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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)

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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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