Early treatment failure during treatment of Plasmodium falciparum malaria with atovaquone-proguanil in the Republic of Ivory Coast. 2012

Nathalie Wurtz, and Aurélie Pascual, and Adeline Marin-Jauffre, and Housem Bouchiba, and Nicolas Benoit, and Marc Desbordes, and Maryse Martelloni, and Vincent Pommier de Santi, and Georges Richa, and Nicolas Taudon, and Bruno Pradines, and Sébastien Briolant
Unité de Parasitologie - Unité de Recherche pour les Maladies Infectieuses et Tropicales Emergentes - UMR 6236, Institut de Recherche Biomédicale des Armées, Marseille, France. nathalie_wurtz@yahoo.fr

The increased spread of drug-resistant malaria highlights the need for alternative drugs for treatment and chemoprophylaxis. The combination of atovaquone-proguanil (Malarone®) has shown high efficacy against Plasmodium falciparum with only mild side-effects. Treatment failures have been attributed to suboptimal dosages or to parasite resistance resulting from a point mutation in the cytochrome b gene. In this paper, a case of early treatment failure was reported in a patient treated with atovaquone-proguanil; this failure was not associated with a mutation in the parasite cytochrome b gene, with impaired drug bioavailability, or with re-infection.

UI MeSH Term Description Entries
D007560 Cote d'Ivoire A republic in western Africa, south of MALI and BURKINA FASO, bordered by GHANA on the east. Its administrative capital is Abidjan and Yamoussoukro has been the official capital since 1983. The country was formerly called Ivory Coast. Ivory Coast,Republic of Cote diIvoire
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D010963 Plasmodium falciparum A species of protozoa that is the causal agent of falciparum malaria (MALARIA, FALCIPARUM). It is most prevalent in the tropics and subtropics. Plasmodium falciparums,falciparums, Plasmodium
D002727 Proguanil A biguanide compound which metabolizes in the body to form cycloguanil, an anti-malaria agent. Chlorguanid,Chloroguanide,Bigumal,Chloriguane,Chloroguanide Hydrochloride,Paludrin,Paludrine,Proguanil Hydrochloride,Hydrochloride, Chloroguanide,Hydrochloride, Proguanil
D004338 Drug Combinations Single preparations containing two or more active agents, for the purpose of their concurrent administration as a fixed dose mixture. Drug Combination,Combination, Drug,Combinations, Drug
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000962 Antimalarials Agents used in the treatment of malaria. They are usually classified on the basis of their action against plasmodia at different stages in their life cycle in the human. (From AMA, Drug Evaluations Annual, 1992, p1585) Anti-Malarial,Antimalarial,Antimalarial Agent,Antimalarial Drug,Anti-Malarials,Antimalarial Agents,Antimalarial Drugs,Agent, Antimalarial,Agents, Antimalarial,Anti Malarial,Anti Malarials,Drug, Antimalarial,Drugs, Antimalarial
D016778 Malaria, Falciparum Malaria caused by PLASMODIUM FALCIPARUM. This is the severest form of malaria and is associated with the highest levels of parasites in the blood. This disease is characterized by irregularly recurring febrile paroxysms that in extreme cases occur with acute cerebral, renal, or gastrointestinal manifestations. Plasmodium falciparum Malaria,Malaria, Plasmodium falciparum
D017211 Treatment Failure A measure of the quality of health care by assessment of unsuccessful results of management and procedures used in combating disease, in individual cases or series. Failure, Treatment,Failures, Treatment,Treatment Failures

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