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PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
5
pubmed:dateCreated
2002-8-30
pubmed:abstractText
The polymorphism of malaria parasites will greatly influence the efficiency of antimalarial drugs and vaccines. This study determined the genetic diversity of Plasmodium falciparum infections in 107 travelers and estimated the importance of mutations in the parasite dihydrofolate reductase (dhfr) gene for clinical breakthrough during proguanil prophylaxis. Genotyping with regards to the three highly polymorphic antigen-coding regions (merozoite surface protein-1 [msp-1], msp-2, and the glutamate-rich protein [glurp]) revealed multiple genotypes (up to five) in 64% of the patients. Single genotype infections were mainly associated with prior intake of antimalarial drugs, but also with a shorter stay in a malaria-endemic area and low parasite density. Malaria breakthrough despite proguanil prophylaxis was always associated with mutations in the dhfr gene; always the Asn-108 mutation and often the Ile-51 and Arg-59 mutations. The Leu-164 mutation was found in four travelers from Africa. Travelers with limited time in an endemic area were often infected with polyclonal P. falciparum infections, which suggests that single mosquito inoculations are often composed of several genetically diverse parasites. Chemoprophylaxis reduces the number of infecting clones and selects for resistant parasites as shown for proguanil through mutations in the dhfr gene.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
AIM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
May
pubmed:issn
0002-9637
pubmed:author
pubmed:issnType
Print
pubmed:volume
66
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
487-91
pubmed:dateRevised
2010-11-18
pubmed:meshHeading
pubmed-meshheading:12201581-Adolescent, pubmed-meshheading:12201581-Adult, pubmed-meshheading:12201581-Aged, pubmed-meshheading:12201581-Analysis of Variance, pubmed-meshheading:12201581-Animals, pubmed-meshheading:12201581-Antigens, Protozoan, pubmed-meshheading:12201581-Antimalarials, pubmed-meshheading:12201581-Child, pubmed-meshheading:12201581-Child, Preschool, pubmed-meshheading:12201581-Female, pubmed-meshheading:12201581-Humans, pubmed-meshheading:12201581-Infant, pubmed-meshheading:12201581-Malaria, Falciparum, pubmed-meshheading:12201581-Male, pubmed-meshheading:12201581-Middle Aged, pubmed-meshheading:12201581-Plasmodium falciparum, pubmed-meshheading:12201581-Proguanil, pubmed-meshheading:12201581-Sweden, pubmed-meshheading:12201581-Tetrahydrofolate Dehydrogenase, pubmed-meshheading:12201581-Travel
pubmed:year
2002
pubmed:articleTitle
Polyclonal Plasmodium falciparum malaria in travelers and selection of antifolate mutations after proguanil prophylaxis.
pubmed:affiliation
Department of Medicine, Karolinska Institutet, Karolinska Hospital, Stockholm, Sweden. anna.farnert@medks.ki.se
pubmed:publicationType
Journal Article, Research Support, Non-U.S. Gov't