  4. Dondorp  AM, Nosten  F, Yi  P, Das  D, Phyo  AP, Tarning  J, Artemisinin resistance in Plasmodium falciparum malaria. N Engl J Med. 2009;361:455–67. DOIPubMedGoogle Scholar
  5. Bacaner  N, Stauffer  B, Boulware  DR, Walker  PF, Keystone  JS. Travel medicine considerations for North American immigrants visiting friends and relatives. JAMA. 2004;291:2856–64. DOIPubMedGoogle Scholar
  6. Johnson  JD, Dennull  RA, Gerena  L, Lopez-Sanchez  M, Roncal  NE, Waters  NC. Assessment and continued validation of the malaria SYBR green I-based fluorescence assay for use in malaria drug screening. Antimicrob Agents Chemother. 2007;51:1926–33. DOIPubMedGoogle Scholar
  7. Price  RN, Cassar  C, Brockman  A, Duraisingh  M, van Vugt  M, White  NJ, The pfmdr1 gene is associated with a multidrug-resistant phenotype in Plasmodium falciparum from the western border of Thailand. Antimicrob Agents Chemother. 1999;43:2943–9.PubMedGoogle Scholar
  8. Jambou  R, Legrand  E, Niang  M, Khim  N, Lim  P, Volney  B, Resistance of Plasmodium falciparum field isolates to in-vitro artemether and point mutations of the SERCA-type PfATPase6. Lancet. 2005;366:1960–3. DOIPubMedGoogle Scholar
  9. Livak  KJ, Schmittgen  TD. Analysis of relative gene expression data using real- time quantitative PCR and the 2–-∆∆CT method. Methods. 2001;25:402–8. DOIPubMedGoogle Scholar
  10. Imwong  M, Dondorp  AM, Nosten  F, Yi  P, Mungthin  M, Hanchana  S, Exploring the contribution of candidate genes to artemisinin resistance in Plasmodium falciparum. Antimicrob Agents Chemother. 2010;54:2886–92. DOIPubMedGoogle Scholar
  11. Chavchich  M, Gerena  L, Peters  J, Chen  N, Cheng  Q, Kyle  DE. Role of pfmdr1 amplification and expression in induction of resistance to artemisinin derivatives in Plasmodium falciparum. Antimicrob Agents Chemother. 2010;54:2455–64. DOIPubMedGoogle Scholar
  12. Noedl  H, Se  Y, Schaecher  K, Smith  BL, Socheat  D, Fukuda  MM. Artemisinin Resistance in Cambodia 1 (ARC1) Study Consortium. Evidence of artemisinin-resistant malaria in western Cambodia. N Engl J Med. 2008;359:2619–20. DOIPubMedGoogle Scholar
  13. Plowe  CV, Roper  C, Barnwell  JW, Happi  CT, Joshi  HH, Mbacham  W, World Antimalarial Resistance Network (WARN) III: molecular markers for drug resistant malaria. Malar J. 2007;6:121. DOIPubMedGoogle Scholar

Main Article

Page created: September 07, 2011
Page updated: September 07, 2011
Page reviewed: September 07, 2011
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
file_external