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

• 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

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.