Case Report of Attenuated-Responsiveness to Coartem® in Western Kenya
Edwin Kamau *
Global Emerging Infections Surveillance (GEIS) Program, United States Army Medical Research Unit-Kenya (USAMRU-K), Kenya Medical Research Institute (KEMRI) - Walter Reed Project, Kisumu and Nairobi, Kenya.
Hoseah M. Akala
Global Emerging Infections Surveillance (GEIS) Program, United States Army Medical Research Unit-Kenya (USAMRU-K), Kenya Medical Research Institute (KEMRI) - Walter Reed Project, Kisumu and Nairobi, Kenya.
Angela O. Achieng
Global Emerging Infections Surveillance (GEIS) Program, United States Army Medical Research Unit-Kenya (USAMRU-K), Kenya Medical Research Institute (KEMRI) - Walter Reed Project, Kisumu and Nairobi, Kenya.
Redemptah Yeda
Global Emerging Infections Surveillance (GEIS) Program, United States Army Medical Research Unit-Kenya (USAMRU-K), Kenya Medical Research Institute (KEMRI) - Walter Reed Project, Kisumu and Nairobi, Kenya.
Luicer A. Ingasia
Global Emerging Infections Surveillance (GEIS) Program, United States Army Medical Research Unit-Kenya (USAMRU-K), Kenya Medical Research Institute (KEMRI) - Walter Reed Project, Kisumu and Nairobi, Kenya.
Agnes C. Cheruiyot
Global Emerging Infections Surveillance (GEIS) Program, United States Army Medical Research Unit-Kenya (USAMRU-K), Kenya Medical Research Institute (KEMRI) - Walter Reed Project, Kisumu and Nairobi, Kenya.
Dennis W. Juma
Global Emerging Infections Surveillance (GEIS) Program, United States Army Medical Research Unit-Kenya (USAMRU-K), Kenya Medical Research Institute (KEMRI) - Walter Reed Project, Kisumu and Nairobi, Kenya.
Charles Okudo
Global Emerging Infections Surveillance (GEIS) Program, United States Army Medical Research Unit-Kenya (USAMRU-K), Kenya Medical Research Institute (KEMRI) - Walter Reed Project, Kisumu and Nairobi, Kenya.
Duke Omariba
Global Emerging Infections Surveillance (GEIS) Program, United States Army Medical Research Unit-Kenya (USAMRU-K), Kenya Medical Research Institute (KEMRI) - Walter Reed Project, Kisumu and Nairobi, Kenya.
Catherine Muriuki
Global Emerging Infections Surveillance (GEIS) Program, United States Army Medical Research Unit-Kenya (USAMRU-K), Kenya Medical Research Institute (KEMRI) - Walter Reed Project, Kisumu and Nairobi, Kenya.
Eunice A. Owiti
Global Emerging Infections Surveillance (GEIS) Program, United States Army Medical Research Unit-Kenya (USAMRU-K), Kenya Medical Research Institute (KEMRI) - Walter Reed Project, Kisumu and Nairobi, Kenya.
Eunice A. Owiti
Global Emerging Infections Surveillance (GEIS) Program, United States Army Medical Research Unit-Kenya (USAMRU-K), Kenya Medical Research Institute (KEMRI) - Walter Reed Project, Kisumu and Nairobi, Kenya.
Patrick Omondi
Global Emerging Infections Surveillance (GEIS) Program, United States Army Medical Research Unit-Kenya (USAMRU-K), Kenya Medical Research Institute (KEMRI) - Walter Reed Project, Kisumu and Nairobi, Kenya.
Amos Otedo
Kisumu East District Hospital, Ministry of Health, P.O. Box 1818 - 40100 Kisumu, Kenya.
Ben Andagalu
Kisumu East District Hospital, Ministry of Health, P.O. Box 1818 - 40100 Kisumu, Kenya.
Bernhards Ogutu
Global Emerging Infections Surveillance (GEIS) Program, United States Army Medical Research Unit-Kenya (USAMRU-K), Kenya Medical Research Institute (KEMRI) - Walter Reed Project, Kisumu and Nairobi, Kenya.
*Author to whom correspondence should be addressed.
Abstract
We describe a case of attenuated-responsiveness to Artemether-Lumefantrine (AL) in western Kenya. A 4-year old patient with 14% parasitemia was treated with Coartem® but on day 7 still had 5% parasitemia. Parasite genetic profile had similar genetic polymorphism as that selected for when AL is administered. In vitro analysis revealed elevated IC50s for AL components compared to the reference P. falciparum clone 3D7 and samples collected at this site over the last 5 years. There is need for continued global surveillance to effectively manage emergence and spread of artemisinin drug resistance which has now been found in Southeast Asia.
Keywords: Coartem, resistance, Malaria, artemether-lumefantrine, treatment-failure.