Effectiveness of Quinine Monotherapy for the Treatment of Plasmodium Falciparum Infection in Pregnant Women in Lambaréné, Gabon

Adegnika, Ayôla Akim; Breitling, Lutz P.; Agnandji, Selidji Todagbé; Chai, Sanders K.; Schütte, Daniela; Oyakhirome, Sunny; Schwarz, Norbert; Grobusch, Martin P.; Missinou, Michel A.; Ramharter, Michael; Issifou, Saadou; Kremsner, Peter G.

doi:10.4269/ajtmh.2005.73.263

Cited by 36 publications

(27 citation statements)

References 20 publications

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“…1 To date, resistance to QN remains particularly patchy and rare, [2][3][4][5][6][7][8][9][10][11][12] and only few cases of clinical failure have been reported in Asia and South America. The mechanism underlying QN resistance is not well-understood, and it is probably complex and multigenic.…”

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confidence: 99%

Plasmodium falciparum Na+/H+ Exchanger (pfnhe-1) Genetic Polymorphism in Indian Ocean Malaria-Endemic Areas

Andriantsoanirina

Khim²,

Ratsimbasoa³

et al. 2013

The American Society of Tropical Medicine and Hygiene

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Abstract. To date, 11 studies conducted in different countries to test the association between Plasmodium falciparum Na + /H + exchanger gene ( pfnhe-1; PF13_0019) polymorphisms and in vitro susceptibility to quinine have generated conflicting data. In this context and to extend our knowledge of the genetic polymorphism of Pfnhe gene, we have sequenced the ms4760 locus from 595 isolates collected in the Comoros (N = 250; an area with a high prevalence of chloroquine and sulfadoxine-pyrimethamine resistance) and Madagascar (N = 345; a low drug-resistance area). Among them, 29 different alleles were observed, including 8 (27%) alleles not previously described. Isolates from the Comoros showed more repeats in block II (DNNND), which some studies have found to be positively associated with in vitro resistance to quinine, compared with isolates from Madagascar. Additional studies are required to better define the mechanisms underlying quinine resistance, which involve multiple gene interactions.Quinine (QN), a natural quinoline derivative compound found in Cinchona bark, has been used for centuries in malaria-endemic regions.1 To date, resistance to QN remains particularly patchy and rare, 2-12 and only few cases of clinical failure have been reported in Asia and South America. The mechanism underlying QN resistance is not well-understood, and it is probably complex and multigenic. Since the seminal work by Ferdig and others 13 in 2004, 11 studies have been conducted in different countries to evaluate implication of ms4760 polymorphisms in QN resistance, [14][15][16][17][18][19][20][21][22][23][24] and conflicting data have been reported, likely because of the different geographical origin of parasites (implying different genetic backgrounds), the type of parasites used (fresh isolates, culture-adapted strains, and reference lines), and the method used to assess in vitro QN susceptibility. 21,25 In this context and to extend our previous work regarding ms4760 polymorphisms in Plasmodium falciparum parasites circulating in malaria-endemic areas in the Indian Ocean, Parasite DNA was extracted from blood spots with Instagene matrix (Bio-Rad, Marnes la Coquette, France) according to the manufacturer's instructions or directly from 100 μL infected blood by the phenol-chloroform method. 26The parasite species was confirmed by real-time polymerase chain reaction (PCR) as described in the work by Mangold and others.27 Amplification and sequencing of the ms4760 locus in the P. falciparum Na + /H + exchanger gene (pfnhe-1) was performed in accordance with the protocol described earlier.14 pfnhe-1 ms4760 alleles were constructed from a full sequence presenting an unambiguous single-allele signal at all positions and used P. falciparum 3D7 (sodium/hydrogen exchanger, Na + , H + antiporter, PF13_0019, XM_001349726) as the reference.Genetic diversity was assessed by Nei's unbiased expected heterozygosity (H e ) from haploid data and calculated as H e = [n/(n -1)][1 − p i ] (n = the number of isolates sampled; p i = the frequency o...

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confidence: 99%

Plasmodium falciparum Na+/H+ Exchanger (pfnhe-1) Genetic Polymorphism in Indian Ocean Malaria-Endemic Areas

Andriantsoanirina

Khim²,

Ratsimbasoa³

et al. 2013

The American Society of Tropical Medicine and Hygiene

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Section: Discussionmentioning

confidence: 99%

“…Therapeutic responses to quinine in the face of globally multi-drug-resistant malaria have been reported as < 60% (38). This low cure rate is improved by combining quinine with clindamycin in pregnant patients (tetracycline or doxycycline for non-pregnant patients) for a 7-day treatment course (2,38,39). Quinine is poorly tolerated, with side effects including the symptom cluster termed ''cinchonism:'' headache, blurred vision, nausea, vomiting, vertigo, tinnitus, flushing, pruritus, and abdominal pain (40,41).…”

Section: Discussionmentioning

confidence: 99%

Malaria in Pregnancy: Update on Emergency Management

Smereck

2011

The Journal of Emergency Medicine

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“…Quinine associated with clindamycine remains a safe therapeutic option during pregnancy [102]. Combination with azithromycin and quinine in monotherapy should be avoided in nonimmune pregnant travelers [110,111].…”

Section: Bottieau Vekemans and Van Gompelmentioning

confidence: 99%

Therapy of vector-borne protozoan infections in nonendemic settings

Bottieau

Vekemans

Gompel

2011

Expert Review of Anti-infective Therapy

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Vector-borne protozoan infections are responsible for a wide variety of illnesses (mainly malaria, trypanosomiasis and leishmaniasis) affecting tropical and subtropical areas, but increasingly diagnosed in nonendemic settings. This article summarizes the therapeutic developments for these conditions during the past decade and focuses specifically on treatment recommendations for returning travelers and migrants. The treatment of malaria has known the most spectacular improvements. Progress in the management of leishmaniasis and trypanosomiasis has also been substantial and includes introduction of new drugs into clinical practice, combinations of existing drugs, or new laboratory tools for treatment monitoring as well as extension of treatment indications to new groups of patients. Serious gaps still exist in terms of effectiveness and tolerance. Since the research pipeline is very limited for the coming 5-10 years, optimized combinations of existing drugs need to be urgently explored.

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Effectiveness of Quinine Monotherapy for the Treatment of Plasmodium Falciparum Infection in Pregnant Women in Lambaréné, Gabon

Cited by 36 publications

References 20 publications

Plasmodium falciparum Na+/H+ Exchanger (pfnhe-1) Genetic Polymorphism in Indian Ocean Malaria-Endemic Areas

Plasmodium falciparum Na+/H+ Exchanger (pfnhe-1) Genetic Polymorphism in Indian Ocean Malaria-Endemic Areas

Malaria in Pregnancy: Update on Emergency Management

Therapy of vector-borne protozoan infections in nonendemic settings

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