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Dhameliya TM, Vekariya DD, Bhatt PR, Kachroo T, Virani KD, Patel KR, Bhatt S, Dholakia SP. Synthetic account on indoles and their analogues as potential anti-plasmodial agents. Mol Divers 2024:10.1007/s11030-024-10842-8. [PMID: 38709459 DOI: 10.1007/s11030-024-10842-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 03/07/2024] [Indexed: 05/07/2024]
Abstract
Malaria caused by P. falciparum, has been recognized as one of the major infectious diseases causing the death of several patients as per the reports from the World Health Organization. In search of effective therapeutic agents against malaria, several research groups have started working on the design and development of novel heterocycles as anti-malarial agents. Heterocycles have been recognized as the pharmacophoric features for the different types of medicinally important activities. Among all these heterocycles, nitrogen containing aza-heterocycles should not be underestimated owing to their wide therapeutic window. Amongst the aza-heterocycles, indoles and fused indoles such as marinoquinolines, isocryptolepines and their regioisomers, manzamines, neocryptolenines, and indolones have been recognized as anti-malarial agents active against P. falciparum. The present work unleashes the synthetic attempts of anti-malarial indoles and fused indoles through cyclocondensation, Fischer-indole synthesis, etc. along with the brief discussions on structure-activity relationships, in vitro or in vivo studies for the broader interest of these medicinal chemists, working on their design and development as potential anti-malarial agents.
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Affiliation(s)
- Tejas M Dhameliya
- Department of Pharmaceutical Chemistry and Quality Assurance, L. M. College of Pharmacy, Navrangpura, Ahmedabad, 380 009, Gujarat, India.
- Present Address: Department of Pharmaceutical Chemistry, Institute of Pharmacy, Nirma University, Ahmedabad, 382481, Gujarat, India.
| | - Drashtiben D Vekariya
- Department of Pharmaceutical Chemistry and Quality Assurance, L. M. College of Pharmacy, Navrangpura, Ahmedabad, 380 009, Gujarat, India
| | - Pooja R Bhatt
- Department of Pharmaceutical Chemistry and Quality Assurance, L. M. College of Pharmacy, Navrangpura, Ahmedabad, 380 009, Gujarat, India
| | - Tarun Kachroo
- Department of Pharmaceutical Chemistry and Quality Assurance, L. M. College of Pharmacy, Navrangpura, Ahmedabad, 380 009, Gujarat, India
| | - Kumkum D Virani
- Department of Pharmaceutical Chemistry and Quality Assurance, L. M. College of Pharmacy, Navrangpura, Ahmedabad, 380 009, Gujarat, India
| | - Khushi R Patel
- Department of Pharmaceutical Chemistry and Quality Assurance, L. M. College of Pharmacy, Navrangpura, Ahmedabad, 380 009, Gujarat, India
| | - Shelly Bhatt
- Department of Pharmaceutical Chemistry and Quality Assurance, L. M. College of Pharmacy, Navrangpura, Ahmedabad, 380 009, Gujarat, India
| | - Sandip P Dholakia
- Department of Pharmaceutical Chemistry and Quality Assurance, L. M. College of Pharmacy, Navrangpura, Ahmedabad, 380 009, Gujarat, India
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Castañeda-Mogollón D, Toppings NB, Kamaliddin C, Lang R, Kuhn S, Pillai DR. Amplicon Deep Sequencing Reveals Multiple Genetic Events Lead to Treatment Failure with Atovaquone-Proguanil in Plasmodium falciparum. Antimicrob Agents Chemother 2023; 67:e0170922. [PMID: 37154745 PMCID: PMC10269153 DOI: 10.1128/aac.01709-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 03/05/2023] [Indexed: 05/10/2023] Open
Abstract
Atovaquone-proguanil (AP) is used as treatment for uncomplicated malaria, and as a chemoprophylactic agent against Plasmodium falciparum. Imported malaria remains one of the top causes of fever in Canadian returning travelers. Twelve sequential whole-blood samples before and after AP treatment failure were obtained from a patient diagnosed with P. falciparum malaria upon their return from Uganda and Sudan. Ultradeep sequencing was performed on the cytb, dhfr, and dhps markers of treatment resistance before and during the episode of recrudescence. Haplotyping profiles were generated using three different approaches: msp2-3D7 agarose and capillary electrophoresis, and cpmp using amplicon deep sequencing (ADS). A complexity of infection (COI) analysis was conducted. De novo cytb Y268C mutants strains were observed during an episode of recrudescence 17 days and 16 h after the initial malaria diagnosis and AP treatment initiation. No Y268C mutant reads were observed in any of the samples prior to the recrudescence. SNPs in the dhfr and dhps genes were observed upon initial presentation. The haplotyping profiles suggest multiple clones mutating under AP selection pressure (COI > 3). Significant differences in COI were observed by capillary electrophoresis and ADS compared to the agarose gel results. ADS using cpmp revealed the lowest haplotype variation across the longitudinal analysis. Our findings highlight the value of ultra-deep sequencing methods in the understanding of P. falciparum haplotype infection dynamics. Longitudinal samples should be analyzed in genotyping studies to increase the analytical sensitivity.
