☆ 4.5 Article

Failure of atovaquone-proguanil malaria chemoprophylaxis in a traveler to Ghana

TRAVEL MEDICINE AND INFECTIOUS DISEASE (2015)

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Journal

TRAVEL MEDICINE AND INFECTIOUS DISEASE
Volume 13, Issue 1, Pages 89-93

Publisher

ELSEVIER SCI LTD
DOI: 10.1016/j.tmaid.2014.12.010

Keywords

Drug resistance; Malabsorption; Malaria; Malarone; Plasmodium falciparum

Categories

Public, Environmental & Occupational Health Infectious Diseases

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Clinical failure of Malarone (TM) chemoprophylaxis is extremely rare. We report a case of Plasmodium falciparum malaria in a returned traveler to Ghana who fully adhered to atovaquone-proguanil (Malarone (TM)) chemoprophylaxis daily dosing, yet took the pills on an empty stomach. Screening of the P. falciparum isolate revealed triple codon mutation of Dhfr at positions 51, 59, and 108. Plasma drug levels of both atovaquone and proguanil revealed sub-therapeutic concentrations. (C) 2014 Elsevier Ltd. All rights reserved.

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