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Emergence of atovaquone-proguanil resistance during treatment of Plasmodium falciparum malaria acquired by a non-immune north American traveller to west Africa.
Am J Trop Med Hyg. 2005 Apr; 72(4):407-9.AJ

Abstract

The importation of drug-resistant malaria is a growing public health problem in non-endemic countries. The combination of atovaquone and proguanil (Malarone) has become established as an agent of choice to prevent and treat chloroquine-resistant Plasmodium falciparum malaria in travelers. We describe the first reported case in North America of genetically confirmed atovaquone/proguanil-resistant P. falciparum malaria. Polymerase chain reaction and sequence analysis of the primary and recrudescent isolates confirmed the acquisition of a point mutation (Tyr268Ser) in the cytochrome b gene of the recrudescent isolate known to confer high-level resistance to atovaquone. Suboptimal therapy may have played a contributory role in the emergence of resistance.

Authors+Show Affiliations

Department of Pediatrics, Medicine, Medical Microbiology & Infectious Diseases, University of Calgary, Calgary, Alberta, Canada.No affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15827276

Citation

Kuhn, Susan, et al. "Emergence of Atovaquone-proguanil Resistance During Treatment of Plasmodium Falciparum Malaria Acquired By a Non-immune North American Traveller to West Africa." The American Journal of Tropical Medicine and Hygiene, vol. 72, no. 4, 2005, pp. 407-9.
Kuhn S, Gill MJ, Kain KC. Emergence of atovaquone-proguanil resistance during treatment of Plasmodium falciparum malaria acquired by a non-immune north American traveller to west Africa. Am J Trop Med Hyg. 2005;72(4):407-9.
Kuhn, S., Gill, M. J., & Kain, K. C. (2005). Emergence of atovaquone-proguanil resistance during treatment of Plasmodium falciparum malaria acquired by a non-immune north American traveller to west Africa. The American Journal of Tropical Medicine and Hygiene, 72(4), 407-9.
Kuhn S, Gill MJ, Kain KC. Emergence of Atovaquone-proguanil Resistance During Treatment of Plasmodium Falciparum Malaria Acquired By a Non-immune North American Traveller to West Africa. Am J Trop Med Hyg. 2005;72(4):407-9. PubMed PMID: 15827276.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Emergence of atovaquone-proguanil resistance during treatment of Plasmodium falciparum malaria acquired by a non-immune north American traveller to west Africa. AU - Kuhn,Susan, AU - Gill,M John, AU - Kain,Kevin C, PY - 2005/4/14/pubmed PY - 2005/5/27/medline PY - 2005/4/14/entrez SP - 407 EP - 9 JF - The American journal of tropical medicine and hygiene JO - Am J Trop Med Hyg VL - 72 IS - 4 N2 - The importation of drug-resistant malaria is a growing public health problem in non-endemic countries. The combination of atovaquone and proguanil (Malarone) has become established as an agent of choice to prevent and treat chloroquine-resistant Plasmodium falciparum malaria in travelers. We describe the first reported case in North America of genetically confirmed atovaquone/proguanil-resistant P. falciparum malaria. Polymerase chain reaction and sequence analysis of the primary and recrudescent isolates confirmed the acquisition of a point mutation (Tyr268Ser) in the cytochrome b gene of the recrudescent isolate known to confer high-level resistance to atovaquone. Suboptimal therapy may have played a contributory role in the emergence of resistance. SN - 0002-9637 UR - https://www.unboundmedicine.com/medline/citation/15827276/Emergence_of_atovaquone_proguanil_resistance_during_treatment_of_Plasmodium_falciparum_malaria_acquired_by_a_non_immune_north_American_traveller_to_west_Africa_ L2 - https://www.diseaseinfosearch.org/result/4415 DB - PRIME DP - Unbound Medicine ER -