Published in
BioMed Central, Malaria Journal, 1(12), 2013
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Susceptibility of human Plasmodium knowlesi infections to anti-malarials
,
Staines Hm,
Angela Siner,
Lu Chan Woon,
Mohammed Atique Ahmed,
Ahmed Ma,
Woon Lc,
Pasini Em,
Erica M. Pasini,
Kocken Ch,
Clemens Hm M. Kocken ,
Balbir Singh ,
Janet Cox-Singh
and other authors.
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Abstract
Abstract 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.