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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.

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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;361:45567. 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;291:285664. 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;51:192633. 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;43:29439.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;366:19603. 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;25:4028. 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;54:288692. 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;54:245564. 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;359:261920. 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

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