Susceptibility of human plasmodium knowlesi infections to anti-malarials
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Background: Evidence suggests that Plasmodium knowlesi malaria in Sarawak, Malaysian Borneo remains zoonotic, meaning anti-malarial drug resistance is unlikely to have developed in the absence of drug selection pressure. Therefore, adequate response to available anti-malarial treatments is assumed. Methods: Here the ex vivo sensitivity of human P. knowlesi isolates in Malaysian Borneo were studied, using a WHO schizont maturation assay modified to accommodate the quotidian life cycle of this parasite. The in vitro sensitivities of P. knowlesi H strain adapted from a primate infection to in vitro culture (by measuring the production of Plasmodium lactate dehydrogenase) were also examined together with some assays using Plasmodium falciparum and Plasmodium vivax. Results: Plasmodium knowlesi is uniformly highly sensitive to artemisinins, variably and moderately sensitive to chloroquine, and less sensitive to mefloquine. Conclusions: Taken together with reports of clinical failures when P. knowlesi is treated with mefloquine, the data suggest that caution is required if using mefloquine in prevention or treatment of P. knowlesi infections, until further studies are undertaken.
Fatih , F A , Staines , H M , Siner , A , Ahmed , M A , Woon , L C , Pasini , E M , Kocken , C H M , Singh , B , Cox Singh , J & Krishna , S 2013 , ' Susceptibility of human plasmodium knowlesi infections to anti-malarials ' Malaria Journal , vol 12 , 425 . DOI: 10.1186/1475-2875-12-425
© 2013 Fatih et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
This study was funded by the Medical Research Council (MRC) UK; Grant number G0801971 and the European Community’s Seventh Framework Programme (FP7/2007-2013), EVIMALAR network of Excellence under grant agreement N° 242095 and NANOMAL under grant agreement N° 304948
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