| Autor: |
Chenet SM; 1Instituto de Enfermedades Tropicales, Universidad Nacional Toribio Rodríguez de Mendoza (UNTRM), Chachapoyas, Perú.; 2Instituto de Salud Pública de Chile (ISP), Santiago, Chile., Oyarce A; 2Instituto de Salud Pública de Chile (ISP), Santiago, Chile., Fernandez J; 2Instituto de Salud Pública de Chile (ISP), Santiago, Chile., Tapia-Limonchi R; 1Instituto de Enfermedades Tropicales, Universidad Nacional Toribio Rodríguez de Mendoza (UNTRM), Chachapoyas, Perú., Weitzel T; 3Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile., Tejedo JR; 1Instituto de Enfermedades Tropicales, Universidad Nacional Toribio Rodríguez de Mendoza (UNTRM), Chachapoyas, Perú.; 4Departamento de Biología Molecular e Ingeniería Bioquímica, Universidad Pablo de Olavide (UPO), Seville, Spain.; 5Diabetes and Associated Metabolic Diseases Networking Biomedical Research Centre (CIBERDEM), Madrid, Spain., Udhayakumar V; 6Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia., Jercic MI; 2Instituto de Salud Pública de Chile (ISP), Santiago, Chile., Lucchi NW; 6Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia. |
| Abstrakt: |
In November 2018, we diagnosed a cluster of falciparum malaria cases in three Chilean travelers returning from Nigeria. Two patients were treated with sequential intravenous artesunate plus oral atovaquone/proguanil (AP) and one with oral AP. The third patient, a 23-year-old man, presented with fever on day 29 after oral AP treatment and was diagnosed with recrudescent falciparum malaria. The patient was then treated with oral mefloquine, followed by clinical recovery and resolution of parasitemia. Analysis of day 0 and follow-up blood samples, collected on days 9, 29, 34, 64, and 83, revealed that parasitemia had initially decreased but then increased on day 29. Sequencing confirmed Tyr268Cys mutation in the cytochrome b gene, associated with atovaquone resistance, in isolates collected on days 29 and 34 and P. falciparum dihydrofolate reductase mutation Asn51Ile, associated with proguanil resistance in all successfully sequenced samples. Molecular characterization of imported malaria contributes to clinical management in non-endemic countries, helps ascertain the appropriateness of antimalarial treatment policies, and contributes to the reporting of drug resistance patterns from endemic regions. |
