Molecular Analysis of Recrudescent Parasites in a Plasmodium Falciparum Drug Efficacy Trial in Gabon

Trans R Soc Trop Med Hyg. Nov-Dec 1997;91(6):719-24. doi: 10.1016/s0035-9203(97)90539-3.

Abstract

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 post-treatment 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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Animals
  • Antimalarials / therapeutic use
  • Drug Resistance
  • Gabon
  • Humans
  • Malaria, Falciparum / drug therapy
  • Malaria, Falciparum / parasitology*
  • Plasmodium falciparum / genetics*
  • Polymerase Chain Reaction
  • Polymorphism, Genetic
  • Recurrence

Substances

  • Antimalarials