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Affiliation(s)
- Daniel Castañeda-Mogollón
- Cumming School of Medicine, Department of Pathology & Laboratory Medicine, the University of Calgary, Calgary, Alberta, Canada
- Cumming School of Medicine, Department of Microbiology, Immunology, and Infectious Diseases, the University of Calgary, Calgary, Alberta, Canada
- Calvin, Phoebe & Joan Snyder Institute for Chronic Diseases, the University of Calgary, Calgary, Alberta, Canada
| | - Noah B. Toppings
- Cumming School of Medicine, Department of Pathology & Laboratory Medicine, the University of Calgary, Calgary, Alberta, Canada
- Cumming School of Medicine, Department of Microbiology, Immunology, and Infectious Diseases, the University of Calgary, Calgary, Alberta, Canada
- Calvin, Phoebe & Joan Snyder Institute for Chronic Diseases, the University of Calgary, Calgary, Alberta, Canada
| | - Claire Kamaliddin
- Cumming School of Medicine, Department of Pathology & Laboratory Medicine, the University of Calgary, Calgary, Alberta, Canada
- Cumming School of Medicine, Department of Microbiology, Immunology, and Infectious Diseases, the University of Calgary, Calgary, Alberta, Canada
- Calvin, Phoebe & Joan Snyder Institute for Chronic Diseases, the University of Calgary, Calgary, Alberta, Canada
| | - Raynell Lang
- Cumming School of Medicine, Department of Medicine, the University of Calgary, Calgary, Alberta, Canada
- Cumming School of Medicine, Department of Community Health Sciences, the University of Calgary, Calgary, Alberta, Canada
| | - Susan Kuhn
- Cumming School of Medicine, Department of Pediatrics, the University of Calgary, Calgary, Alberta, Canada
| | - Dylan R. Pillai
- Cumming School of Medicine, Department of Pathology & Laboratory Medicine, the University of Calgary, Calgary, Alberta, Canada
- Cumming School of Medicine, Department of Microbiology, Immunology, and Infectious Diseases, the University of Calgary, Calgary, Alberta, Canada
- Calvin, Phoebe & Joan Snyder Institute for Chronic Diseases, the University of Calgary, Calgary, Alberta, Canada
- Alberta Precision Laboratories, Diagnostic & Scientific Centre, Calgary, Alberta, Canada
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3
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Ortiz M, Rodríguez H, Lucci E, Coro J, Pernía B, Montero-Calderon A, Tingo-Jácome FJ, Espinoza L, Spencer LM. Serological Cross-Reaction between Six Thiadiazine by Indirect ELISA Test and Their Antimicrobial Activity. Methods Protoc 2023; 6:mps6020037. [PMID: 37104019 PMCID: PMC10146945 DOI: 10.3390/mps6020037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 03/25/2023] [Accepted: 03/31/2023] [Indexed: 04/07/2023] Open
Abstract
Malaria is a parasitic infection caused by a protozoon of the genus Plasmodium, transmitted to humans by female biting mosquitoes of the genus Anopheles. Chloroquine and its derivates have caused the parasite to develop drug resistance in endemic areas. For this reason, new anti-malarial drugs as treatments are crucial. This work aimed to evaluate the humoral response. with hyper-immune sera, of mice immunized with six derivatives of tetrahydro-(2H)-1,3,5-thiadiazine-2-thione (bis-THTT) by indirect ELISA test. The cross-reactivity between the compounds as antigens and their microbial activity on Gram-positive and Gram-negative bacteria was evaluated. The results of the humoral evaluation by indirect ELISA show that three bis-THTTs react with almost all of the above. Besides, three compounds used as antigens stimulate the BALB/c mice’s immune system. The best combination of two antigens as a combined therapy displays similar absorbances between the antigens in the mixture, showing similar recognition by antibodies and their compounds. In addition, our results showed that different bis-THTT presented antimicrobial activity on Gram-positive bacteria, mainly on Staphylococcus aureus strains, and no inhibitory activity was observed on the Gram-negative bacteria tested.
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Affiliation(s)
- Mishell Ortiz
- School of Biological Sciences and Engineering, Yachay Tech University, San Miguel de Urcuquí 100119, Ecuador
| | - Hortensia Rodríguez
- School of Chemical Sciences and Engineering, Yachay Tech University, San Miguel de Urcuquí 100119, Ecuador
| | - Elisabetta Lucci
- Departamento de Tecnología de Procesos Biológicos y Bioquímicos, Universidad Simón Bolívar, Caracas 89000, Venezuela
| | - Julieta Coro
- Laboratory of Chemical and Biomolecular Synthesis, Faculty of Chemistry, Habana University, Habana 10400, Cuba
| | - Beatriz Pernía
- Faculty of Natural Sciences, University of Guayaquil, Av. Raúl Gómez Lince s/n y Av. Juan Tanca Marengo, Guayaquil 090150, Ecuador
| | - Abigail Montero-Calderon
- School of Agricultural and Agro-Industrial Sciences, Yachay Tech University, San Miguel de Urcuquí 100119, Ecuador
| | | | - Leslie Espinoza
- School of Biological Sciences and Engineering, Yachay Tech University, San Miguel de Urcuquí 100119, Ecuador
| | - Lilian M. Spencer
- School of Biological Sciences and Engineering, Yachay Tech University, San Miguel de Urcuquí 100119, Ecuador
- Cell Biology Department, Simón Bolívar University, Valle de Sartenejas, Caracas 89000, Venezuela
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4
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Aminin D, Polonik S. 1,4-Naphthoquinones: Some Biological Properties and Application. Chem Pharm Bull (Tokyo) 2020; 68:46-57. [DOI: 10.1248/cpb.c19-00911] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Dmitry Aminin
- G.B. Elyakov Pacific Institute of Bioorganic Chemistry, Far-Eastern Branch of the Russian Academy of Science
- Department of Biomedical Science and Environmental Biology, Kaohsiung Medical University
| | - Sergey Polonik
- G.B. Elyakov Pacific Institute of Bioorganic Chemistry, Far-Eastern Branch of the Russian Academy of Science
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Staines HM, Burrow R, Teo BHY, Chis Ster I, Kremsner PG, Krishna S. Clinical implications of Plasmodium resistance to atovaquone/proguanil: a systematic review and meta-analysis. J Antimicrob Chemother 2019; 73:581-595. [PMID: 29237012 PMCID: PMC5890752 DOI: 10.1093/jac/dkx431] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2017] [Accepted: 10/23/2017] [Indexed: 11/26/2022] Open
Abstract
Background Atovaquone/proguanil, registered as Malarone®, is a fixed-dose combination recommended for first-line treatment of uncomplicated Plasmodium falciparum malaria in non-endemic countries and its prevention in travellers. Mutations in the cytochrome bc1 complex are causally associated with atovaquone resistance. Methods This systematic review assesses the clinical efficacy of atovaquone/proguanil treatment of uncomplicated malaria and examines the extent to which codon 268 mutation in cytochrome b influences treatment failure and recrudescence based on published information. Results Data suggest that atovaquone/proguanil treatment efficacy is 89%–98% for P. falciparum malaria (from 27 studies including between 18 and 253 patients in each case) and 20%–26% for Plasmodium vivax malaria (from 1 study including 25 patients). The in vitro P. falciparum phenotype of atovaquone resistance is an IC50 value >28 nM. Case report analyses predict that recrudescence in a patient presenting with parasites carrying cytochrome b codon 268 mutation will occur on average at day 29 (95% CI: 22, 35), 19 (95% CI: 7, 30) days longer than if the mutation is absent. Conclusions Evidence suggests atovaquone/proguanil treatment for P. falciparum malaria is effective. Late treatment failure is likely to be associated with a codon 268 mutation in cytochrome b, though recent evidence from animal models suggests these mutations may not spread within the population. However, early treatment failure is likely to arise through alternative mechanisms, requiring further investigation.
