Abstract
We present case histories of four patients treated with artemether-lumefantrine for falciparum malaria in UK hospitals in 2015 to 2016. Each subsequently presented with recurrent symptoms and Plasmodium falciparum parasitemia within 6 weeks of treatment with no intervening travel to countries where malaria is endemic. Parasite isolates, all of African origin, harbored variants at some candidate resistance loci. No evidence of pfk13-mediated artemisinin resistance was found. Vigilance for signs of unsatisfactory antimalarial efficacy among imported cases of malaria is recommended.
Keywords:
antimalarial agents; drug resistance mechanisms; imported malaria; parasite genotyping; treatment failure.
Copyright © 2017 Sutherland et al.
MeSH terms
-
Africa
-
Aged
-
Antimalarials / therapeutic use*
-
Artemether, Lumefantrine Drug Combination
-
Artemisinins / therapeutic use*
-
Drug Combinations
-
Drug Resistance / genetics*
-
Ethanolamines / therapeutic use*
-
Female
-
Fluorenes / therapeutic use*
-
Gene Expression
-
Genetic Loci
-
Humans
-
Malaria, Falciparum / drug therapy*
-
Malaria, Falciparum / parasitology
-
Malaria, Falciparum / pathology
-
Male
-
Parasitemia / drug therapy*
-
Parasitemia / parasitology
-
Parasitemia / pathology
-
Plasmodium falciparum / drug effects*
-
Plasmodium falciparum / genetics
-
Plasmodium falciparum / growth & development
-
Protozoan Proteins / genetics*
-
Recurrence
-
Travel
-
Treatment Failure
-
United Kingdom
-
Young Adult
Substances
-
Antimalarials
-
Artemether, Lumefantrine Drug Combination
-
Artemisinins
-
Drug Combinations
-
Ethanolamines
-
Fluorenes
-
Protozoan Proteins