Molecular analysis of recrudescent parasites in a Plasmodium falciparum drug efficacy trial in Gabon

Recrudescent Plasmodium falciparum parasites were sampled from 108 children taking part in a drug efficacy trial in Gabon. A finger-prick blood sample was taken from each child before treatment, and a posttreatment sample taken of the recrudescent parasites. Sample deoxyribonucleic acid was amplifie...

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Bibliographic Details
Published in:Transactions of the Royal Society of Tropical Medicine and Hygiene 1997-11, Vol.91 (6), p.719-724
Main Authors: Ranford-Cartwright, L.C., Taylor, J., Umasunthar, T., Taylor, L.H., Babiker, H.A., Lell, B., Schmidt-Ott, J.R., Lehman, L.G., Walliker, D., Kremsner, P.G.
Format: Article
Language:English
Subjects:
Adolescent
Animals
Antimalarials - therapeutic use
Biological and medical sciences
Drug Resistance
Gabon
genotypes
Human protozoal diseases
Humans
Infectious diseases
Malaria
Malaria, Falciparum - drug therapy
Malaria, Falciparum - parasitology
Medical sciences
Parasitic diseases
Plasmodium falciparum
Plasmodium falciparum - genetics
Polymerase Chain Reaction
Polymorphism, Genetic
Population
Protozoal diseases
recrudescence
Recurrence
Tropical medicine
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Summary:Recrudescent Plasmodium falciparum parasites were sampled from 108 children taking part in a drug efficacy trial in Gabon. A finger-prick blood sample was taken from each child before treatment, and a posttreatment sample taken of the recrudescent parasites. Sample deoxyribonucleic acid was amplified by the polymerase chain reaction using primers specific to the P. falciparum antigen genes MSP-1, MSP-2 and GLURP. Seventy-seven children had identical parasites in their pre- and post-treatment samples, indicating genuine recrudescences of resistant parasites. Fourteen children had completely different parasites in their pre- and post-treatment samples, indicating either a fresh infection from a mosquito or growth of a population of parasites not detected in the pre-treatment sample, perhaps due to sequestration. The remaining 17 children had a mixture of pre-treatment and new parasites in their post-treatment samples. This study demonstrated the use of polymorphic markers to confirm whether parasites in patients with clinical recrudescences after drug treatment are genuinely resistant.
ISSN:0035-9203
1878-3503
DOI:10.1016/S0035-9203(97)90539-3