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Affiliation(s)
- Henry M Staines
- Centre for Diagnostics and Antimicrobial Resistance, Institute for Infection & Immunity, St George's University of London, London, UK.,Institute for Infection & Immunity, St George's University of London, London, UK
| | - Rebekah Burrow
- Institute for Infection & Immunity, St George's University of London, London, UK
| | - Beatrix Huei-Yi Teo
- Institute for Infection & Immunity, St George's University of London, London, UK
| | - Irina Chis Ster
- Institute for Infection & Immunity, St George's University of London, London, UK
| | - Peter G Kremsner
- Institut für Tropenmedizin Universitätsklinikum Tübingen, Tübingen, Germany.,Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
| | - Sanjeev Krishna
- Centre for Diagnostics and Antimicrobial Resistance, Institute for Infection & Immunity, St George's University of London, London, UK.,Institute for Infection & Immunity, St George's University of London, London, UK.,Institut für Tropenmedizin Universitätsklinikum Tübingen, Tübingen, Germany.,Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon.,St George's University Hospitals NHS Foundation Trust, London, UK
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6
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Robin C, Lê MP, Melica G, Massias L, Redjoul R, Khoudour N, Leclerc M, Beckerich F, Maury S, Hulin A, Cordonnier C. Plasma concentrations of atovaquone given to immunocompromised patients to prevent Pneumocystis jirovecii. J Antimicrob Chemother 2018. [PMID: 28651341 DOI: 10.1093/jac/dkx198] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Objectives Atovaquone is one of the alternatives to trimethoprim/sulfamethoxazole for prophylaxis of Pneumocystis jirovecii pneumonia (PCP) in immunocompromised patients. In volunteers, there was wide inter-individual variability in atovaquone bioavailability. The aim of this study was to assess the plasma concentrations of atovaquone in immunocompromised patients under PCP prophylaxis. Methods Adult haematology or HIV-positive patients receiving atovaquone (750 mg oral suspension twice a day) for PCP prophylaxis were included. Plasma concentrations were assessed using UV-HPLC, around 12 h after the evening dose (Cmin) and 1-5 h after the morning dose (Cmax). Results A total of 82 measurements were performed in 33 patients. This included 19 HSCT recipients, 7 haematology non-transplant patients and 7 HIV-positive patients. The median Cmin (IQR) was 11.3 μg/mL (6.2-27.8) and the median Cmax was 13.4 μg/mL (6.0-28.3). The Cmin and Cmax of atovaquone were not different between HIV-negative and HIV-positive patients, or between HSCT and non-HSCT patients. Atovaquone concentrations were not influenced by the co-administration of valaciclovir (n = 20) or ciclosporin (n = 11), by gut graft-versus-host disease (n = 7) or by the intake of atovaquone with food. Nineteen of the 33 (58%) patients had Cmin <15 μg/mL, a threshold associated with a low rate of clinical response in PCP treatment. Conclusions Atovaquone is poorly absorbed in more than half of immunocompromised patients and its bioavailability varies between individuals. These unpredictable variations raise the question of therapeutic drug monitoring, in order to identify patients with low concentrations and those who could benefit from regimen adaptation or from alternatives.
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Affiliation(s)
- Christine Robin
- Assistance Publique-Hôpitaux de Paris (AP-HP), Henri Mondor Teaching Hospital, Department of Haematology, Créteil, France.,University Paris-Est Créteil (UPEC), Créteil, France
| | - Minh Patrick Lê
- APHP, Bichat-Claude Bernard Teaching Hospital, Pharmacology Laboratory, Paris, France.,IAME, Inserm UMR1137, Université Paris Diderot-Sorbonne Paris Cité, Paris, France
| | - Giovanna Melica
- AP-HP, Henri Mondor Teaching Hospital, Department of Clinical Immunology, Créteil, France
| | - Laurent Massias
- APHP, Bichat-Claude Bernard Teaching Hospital, Pharmacology Laboratory, Paris, France.,IAME, Inserm UMR1137, Université Paris Diderot-Sorbonne Paris Cité, Paris, France
| | - Rabah Redjoul
- Assistance Publique-Hôpitaux de Paris (AP-HP), Henri Mondor Teaching Hospital, Department of Haematology, Créteil, France
| | - Nihel Khoudour
- AP-HP, Henri Mondor Teaching Hospital, Department of Pharmacology, Créteil, France
| | - Mathieu Leclerc
- Assistance Publique-Hôpitaux de Paris (AP-HP), Henri Mondor Teaching Hospital, Department of Haematology, Créteil, France.,University Paris-Est Créteil (UPEC), Créteil, France
| | - Florence Beckerich
- Assistance Publique-Hôpitaux de Paris (AP-HP), Henri Mondor Teaching Hospital, Department of Haematology, Créteil, France.,University Paris-Est Créteil (UPEC), Créteil, France
| | - Sébastien Maury
- Assistance Publique-Hôpitaux de Paris (AP-HP), Henri Mondor Teaching Hospital, Department of Haematology, Créteil, France.,University Paris-Est Créteil (UPEC), Créteil, France
| | - Anne Hulin
- AP-HP, Henri Mondor Teaching Hospital, Department of Pharmacology, Créteil, France
| | - Catherine Cordonnier
- Assistance Publique-Hôpitaux de Paris (AP-HP), Henri Mondor Teaching Hospital, Department of Haematology, Créteil, France.,University Paris-Est Créteil (UPEC), Créteil, France
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Baruah UK, Gowthamarajan K, Vanka R, Karri VVSR, Selvaraj K, Jojo GM. Malaria treatment using novel nano-based drug delivery systems. J Drug Target 2017; 25:567-581. [PMID: 28166440 DOI: 10.1080/1061186x.2017.1291645] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
We reside in an era of technological innovation and advancement despite which infectious diseases like malaria remain to be one of the greatest threats to the humans. Mortality rate caused by malaria disease is a huge concern in the twenty-first century. Multiple drug resistance and nonspecific drug targeting of the most widely used drugs are the main reasons/drawbacks behind the failure in malarial therapy. Dose-related toxicity because of high doses is also a major concern. Therefore, to overcome these problems nano-based drug delivery systems are being developed to facilitate site-specific or target-based drug delivery and hence minimizing the development of resistance progress and dose-dependent toxicity issues. In this review, we discuss about the shortcomings in treating malaria and how nano-based drug delivery systems can help in curtailing the infectious disease malaria.
