Malaria Journal (Feb 2002)

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

  • Warhurst David C,
  • Adagu Ipemida S,
  • Butcher Geoffrey A,
  • Fivelman Quinton L,
  • Pasvol Geoffrey

DOI
https://doi.org/10.1186/1475-2875-1-1
Journal volume & issue
Vol. 1, no. 1
p. 1

Abstract

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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.