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

Abstract 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 prophylaxi...

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Bibliographic Details
Published in:Malaria Journal
Main Authors: Warhurst David C, Adagu Ipemida S, Butcher Geoffrey A, Fivelman Quinton L, Pasvol Geoffrey
Format: Article in Journal/Newspaper
Language:English
Published: BMC 2002
Subjects:
Arctic medicine. Tropical medicine
RC955-962
Infectious and parasitic diseases
RC109-216
Arctic
Online Access:https://doi.org/10.1186/1475-2875-1-1
https://doaj.org/article/9032c516f1a240ebacced2ef86cd7fdc
Description
Summary:Abstract 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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