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Affiliation(s)
- Uday Krishna Baruah
- a Department of Pharmaceutics , JSS College of Pharmacy, Ootacamund, JSS University , Mysuru , India
| | - Kuppusamy Gowthamarajan
- a Department of Pharmaceutics , JSS College of Pharmacy, Ootacamund, JSS University , Mysuru , India
| | - Ravisankar Vanka
- a Department of Pharmaceutics , JSS College of Pharmacy, Ootacamund, JSS University , Mysuru , India
| | | | - Kousalya Selvaraj
- a Department of Pharmaceutics , JSS College of Pharmacy, Ootacamund, JSS University , Mysuru , India
| | - Gifty M Jojo
- a Department of Pharmaceutics , JSS College of Pharmacy, Ootacamund, JSS University , Mysuru , India
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8
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de Gier B, Suryapranata FST, Croughs M, van Genderen PJJ, Keuter M, Visser LG, van Vugt M, Sonder GJB. Increase in imported malaria in the Netherlands in asylum seekers and VFR travellers. Malar J 2017; 16:60. [PMID: 28148300 PMCID: PMC5288937 DOI: 10.1186/s12936-017-1711-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Accepted: 01/25/2017] [Indexed: 01/12/2023] Open
Abstract
Background Malaria is a notifiable disease in the Netherlands, a non-endemic country. Imported malaria infections occur regularly among travellers, migrants and visitors. Surveillance data were analysed from 2008 to 2015. Trends in amounts of notifications among risk groups were analysed using Poisson regression. For asylum seekers, yearly incidence was calculated per region of origin, using national asylum request statistics as denominator data. For tourists, denominator data were used from travel statistics to estimate incidence per travel region up to 2012. Results A modest increase in overall imported malaria notifications occurred in 2008–2015 (from 222 in 2008 to 344 in 2015). Notably, in 2014 and 2015 sharp increases were seen in malaria among travellers visiting friends and relatives (VFR), and in asylum seekers. Of all Plasmodium falciparum infections, most (1254/1337; 93.8%) were imported from Africa; 1037/1337 (77.6%) were imported from Central and West Africa. Malaria in VFR was mostly caused by P. falciparum infection after visiting Ghana (22%) or Nigeria (19%). Malaria in asylum seekers was mostly caused by Plasmodium vivax infection from the Horn of Africa. The large number of notifications in asylum seekers resulted from both an increase in number of asylum seekers and a striking increase of malaria incidence in this group. Incidence of malaria in asylum seekers from the Horn of Africa ranged between 0.02 and 0.3% in 2008–2013, but rose to 1.6% in 2014 and 1.3% in 2015. In 2008–2012, incidence in tourists visiting Central and West Africa dropped markedly. Conclusions Imported malaria is on the rise again in the Netherlands, most notably since 2013. This is mostly due to immigration of asylum seekers from the Horn of Africa. The predominance of P. vivax infection among asylum seekers warrants vigilance in health workers when a migrant presents with fever, as relapses of this type of malaria can occur long after arrival in the Netherlands. Electronic supplementary material The online version of this article (doi:10.1186/s12936-017-1711-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Brechje de Gier
- Department for Early Warning and Surveillance, Center for Epidemiology and Surveillance of Infectious Diseases, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Franciska S T Suryapranata
- Department of Infectious Diseases, Public Health Service (GGD) of Amsterdam, Nieuwe Achtergracht 100, PO Box 2200, 1000 CE, Amsterdam, The Netherlands. .,National Coordination Centre for Travellers' Health Advice (LCR), Nieuwe Achtergracht 100, PO Box 1008, 1000 BA, Amsterdam, The Netherlands.
| | - Mieke Croughs
- Department of Environment, Public Health Service (GGD) Hart voor Brabant, Ringbaan West 227, 5037 PC, Tilburg, The Netherlands.,Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Perry J J van Genderen
- Institute for Tropical Diseases, Harbour Hospital Rotterdam, Haringvliet 72, 3011 TG, Rotterdam, The Netherlands
| | - Monique Keuter
- Nijmegen Institute for International Health, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Leo G Visser
- Department of Infectious Diseases, Leiden University Medical Centre, C5P46, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands
| | - Michele van Vugt
- Department of Internal Medicine, Division of Infectious Diseases, Tropical Medicine and AIDS, Academic Medical Centre, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Gerard J B Sonder
- Department of Infectious Diseases, Public Health Service (GGD) of Amsterdam, Nieuwe Achtergracht 100, PO Box 2200, 1000 CE, Amsterdam, The Netherlands.,National Coordination Centre for Travellers' Health Advice (LCR), Nieuwe Achtergracht 100, PO Box 1008, 1000 BA, Amsterdam, The Netherlands.,Department of Internal Medicine, Division of Infectious Diseases, Tropical Medicine and AIDS, Academic Medical Centre, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
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Roseau JB, Pradines B, Paleiron N, Vedy S, Madamet M, Simon F, Javelle E. Failure of dihydroartemisinin plus piperaquine treatment of falciparum malaria by under-dosing in an overweight patient. Malar J 2016; 15:479. [PMID: 27646822 PMCID: PMC5028982 DOI: 10.1186/s12936-016-1535-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Accepted: 09/13/2016] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Artemisinin-based combination therapy (ACT) introduced in the mid-1990s has been recommended since 2005 by the World Health Organization as first-line treatment against Plasmodium falciparum in all endemic countries. In 2010, the combination dihydroartemisinin-piperaquine (DP) was recommended for the treatment of uncomplicated P. falciparum malaria. DP is one of the first-line treatments used by the French army since 2013. CASE PRESENTATION A case of P. falciparum clinical failure with DP at day 20 was described in a 104 kg French soldier deployed in Djibouti. He was admitted to hospital for supervision of oral treatment with DP [40 mg dihydroartemisinin (DHA) plus 320 mg piperaquine tetraphosphate (PPQ)]. This corresponded to a cumulative dose of 4.6 mg/kg DHA and 37 mg/kg PPQ in the present patient, which is far below the WHO recommended ranges. No mutation was found in the propeller domain of the Kelch 13 (k13) gene, which is associated with artemisinin resistance in Southeast Asia. Pfmdr1 N86, 184F, S1034 and N1042 polymorphisms and haplotype 72-76 CVIET for the pfcrt gene were found in the present case. There was no evidence of resistance to DP. CONCLUSION This case confirms the risk of therapeutic failure with dihydroartemisinin-piperaquine by under-dosing in patients weighing more than 100 kg. This therapeutic failure with DP by under-dosing highlighted the importance of appropriate dosing guidelines and the need of research data (efficacy, pharmacokinetics and pharmacodynamics) in over-weight patient group.
