title: Decreasing pfmdr1 copy number suggests that Plasmodium falciparum in Western Cambodia is regaining in vitro susceptibility to mefloquine.
abstract: Dihydroartemisinin-piperaquine is the current frontline artemisinin combination therapy (ACT) for Plasmodium falciparum malaria in Cambodia but is now failing in several western provinces. To investigate artesunate plus mefloquine (AS+MQ) as a replacement ACT, we measured the prevalence of multiple pfmdr1 copies--a molecular marker for MQ resistance--in 844 P. falciparum clinical isolates collected in 2008 to 2013. The pfmdr1 copy number is decreasing in Western Cambodia, suggesting that P. falciparum is regaining in vitro susceptibility to MQ.
authors.affiliation: Laboratory of Malaria and Vector Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, Maryland, USA National Center for Parasitology, Entomology, and Malaria Control, Phnom Penh, Cambodia.
authors.forename: Pharath
authors.initials: P
authors.lastname: Lim
authors.affiliation: National Center for Parasitology, Entomology, and Malaria Control, Phnom Penh, Cambodia.
authors.forename: Dalin
authors.initials: D
authors.lastname: Dek
authors.affiliation: National Center for Parasitology, Entomology, and Malaria Control, Phnom Penh, Cambodia.
authors.forename: Vorleak
authors.initials: V
authors.lastname: Try
authors.affiliation: National Center for Parasitology, Entomology, and Malaria Control, Phnom Penh, Cambodia.
authors.forename: Sokunthea
authors.initials: S
authors.lastname: Sreng
authors.affiliation: National Center for Parasitology, Entomology, and Malaria Control, Phnom Penh, Cambodia.
authors.forename: Seila
authors.initials: S
authors.lastname: Suon
authors.affiliation: Laboratory of Malaria and Vector Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, Maryland, USA rfairhurst@niaid.nih.gov.
authors.forename: Rick M
authors.initials: RM
authors.lastname: Fairhurst
mesh_terms: D000962:Antimalarials / Q000494:pharmacology*; D015767:Mefloquine / Q000494:pharmacology*; D027425:ATP-Binding Cassette, Sub-Family C Proteins / Q000235:genetics*; D021261:Parasitic Sensitivity Tests; D010963:Plasmodium falciparum / Q000187:drug effects* / Q000235:genetics*; D015800:Protozoan Proteins / Q000235:genetics*
chemical_list: D000962:Antimalarials; D015767:Mefloquine; D027425:ATP-Binding Cassette, Sub-Family C Proteins; D015800:Protozoan Proteins; C513498:Mdr1 protein, Plasmodium falciparum