Estimating True Antimalarial Efficacy by Heteroduplex Tracking Assay in Patients with Complex Plasmodium Falciparum Infections

Overview

Journal Antimicrob Agents Chemother

Publisher American Society for Microbiology

Specialty Pharmacology

Date 2006 Nov 23

PMID 17116685

Citations 25

Authors

Jesse J Kwiek

Alisa P Alker

Emily C Wenink

Marjorie Chaponda

Linda V Kalilani

Steven R Meshnick

Affiliations

Soon will be listed here.

Abstract

Heteroduplex tracking assays (HTAs) of Plasmodium falciparum merozoite surface protein 1 block-2 were used to assess complexity of infection and treatment efficacy in a trial of three antimalarial treatments in 141 Malawian pregnant women. An elevated complexity of infection (COI) was associated with anemia, parasite burden, and human immunodeficiency virus infection but was not associated with age or gravidity. Comparisons of HTA patterns before and after treatment allowed the classification of 20 of 30 (66%) recurrent episodes as either definite treatment failures or reinfections. An elevated COI was strongly associated with treatment failure (P=0.003). An algorithm was developed to assign a probability of failure for the 10 indeterminate participants, some of whose infections shared a single variant of high prevalence (>10%). By summing these probabilities, treatment efficacy was estimated.

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