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Affiliation(s)
- Jean Baptiste Roseau
- Service de Pneumologie, Hôpital d'Instruction des Armées Laveran, Marseille, France.,Groupe Médico-chirurgical Bouffard, Djibouti, Republic of Djibouti
| | - Bruno Pradines
- Unité de Parasitologie et d'Entomologie, Département des Maladies Infectieuses, Institut de Recherche Biomédicale des Armées, Marseille, France. .,Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes, UM 63, CNRS 7278, IRD 198, Inserm 1095, Aix Marseille Université, Marseille, France. .,Centre National de Référence du Paludisme, Marseille, France.
| | - Nicolas Paleiron
- Groupe Médico-chirurgical Bouffard, Djibouti, Republic of Djibouti.,Service de Pneumologie, Hôpital d'Instruction des Armées Clermont-Tonnerre, Brest, France
| | - Serge Vedy
- Groupe Médico-chirurgical Bouffard, Djibouti, Republic of Djibouti
| | - Marylin Madamet
- Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes, UM 63, CNRS 7278, IRD 198, Inserm 1095, Aix Marseille Université, Marseille, France.,Centre National de Référence du Paludisme, Marseille, France.,Equipe Résidente de Recherche en Infectiologie Tropicale, Institut de Recherche Biomédicale des Armées, Hôpital d'Instruction des Armées, Marseille, France
| | - Fabrice Simon
- Service de pathologie infectieuse et tropicale, Hôpital d'Instruction des Armées Laveran, Marseille, France.,Ecole du Val de Grâce, Paris, France
| | - Emilie Javelle
- Service de pathologie infectieuse et tropicale, Hôpital d'Instruction des Armées Laveran, Marseille, France.
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Paloque L, Ramadani AP, Mercereau-Puijalon O, Augereau JM, Benoit-Vical F. Plasmodium falciparum: multifaceted resistance to artemisinins. Malar J 2016; 15:149. [PMID: 26955948 PMCID: PMC4784301 DOI: 10.1186/s12936-016-1206-9] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2015] [Accepted: 03/01/2016] [Indexed: 11/18/2022] Open
Abstract
Plasmodium falciparum resistance to artemisinins, the most potent and fastest acting anti-malarials, threatens malaria elimination strategies. Artemisinin resistance is due to mutation of the PfK13 propeller domain and involves an unconventional mechanism based on a quiescence state leading to parasite recrudescence as soon as drug pressure is removed. The enhanced P. falciparum quiescence capacity of artemisinin-resistant parasites results from an increased ability to manage oxidative damage and an altered cell cycle gene regulation within a complex network involving the unfolded protein response, the PI3K/PI3P/AKT pathway, the PfPK4/eIF2α cascade and yet unidentified transcription factor(s), with minimal energetic requirements and fatty acid metabolism maintained in the mitochondrion and apicoplast. The detailed study of these mechanisms offers a way forward for identifying future intervention targets to fend off established artemisinin resistance.
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Affiliation(s)
- Lucie Paloque
- CNRS, LCC (Laboratoire de Chimie de Coordination) UPR8241, 205 route de Narbonne, BP 44099, 31077, Toulouse Cedex 4, France. .,Université de Toulouse, UPS, INPT, 31077, Toulouse Cedex 4, France.
| | - Arba P Ramadani
- CNRS, LCC (Laboratoire de Chimie de Coordination) UPR8241, 205 route de Narbonne, BP 44099, 31077, Toulouse Cedex 4, France. .,Université de Toulouse, UPS, INPT, 31077, Toulouse Cedex 4, France. .,Department of Pharmacology and Therapy, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia.
| | | | - Jean-Michel Augereau
- CNRS, LCC (Laboratoire de Chimie de Coordination) UPR8241, 205 route de Narbonne, BP 44099, 31077, Toulouse Cedex 4, France. .,Université de Toulouse, UPS, INPT, 31077, Toulouse Cedex 4, France.
| | - Françoise Benoit-Vical
- CNRS, LCC (Laboratoire de Chimie de Coordination) UPR8241, 205 route de Narbonne, BP 44099, 31077, Toulouse Cedex 4, France. .,Université de Toulouse, UPS, INPT, 31077, Toulouse Cedex 4, France.
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11
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Ingasia LA, Akala HM, Imbuga MO, Opot BH, Eyase FL, Johnson JD, Bulimo WD, Kamau E. Molecular characterization of the cytochrome b gene and in vitro atovaquone susceptibility of Plasmodium falciparum isolates from Kenya. Antimicrob Agents Chemother 2015; 59:1818-21. [PMID: 25583715 PMCID: PMC4325819 DOI: 10.1128/aac.03956-14] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Accepted: 01/04/2015] [Indexed: 11/20/2022] Open
Abstract
The prevalence of a genetic polymorphism(s) at codon 268 in the cytochrome b gene, which is associated with failure of atovaquone-proguanil treatment, was analyzed in 227 Plasmodium falciparum parasites from western Kenya. The prevalence of the wild-type allele was 63%, and that of the Y268S (denoting a Y-to-S change at position 268) mutant allele was 2%. There were no pure Y268C or Y268N mutant alleles, only mixtures of a mutant allele(s) with the wild type. There was a correlation between parasite 50% inhibitory concentration (IC50) and parasite genetic polymorphism; mutant alleles had higher IC50s than the wild type.
