pfk13-Independent Treatment Failure in Four Imported Cases of Plasmodium falciparum Malaria Treated with Artemether-Lumefantrine in the United Kingdom

Antimicrob Agents Chemother. 2017 Feb 23;61(3):e02382-16. doi: 10.1128/AAC.02382-16. Print 2017 Mar.

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.

Publication types

  • Case Reports

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