title: pfk13-Independent Treatment Failure in Four Imported Cases of Plasmodium falciparum Malaria Treated with Artemether-Lumefantrine in the United Kingdom.
abstract: We present case histories of four patients treated with artemether-lumefantrine for falciparum malaria in UK hospitals in 2015 to 2016. Each subsequently presented with recurrent symptoms andPlasmodium falciparumparasitemia within 6 weeks of treatment with no intervening travel to countries where malaria is endemic. Parasite isolates, all of African origin, harbored variants at some candidate resistance loci. No evidence ofpfk13-mediated artemisinin resistance was found. Vigilance for signs of unsatisfactory antimalarial efficacy among imported cases of malaria is recommended.
authors.affiliation: Public Health England Malaria Reference Laboratory, London School of Hygiene & Tropical Medicine, London, United Kingdom Colin.sutherland@lshtm.ac.uk Debbie.nolder@lshtm.ac.uk.|Department of Immunology & Infection, Faculty of Infectious & Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom.
authors.forename: Colin J
authors.initials: CJ
authors.lastname: Sutherland
authors.affiliation: Public Health England Malaria Reference Laboratory, London School of Hygiene & Tropical Medicine, London, United Kingdom.
authors.forename: Paul
authors.initials: P
authors.lastname: Lansdell
authors.affiliation: Wellcome Trust Sanger Institute, Hinxton, United Kingdom.
authors.forename: Mandy
authors.initials: M
authors.lastname: Sanders
authors.affiliation: Department of Immunology & Infection, Faculty of Infectious & Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom.
authors.forename: Julian
authors.initials: J
authors.lastname: Muwanguzi
authors.affiliation: Department of Immunology & Infection, Faculty of Infectious & Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom.
authors.forename: Donelly A
authors.initials: DA
authors.lastname: van Schalkwyk
authors.affiliation: Department of Immunology & Infection, Faculty of Infectious & Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom.
authors.forename: Harparkash
authors.initials: H
authors.lastname: Kaur
authors.affiliation: Public Health England Malaria Reference Laboratory, London School of Hygiene & Tropical Medicine, London, United Kingdom Colin.sutherland@lshtm.ac.uk Debbie.nolder@lshtm.ac.uk.
authors.forename: Debbie
authors.initials: D
authors.lastname: Nolder
authors.affiliation: Public Health England Malaria Reference Laboratory, London School of Hygiene & Tropical Medicine, London, United Kingdom.
authors.forename: Julie
authors.initials: J
authors.lastname: Tucker
authors.affiliation: Wellcome Trust Sanger Institute, Hinxton, United Kingdom.
authors.forename: Hayley M
authors.initials: HM
authors.lastname: Bennett
authors.affiliation: Wellcome Trust Sanger Institute, Hinxton, United Kingdom.
authors.forename: Thomas D
authors.initials: TD
authors.lastname: Otto
authors.affiliation: Wellcome Trust Sanger Institute, Hinxton, United Kingdom.
authors.forename: Matthew
authors.initials: M
authors.lastname: Berriman
authors.affiliation: Hospital for Tropical Diseases, London, United Kingdom.
authors.forename: Trupti A
authors.initials: TA
authors.lastname: Patel
authors.affiliation: Haematology Department, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom.
authors.forename: Roderick
authors.initials: R
authors.lastname: Lynn
authors.affiliation: Infectious Diseases Department, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom.
authors.forename: Effrossyni
authors.initials: E
authors.lastname: Gkrania-Klotsas
authors.affiliation: Public Health England Malaria Reference Laboratory, London School of Hygiene & Tropical Medicine, London, United Kingdom.|Hospital for Tropical Diseases, London, United Kingdom.
authors.forename: Peter L
authors.initials: PL
authors.lastname: Chiodini
mesh_terms: D000349:Africa; D000368:Aged; D000962:Antimalarials / Q000627:therapeutic use*; D000077611:Artemether, Lumefantrine Drug Combination; D037621:Artemisinins / Q000627:therapeutic use*; D004338:Drug Combinations; D004351:Drug Resistance / Q000235:genetics*; D004983:Ethanolamines / Q000627:therapeutic use*; D005260:Female; D005449:Fluorenes / Q000627:therapeutic use*; D015870:Gene Expression; D056426:Genetic Loci; D006801:Humans; D016778:Malaria, Falciparum / Q000188:drug therapy* / Q000469:parasitology / Q000473:pathology; D008297:Male; D018512:Parasitemia / Q000188:drug therapy* / Q000469:parasitology / Q000473:pathology; D010963:Plasmodium falciparum / Q000187:drug effects* / Q000235:genetics / Q000254:growth & development; D015800:Protozoan Proteins / Q000235:genetics*; D012008:Recurrence; D014195:Travel; D017211:Treatment Failure; D006113:United Kingdom; D055815:Young Adult
chemical_list: D000962:Antimalarials; D000077611:Artemether, Lumefantrine Drug Combination; D037621:Artemisinins; D004338:Drug Combinations; D004983:Ethanolamines; D005449:Fluorenes; D015800:Protozoan Proteins
keywords: antimalarial agents; drug resistance mechanisms; imported malaria; parasite genotyping; treatment failure