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Affiliation(s)
- Luicer A Ingasia
- Department of Emerging Infectious Diseases-Global Emerging Infections Surveillance and Response System (DEID-GEIS) Program, U.S. Army Medical Research Unit-Kenya (USAMRU-K), Kenya Medical Research Institute (KEMRI)-Walter Reed Project, Kisumu, Kenya
| | - Hoseah M Akala
- Department of Emerging Infectious Diseases-Global Emerging Infections Surveillance and Response System (DEID-GEIS) Program, U.S. Army Medical Research Unit-Kenya (USAMRU-K), Kenya Medical Research Institute (KEMRI)-Walter Reed Project, Kisumu, Kenya
| | - Mabel O Imbuga
- Department of Biochemistry, College of Health Sciences, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya
| | - Benjamin H Opot
- Department of Emerging Infectious Diseases-Global Emerging Infections Surveillance and Response System (DEID-GEIS) Program, U.S. Army Medical Research Unit-Kenya (USAMRU-K), Kenya Medical Research Institute (KEMRI)-Walter Reed Project, Kisumu, Kenya
| | - Fredrick L Eyase
- Department of Emerging Infectious Diseases-Global Emerging Infections Surveillance and Response System (DEID-GEIS) Program, U.S. Army Medical Research Unit-Kenya (USAMRU-K), Kenya Medical Research Institute (KEMRI)-Walter Reed Project, Kisumu, Kenya
| | - Jacob D Johnson
- Department of Emerging Infectious Diseases-Global Emerging Infections Surveillance and Response System (DEID-GEIS) Program, U.S. Army Medical Research Unit-Kenya (USAMRU-K), Kenya Medical Research Institute (KEMRI)-Walter Reed Project, Kisumu, Kenya
| | - Wallace D Bulimo
- Department of Emerging Infectious Diseases-Global Emerging Infections Surveillance and Response System (DEID-GEIS) Program, U.S. Army Medical Research Unit-Kenya (USAMRU-K), Kenya Medical Research Institute (KEMRI)-Walter Reed Project, Kisumu, Kenya
| | - Edwin Kamau
- Department of Emerging Infectious Diseases-Global Emerging Infections Surveillance and Response System (DEID-GEIS) Program, U.S. Army Medical Research Unit-Kenya (USAMRU-K), Kenya Medical Research Institute (KEMRI)-Walter Reed Project, Kisumu, Kenya
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12
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Plucinski MM, Huber CS, Akinyi S, Dalton W, Eschete M, Grady K, Silva-Flannery L, Mathison BA, Udhayakumar V, Arguin PM, Barnwell JW. Novel Mutation in Cytochrome B of Plasmodium falciparum in One of Two Atovaquone-Proguanil Treatment Failures in Travelers Returning From Same Site in Nigeria. Open Forum Infect Dis 2014; 1:ofu059. [PMID: 25734129 PMCID: PMC4281801 DOI: 10.1093/ofid/ofu059] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2014] [Accepted: 07/01/2014] [Indexed: 11/14/2022] Open
Abstract
Background Atovaquone-proguanil (AP) is the most commonly used treatment for uncomplicated Plasmodium falciparum malaria in the United States. Apparent AP treatment failures were reported 7 months apart in 2 American travelers who stayed in the same compound for foreign workers in Rivers State, Nigeria. Methods We analyzed pretreatment (day 0) and day of failure samples from both travelers for mutations in the P falciparum cytochrome B (pfcytb) and dihydrofolate reductase (pfdhfr) genes associated with resistance to atovaquone and cycloguanil, the active metabolite of proguanil, respectively. We genotyped the parasites and sequenced their mitochondrial genomes. Results On day 0, both travelers had proguanil-resistant genotypes but atovaquone-sensitive cytb sequences. Day of failure samples exhibited mutations in cytb for both travelers. One traveler had the common Y268S mutation, whereas the other traveler had a previously unreported mutation, I258M. The travelers had unrelated parasite genotypes and different mitochondrial genomes. Conclusions Despite the infections likely having been contracted in the same site, there is no evidence that the cases were related. The mutations likely arose independently during the acute infection or treatment. Our results highlight the importance of genotyping parasites and sequencing the full cytb and dhfr genes in AP failures to rule out transmission of AP-resistant strains and identify novel mechanisms of AP resistance.
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Affiliation(s)
- Mateusz M Plucinski
- Division of Parasitic Diseases and Malaria, Center for Global Health ; Epidemic Intelligence Service , Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Curtis S Huber
- Division of Parasitic Diseases and Malaria, Center for Global Health
| | - Sheila Akinyi
- Division of Parasitic Diseases and Malaria, Center for Global Health
| | | | - Mary Eschete
- Terrebonne General Medical Center, Houma, Louisiana
| | - Katharine Grady
- Division of Parasitic Diseases and Malaria, Center for Global Health
| | | | - Blaine A Mathison
- Division of Parasitic Diseases and Malaria, Center for Global Health
| | | | - Paul M Arguin
- Division of Parasitic Diseases and Malaria, Center for Global Health
| | - John W Barnwell
- Division of Parasitic Diseases and Malaria, Center for Global Health
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13
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Ashok P, Ganguly S, Murugesan S. Manzamine alkaloids: isolation, cytotoxicity, antimalarial activity and SAR studies. Drug Discov Today 2014; 19:1781-1791. [PMID: 24953707 DOI: 10.1016/j.drudis.2014.06.010] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Revised: 05/14/2014] [Accepted: 06/13/2014] [Indexed: 10/25/2022]
Abstract
The infectious disease Malaria is caused by different species of the genus Plasmodium. Resistance to quinoline antimalarial drugs and decreased susceptibility to artemisinin-based combination therapy have increased the need for novel antimalarial agents. Historically, natural products have been used for the treatment of infectious diseases. Identification of natural products and their semi-synthetic derivatives with potent antimalarial activity is an important method for developing novel antimalarial agents. Manzamine alkaloids are a unique group of β-carboline alkaloids isolated from various species of marine sponge displaying potent antimalarial activity against drug-sensitive and -resistant strains of Plasmodium. In this review, we demonstrate antimalarial potency, cytotoxicity and antimalarial SAR of manzamine alkaloids.
