Open AccessProlonged Selection of pfmdr1 Polymorphisms After Treatment of Falciparum Malaria With Artemether-Lumefantrine in Uganda
Author(s) -
Frederick N. Baliraine,
Philip J. Rosenthal
Publication year - 2011
Publication title -
the journal of infectious diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.69
H-Index - 252
eISSN - 1537-6613
pISSN - 0022-1899
DOI - 10.1093/infdis/jir486
Subject(s) - artemether/lumefantrine , amodiaquine , lumefantrine , artemether , malaria , artesunate , plasmodium falciparum , pyrimethamine , medicine , sulfadoxine/pyrimethamine , artemisinin , biology , sulfadoxine , mefloquine , pharmacology , immunology
We compared the prevalence of key pfmdr1 alleles between pretreatment Plasmodium falciparum parasite isolates and parasites that emerged after treatment of uncomplicated malaria in a longitudinal cohort of Ugandan children. The pfmdr1 86N, 184F, and 1246D alleles were selected after treatment with artemether-lumefantrine, but not after artesunate-amodiaquine or amodiaquine-sulfadoxine-pyrimethamine. Remarkably, selection persisted in infections presenting up to about 60 days after treatment with artemether-lumefantrine. Thus, parasites selected for decreased drug sensitivity can appear long after predicted exposure to antimalarial drugs. Continued surveillance of the clinical efficacy and in vitro activity of new combination therapies is warranted.
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