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Artemether-Lumefantrine Selects For Malaria Parasites With Decreased Lumefantrine Sensitivity Although Parasites Remain Sensitive To This Regimen In Tororo, Uganda, P. Tumwebaze, J. Bloome, O. Byaruhanga, C. Nakazibwe, A. Walakira, J. Okiring, S. L. Nsobya, Roland A. Cooper, P. J. Rosenthal
Artemether-Lumefantrine Selects For Malaria Parasites With Decreased Lumefantrine Sensitivity Although Parasites Remain Sensitive To This Regimen In Tororo, Uganda, P. Tumwebaze, J. Bloome, O. Byaruhanga, C. Nakazibwe, A. Walakira, J. Okiring, S. L. Nsobya, Roland A. Cooper, P. J. Rosenthal
Roland A. Cooper
Artemisinin-based combination therapies (ACTs) may select for malaria parasites with decreased drug sensitivity. We studied the sensitivity of parasites from children enrolled in treatment and prevention trials in Tororo, Uganda from June, 2010 to February, 2012. When Plasmodium falciparum malaria was diagnosed, blood was obtained, parasites (286 isolates) were cultured with serial dilutions of chloroquine (CQ), monodesethylamodiaquine (AQ), quinine (QN), dihydroartemisinin (DHA), lumefantrine (LM), or piperaquine (PQ) for 72 h, and ex vivo sensitivities were assessed by HRP-2-based ELISA. Sensitivities (nM) to CQ (median IC50 486.2; IQR 206.5-748.8), AQ (83.3; 58.4-132.4), PQ (20.3; 7.6-47.5) and QN (126.4; 74.9-196.3) varied widely; …