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Affiliation(s)
- Penta Ashok
- Medicinal Chemistry Research Laboratory, Department of Pharmacy, Birla Institute of Technology & Science, Pilani 333031, India
| | - Swastika Ganguly
- Department of Pharmaceutical Sciences, Birla Institute of Technology, Mesra 835215, India
| | - Sankaranarayanan Murugesan
- Medicinal Chemistry Research Laboratory, Department of Pharmacy, Birla Institute of Technology & Science, Pilani 333031, India.
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14
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Cordel H, Cailhol J, Matheron S, Bloch M, Godineau N, Consigny PH, Gros H, Campa P, Bourée P, Fain O, Ralaimazava P, Bouchaud O. Atovaquone-proguanil in the treatment of imported uncomplicated Plasmodium falciparum malaria: a prospective observational study of 553 cases. Malar J 2013; 12:399. [PMID: 24200190 PMCID: PMC3831254 DOI: 10.1186/1475-2875-12-399] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2013] [Accepted: 10/30/2013] [Indexed: 11/25/2022] Open
Abstract
Background Each year, thousands of cases of uncomplicated malaria are imported into Europe by travellers. Atovaquone-proguanil (AP) has been one of the first-line regimens used in France for uncomplicated malaria for almost ten years. While AP’s efficacy and tolerance were evaluated in several trials, its use in “real life” conditions has never been described. This study aimed to describe outcome and tolerance after AP treatment in a large cohort of travellers returning from endemic areas. Methods Between September 2002 and January 2007, uncomplicated malaria treated in nine French travel clinics with AP were followed for 30 days after AP initiation. Clinical and biological data were collected at admission and during the follow-up. Results A total of 553 patients were included. Eighty-eight percent of them were born in Africa, and 61.8% were infected in West Africa, whereas 0.5% were infected in Asia. Migrants visiting friends and relatives (VFR) constituted 77.9% of the patients, the remainder (32.1%) were backpackers. Three-hundred and sixty-four patients (66%) fulfilled follow-up at day 7 and 265 (48%) completed the study at day 30. Three patients had treatment failure. One-hundred and seventy-seven adverse drug reactions (ADR) were reported during the follow-up; 115 (77%) of them were digestive ADR. Backpackers were more likely to experiment digestive ADR compared to VFR (OR = 3.8; CI 95% [1.8-8.2]). Twenty patients had to be switched to another regimen due to ADR. Conclusion This study seems to be the largest in terms of number of imported uncomplicated malaria cases treated by AP. The high rate of reported digestive ADR is striking and should be taken into account in the follow-up of patients since it could affect their adherence to the treatment. Beside AP, artemisinin combination therapy (ACT) is now recommended as first-line regimen. A comparison of AP and ACT, in terms of efficacy and tolerance, would be useful.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Olivier Bouchaud
- Department of Infectious and Tropical Diseases, Hôpital Avicenne, Assistance Publique-Hôpitaux de Paris, Bobigny, France.
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15
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Nixon GL, Moss DM, Shone AE, Lalloo DG, Fisher N, O'Neill PM, Ward SA, Biagini GA. Antimalarial pharmacology and therapeutics of atovaquone. J Antimicrob Chemother 2013; 68:977-85. [PMID: 23292347 PMCID: PMC4344550 DOI: 10.1093/jac/dks504] [Citation(s) in RCA: 126] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Atovaquone is used as a fixed-dose combination with proguanil (Malarone) for treating children and adults with uncomplicated malaria or as chemoprophylaxis for preventing malaria in travellers. Indeed, in the USA, between 2009 and 2011, Malarone prescriptions accounted for 70% of all antimalarial pre-travel prescriptions. In 2013 the patent for Malarone will expire, potentially resulting in a wave of low-cost generics. Furthermore, the malaria scientific community has a number of antimalarial quinolones with a related pharmacophore to atovaquone at various stages of pre-clinical development. With this in mind, it is timely here to review the current knowledge of atovaquone, with the purpose of aiding the decision making of clinicians and drug developers involved in the future use of atovaquone generics or atovaquone derivatives.
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Affiliation(s)
- Gemma L Nixon
- Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK
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16
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Bouchaud O, Mühlberger N, Parola P, Calleri G, Matteelli A, Peyerl-Hoffmann G, Méchaï F, Gautret P, Clerinx J, Kremsner PG, Jelinek T, Kaiser A, Beltrame A, Schmid ML, Kern P, Probst M, Bartoloni A, Weinke T, Grobusch MP. Therapy of uncomplicated falciparum malaria in Europe: MALTHER - a prospective observational multicentre study. Malar J 2012; 11:212. [PMID: 22720832 PMCID: PMC3477029 DOI: 10.1186/1475-2875-11-212] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2012] [Accepted: 06/08/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Malaria continues to be amongst the most frequent infectious diseases imported to Europe. Whilst European treatment guidelines are based on data from studies carried out in endemic areas, there is a paucity of original prospective treatment data. The objective was to summarize data on treatments to harmonize and optimize treatment for uncomplicated malaria in Europe. METHODS A prospective observational multicentre study was conducted, assessing tolerance and efficacy of treatment regimens for imported uncomplicated falciparum malaria in adults amongst European centres of tropical and travel medicine. RESULTS Between December 2003 and 2009, 504 patients were included in 16 centres from five European countries. Eighteen treatment regimens were reported, the top three being atovaquone-proguanil, mefloquine, and artemether-lumefantrine. Treatments significantly differed with respect to the occurrence of treatment changes (p = 0.005) and adverse events (p = 0.001), parasite and fever clearance times (p < 0.001), and hospitalization rates (p = 0.0066) and durations (p = 0.001). Four recrudescences and two progressions to severe disease were observed. Compared to other regimens, quinine alone was associated with more frequent switches to second line treatment, more adverse events and longer inpatient stays. Parasite and fever clearance times were shortest with artemether-mefloquine combination treatment. Vomiting was the most frequent cause of treatment change, occurring in 5.5% of all patients but 9% of the atovaquone-proguanil group. CONCLUSIONS This study highlights the heterogeneity of standards of care within Europe. A consensus discussion at European level is desirable to foster a standardized management of imported falciparum malaria.
