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

By L.C. Ranford-Cartwright, J. Taylor, T. Umasunthar, L.H. Taylor, H.A. Babiker, B. Lell, J.R. Schmidt-Ott, L.G. Lehman, D. Walliker and P.G. Kremsner


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

Publisher: 'Elsevier BV'
Year: 1997
DOI identifier: 10.1016/s0035-9203(97)90539-3
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Provided by: Enlighten
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