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 male p...

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Bibliographic Details
Published in:Malaria journal Vol. 1; no. 1; p. 1
Main Authors: Fivelman, Quinton L, Butcher, Geoffrey A, Adagu, Ipemida S, Warhurst, David C, Pasvol, Geoffrey
Format: Journal Article
Language:English
Published: England BioMed Central 08.02.2002
BMC
Subjects:
Amino Acid Substitution
Animals
Antimalarials - pharmacology
Antimalarials - therapeutic use
Atovaquone
Case Report
Codon - genetics
Cytochromes b - antagonists & inhibitors
Cytochromes b - genetics
Drug Combinations
Drug Resistance
Humans
London
Malaria, Falciparum - drug therapy
Malaria, Falciparum - enzymology
Malaria, Falciparum - parasitology
Male
Middle Aged
Mutation, Missense
Naphthoquinones - pharmacology
Naphthoquinones - therapeutic use
Nigeria - ethnology
Parasitemia - drug therapy
Parasitemia - parasitology
Plasmodium falciparum - drug effects
Plasmodium falciparum - genetics
Plasmodium falciparum - isolation & purification
Proguanil - pharmacology
Proguanil - therapeutic use
Protozoan Proteins - antagonists & inhibitors
Protozoan Proteins - genetics
Travel
London
Nigeria
ISSN:1475-2875, 1475-2875
Online Access:Get full text
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Summary: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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ISSN:1475-2875
1475-2875
DOI:10.1186/1475-2875-1-1