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Affiliation(s)
- Olivier Bouchaud
- Infectious and Tropical Diseases Department, Hôpital Avicenne-APHP and Université Paris 13, Bobigny, France
| | - Nikolai Mühlberger
- Department of Public Health and Health Technology Assessment, UMIT - University for Health Sciences, Medical Informatics and Technology, Hall i.T, Austria
| | - Philippe Parola
- Infectious and Tropical Medicine Unit, North University Hospital, 13015, Marseille, France
| | - Guido Calleri
- Divisione Malattie Infettive e Tropicali, Ospedale “Amedeo di Savoia”, Torino, Italy
| | - Alberto Matteelli
- Institute of Infectious and Tropical Diseases, University Hospital, Brescia, Italy
| | - Gabriele Peyerl-Hoffmann
- Centre for Infectious Diseases and Travel Medicine, University Hospital Freiburg, Freiburg, Germany
| | - Frédéric Méchaï
- Infectious and Tropical Diseases Department, Hôpital Avicenne-APHP and Université Paris 13, Bobigny, France
| | - Philippe Gautret
- Infectious and Tropical Medicine Unit, North University Hospital, 13015, Marseille, France
| | - Jan Clerinx
- Institute of Tropical Medicine, Antwerp, Belgium
| | - Peter G Kremsner
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany
| | - Tomas Jelinek
- Berlin Centre for Travel and Tropical Medicine, Berlin, Germany
| | - Annette Kaiser
- Institute of Medical Microbiology and Parasitology, University of Bonn, Bonn, Germany
| | - Anna Beltrame
- Clinica de Malattie Infettive, AOU di Udine, Udine, Italy
| | - Matthias L Schmid
- Department of Infection & Tropical Medicine, Royal Victoria Infirmary, Newcastle upon Tyne, UK
| | - Peter Kern
- Comprehensive Infectious Diseases Center, University Hospitals, Ulm, Germany
| | - Meike Probst
- Medizinische Klinik m. S. Infektiologie, Charité University Hospital, Berlin, Germany
| | - Alessandro Bartoloni
- Infectious and Tropical Diseases Unit, AOU Careggi, and Department of Critical Care Medicine and Surgery, University of Florence, Florence, Italy
| | - Thomas Weinke
- Department of Gastroenterology and Infectious Diseases, Klinikum Ernst von Bergmann, Potsdam, Germany
| | - Martin P Grobusch
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany
- Centre for Tropical and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Amsterdam Medical Centre, University of Amsterdam, Meibergdreef 9, PO Box 22700, 1100 DE, Amsterdam, The Netherlands
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17
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Wurtz N, Pascual A, Marin-Jauffre A, Bouchiba H, Benoit N, Desbordes M, Martelloni M, Pommier de Santi V, Richa G, Taudon N, Pradines B, Briolant S. Early treatment failure during treatment of Plasmodium falciparum malaria with atovaquone-proguanil in the Republic of Ivory Coast. Malar J 2012; 11:146. [PMID: 22551095 PMCID: PMC3447648 DOI: 10.1186/1475-2875-11-146] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2012] [Accepted: 05/02/2012] [Indexed: 11/29/2022] Open
Abstract
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.
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Affiliation(s)
- Nathalie Wurtz
- Unité de Parasitologie - Unité de Recherche pour les Maladies Infectieuses et Tropicales Emergentes - UMR 6236, Institut de Recherche Biomédicale des Armées, Marseille, France.
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18
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Kimura M, Koga M, Kikuchi T, Miura T, Maruyama H. Efficacy and safety of atovaquone-proguanil in treating imported malaria in Japan: the second report from the research group. Parasitol Int 2012; 61:466-9. [PMID: 22484597 DOI: 10.1016/j.parint.2012.03.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2012] [Revised: 02/20/2012] [Accepted: 03/20/2012] [Indexed: 10/28/2022]
Abstract
Malaria remains an important health risk among travelers to tropical/subtropical regions. However, in Japan, only 2 antimalarials are licensed for clinical use - oral quinine and mefloquine. The Research Group on Chemotherapy of Tropical Diseases introduced atovaquone-proguanil in 1999, and reported on its excellent antimalarial efficacy and safety for treating non-immune patients with uncomplicated Plasmodium falciparum malaria (20 adult and 3 pediatric cases) in 2006. In the present study, additional cases of malaria were analyzed to confirm the efficacy and safety of this antimalarial drug. Fourteen adult and 2 pediatric cases of P. falciparum malaria and 13 adult cases and 1 pediatric case of P. vivax/ovale malaria were successfully treated with atovaquone-proguanil, including 3 P. falciparum cases in which the antecedent treatment failed. Two patients with P. vivax malaria were treated twice due to primaquine treatment failure as opposed to atovaquone-proguanil treatment failure. Except for 1 patient with P. falciparum malaria who developed a moderate liver function disturbance, no significant adverse effects were observed. Despite the intrinsic limitations of this study, which was not a formal clinical trial, the data showed that atovaquone-proguanil was an effective and well-tolerated therapeutic option; licensure of this drug in Japan could greatly contribute to individually appropriate treatment options.
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Affiliation(s)
- Mikio Kimura
- Department of Internal Medicine, Shin-Yamanote Hospital, Japan Anti-Tuberculosis Association, Tokyo, Japan.
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19
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Forestier E, Labe A, Raffenot D, Lecomte C, Rogeaux O. [Post-malaria neurological syndrome complicating a relapse of Plasmodium falciparum malaria after atovaquone-proguanil treatment]. Med Mal Infect 2010; 41:41-3. [PMID: 20800398 DOI: 10.1016/j.medmal.2010.07.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2010] [Revised: 06/01/2010] [Accepted: 07/20/2010] [Indexed: 10/19/2022]
Affiliation(s)
- E Forestier
- Service de maladies infectieuses, centre hospitalier, Chambéry cedex, France.
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Deen JL, von Seidlein L, Dondorp A. Therapy of uncomplicated malaria in children: a review of treatment principles, essential drugs and current recommendations. Trop Med Int Health 2008; 13:1111-30. [DOI: 10.1111/j.1365-3156.2008.02117.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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