1. Effects of mefloquine use on Plasmodium vivax multidrug resistance.
- Author
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Khim N, Andrianaranjaka V, Popovici J, Kim S, Ratsimbasoa A, Benedet C, Barnadas C, Durand R, Thellier M, Legrand E, Musset L, Menegon M, Severini C, Nour BY, Tichit M, Bouchier C, Mercereau-Puijalon O, and Ménard D
- Subjects
- Cambodia epidemiology, French Guiana epidemiology, Gene Expression Regulation drug effects, Humans, Madagascar epidemiology, Malaria, Falciparum epidemiology, Malaria, Falciparum parasitology, Malaria, Vivax epidemiology, Multidrug Resistance-Associated Proteins genetics, Plasmodium falciparum drug effects, Protozoan Proteins genetics, Sudan epidemiology, Drug Resistance drug effects, Malaria, Vivax parasitology, Mefloquine therapeutic use, Multidrug Resistance-Associated Proteins metabolism, Plasmodium vivax drug effects, Protozoan Proteins metabolism
- Abstract
Numerous studies have indicated a strong association between amplification of the multidrug resistance-1 gene and in vivo and in vitro mefloquine resistance of Plasmodium falciparum. Although falciparum infection usually is not treated with mefloquine, incorrect diagnosis, high frequency of undetected mixed infections, or relapses of P. vivax infection triggered by P. falciparum infections expose non-P. falciparum parasites to mefloquine. To assess the consequences of such unintentional treatments on P. vivax, we studied variations in number of Pvmdr-1 (PlasmoDB accession no. PVX_080100, NCBI reference sequence NC_009915.1) copies worldwide in 607 samples collected in areas with different histories of mefloquine use from residents and from travelers returning to France. Number of Pvmdr-1 copies correlated with drug use history. Treatment against P. falciparum exerts substantial collateral pressure against sympatric P. vivax, jeopardizing future use of mefloquine against P. vivax. A drug policy is needed that takes into consideration all co-endemic species of malaria parasites.
- Published
- 2014
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