Atovaquone/Proguanil Resistance in an Imported Malaria Case in Chile

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dc.contributor.authorChenet, Stella
dc.contributor.authorOyarce, Alan
dc.contributor.authorFernández, Jorge
dc.contributor.authorTapia, Rafael
dc.contributor.authorWeitzel, Thomas
dc.contributor.authorTejedo, Juan
dc.contributor.authorUdhayakumar, Venkatachalam
dc.contributor.authorJercic, María Isabel
dc.contributor.authorLucchi, Naomi
dc.date.accessioned2022-04-13T16:25:55Z
dc.date.available2022-04-13T16:25:55Z
dc.date.issued2021
dc.description.abstractIn November 2018, we diagnosed a cluster of falciparum malaria cases in three Chilean travelers returning from Nigeria. Two patients were treated with sequential intravenous artesunate plus oral atovaquone/proguanil (AP) and one with oral AP. The third patient, a 23-year-old man, presented with fever on day 29 after oral AP treatment and was diagnosed with recrudescent falciparum malaria. The patient was then treated with oral mefloquine, followed by clinical recovery and resolution of parasitemia. Analysis of day 0 and follow-up blood samples, collected on days 9, 29, 34, 64, and 83, revealed that parasitemia had initially decreased but then increased on day 29. Sequencing confirmed Tyr268Cys mutation in the cytochrome b gene, associated with atovaquone resistance, in isolates collected on days 29 and 34 and P. falciparum dihydrofolate reductase mutation Asn51Ile, associated with proguanil resistance in all successfully sequenced samples. Molecular characterization of imported malaria contributes to clinical management in non-endemic countries, helps ascertain the appropriateness of antimalarial treatment policies, and contributes to the reporting of drug resistance patterns from endemic regions.es
dc.description.versionVersión publicadaes
dc.identifier.citationChenet SM, Oyarce A, Fernandez J, Tapia-Limonchi R, Weitzel T, Tejedo JR, Udhayakumar V, Jercic MI, Lucchi NW. Atovaquone/Proguanil Resistance in an Imported Malaria Case in Chile. Am J Trop Med Hyg. 2021 Mar 29;104(5):1811-1813. doi: 10.4269/ajtmh.20-1095es
dc.identifier.urihttps://doi.org/10.4269/ajtmh.20-1095es
dc.identifier.urihttp://hdl.handle.net/11447/5980
dc.language.isoenes
dc.subjectAntimalarials / therapeutic usees
dc.subjectArtesunate / therapeutic usees
dc.subjectCytochromes / geneticses
dc.subjectDrug Resistance / geneticses
dc.subjectDrug Combinationses
dc.subjectMalaria, Falciparum / drug therapyes
dc.subjectMefloquine / therapeutic usees
dc.subjectParasitemia / drug therapyes
dc.subjectParasitemia / pathologyes
dc.subjectPlasmodium falciparum / growth & developmentes
dc.subjectPlasmodium falciparum / pathogenicityes
dc.subjectTetrahydrofolate Dehydrogenase / geneticses
dc.titleAtovaquone/Proguanil Resistance in an Imported Malaria Case in Chilees
dc.typeArticlees
dcterms.sourceAmerican journal of tropical medicine and hygienees

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