A case report of late treatment failure in Plasmodium falciparum malaria in a traveler from the Democratic Republic of the Congo to India

A young male returned from the Democratic Republic of the Congo (DRC) to India after four months during his official work. Within a week of his arrival, he developed a high-grade fever with nausea and was hospitalized in a private hospital in New Delhi. He was diagnosed with malaria, treated with an...

Full description

Bibliographic Details
Main Authors: Supriya Sharma, Naseem Ahmed, Nafis Faizi, Praveen K. Bharti, Amit Sharma, Bina Srivastava
Format: Article
Language:English
Published: Elsevier 2023-01-01
Series:IDCases
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2214250922002815
_version_ 1797869778498486272
author Supriya Sharma
Naseem Ahmed
Nafis Faizi
Praveen K. Bharti
Amit Sharma
Bina Srivastava
author_facet Supriya Sharma
Naseem Ahmed
Nafis Faizi
Praveen K. Bharti
Amit Sharma
Bina Srivastava
author_sort Supriya Sharma
collection DOAJ
description A young male returned from the Democratic Republic of the Congo (DRC) to India after four months during his official work. Within a week of his arrival, he developed a high-grade fever with nausea and was hospitalized in a private hospital in New Delhi. He was diagnosed with malaria, treated with an artesunate injection as antimalarial, and discharged on day 5th from the hospital. A week later, he was diagnosed with malaria and dengue positive at ICMR-National Institute of Malaria Research, New Delhi. Artesunate with sulphadoxine and pyrimethamine (AS+SP) was administered following India's malaria treatment policy. However, high-grade fever, along with the asexual stage of the P. falciparum parasite, was observed within 28 days of treatment with AS+SP, signifying late treatment failure (LTF). Further, the molecular analysis from both the days of episodes was analyzed using genomic DNA from dried blood spots, revealing resistance to sulphadoxine-pyrimethamine with mutations at codons pfdhfr 51I, pfdhfr 59 R, pfdhfr 108 N, pfdhps 437 A, pfdhps 581 G. No functional mutation associated was found in pfKelch13, but interestingly the sensitive codons to chloroquine (CQ) (wild type pfcrtK76 and pfmdrN86) revealed the probably reversible CQ sensitivity in the sample from DRC.
first_indexed 2024-04-10T00:17:27Z
format Article
id doaj.art-b360086cd37f42b5be83292287488f63
institution Directory Open Access Journal
issn 2214-2509
language English
last_indexed 2024-04-10T00:17:27Z
publishDate 2023-01-01
publisher Elsevier
record_format Article
series IDCases
spelling doaj.art-b360086cd37f42b5be83292287488f632023-03-16T05:04:21ZengElsevierIDCases2214-25092023-01-0131e01653A case report of late treatment failure in Plasmodium falciparum malaria in a traveler from the Democratic Republic of the Congo to IndiaSupriya Sharma0Naseem Ahmed1Nafis Faizi2Praveen K. Bharti3Amit Sharma4Bina Srivastava5ICMR-National Institute of Malaria Research, Sector-8, Dwarka, New Delhi 110077, IndiaICMR-National Institute of Malaria Research, Sector-8, Dwarka, New Delhi 110077, IndiaICMR-National Institute of Malaria Research, Sector-8, Dwarka, New Delhi 110077, India; Jawaharlal Nehru Medical College, AMU, Aligarh, IndiaICMR-National Institute of Malaria Research, Sector-8, Dwarka, New Delhi 110077, India; Academy of Scientific and Innovative Research, IndiaICMR-National Institute of Malaria Research, Sector-8, Dwarka, New Delhi 110077, India; Molecular Medicine, International Centre for Genetic Engineering and Biotechnology, New Delhi, India; Academy of Scientific and Innovative Research, IndiaICMR-National Institute of Malaria Research, Sector-8, Dwarka, New Delhi 110077, India; Corresponding author.A young male returned from the Democratic Republic of the Congo (DRC) to India after four months during his official work. Within a week of his arrival, he developed a high-grade fever with nausea and was hospitalized in a private hospital in New Delhi. He was diagnosed with malaria, treated with an artesunate injection as antimalarial, and discharged on day 5th from the hospital. A week later, he was diagnosed with malaria and dengue positive at ICMR-National Institute of Malaria Research, New Delhi. Artesunate with sulphadoxine and pyrimethamine (AS+SP) was administered following India's malaria treatment policy. However, high-grade fever, along with the asexual stage of the P. falciparum parasite, was observed within 28 days of treatment with AS+SP, signifying late treatment failure (LTF). Further, the molecular analysis from both the days of episodes was analyzed using genomic DNA from dried blood spots, revealing resistance to sulphadoxine-pyrimethamine with mutations at codons pfdhfr 51I, pfdhfr 59 R, pfdhfr 108 N, pfdhps 437 A, pfdhps 581 G. No functional mutation associated was found in pfKelch13, but interestingly the sensitive codons to chloroquine (CQ) (wild type pfcrtK76 and pfmdrN86) revealed the probably reversible CQ sensitivity in the sample from DRC.http://www.sciencedirect.com/science/article/pii/S2214250922002815MalariaP. falciparumLate treatment failureTravel malariaDrug resistanceCQ sensitivity
spellingShingle Supriya Sharma
Naseem Ahmed
Nafis Faizi
Praveen K. Bharti
Amit Sharma
Bina Srivastava
A case report of late treatment failure in Plasmodium falciparum malaria in a traveler from the Democratic Republic of the Congo to India
IDCases
Malaria
P. falciparum
Late treatment failure
Travel malaria
Drug resistance
CQ sensitivity
title A case report of late treatment failure in Plasmodium falciparum malaria in a traveler from the Democratic Republic of the Congo to India
title_full A case report of late treatment failure in Plasmodium falciparum malaria in a traveler from the Democratic Republic of the Congo to India
title_fullStr A case report of late treatment failure in Plasmodium falciparum malaria in a traveler from the Democratic Republic of the Congo to India
title_full_unstemmed A case report of late treatment failure in Plasmodium falciparum malaria in a traveler from the Democratic Republic of the Congo to India
title_short A case report of late treatment failure in Plasmodium falciparum malaria in a traveler from the Democratic Republic of the Congo to India
title_sort case report of late treatment failure in plasmodium falciparum malaria in a traveler from the democratic republic of the congo to india
topic Malaria
P. falciparum
Late treatment failure
Travel malaria
Drug resistance
CQ sensitivity
url http://www.sciencedirect.com/science/article/pii/S2214250922002815
work_keys_str_mv AT supriyasharma acasereportoflatetreatmentfailureinplasmodiumfalciparummalariainatravelerfromthedemocraticrepublicofthecongotoindia
AT naseemahmed acasereportoflatetreatmentfailureinplasmodiumfalciparummalariainatravelerfromthedemocraticrepublicofthecongotoindia
AT nafisfaizi acasereportoflatetreatmentfailureinplasmodiumfalciparummalariainatravelerfromthedemocraticrepublicofthecongotoindia
AT praveenkbharti acasereportoflatetreatmentfailureinplasmodiumfalciparummalariainatravelerfromthedemocraticrepublicofthecongotoindia
AT amitsharma acasereportoflatetreatmentfailureinplasmodiumfalciparummalariainatravelerfromthedemocraticrepublicofthecongotoindia
AT binasrivastava acasereportoflatetreatmentfailureinplasmodiumfalciparummalariainatravelerfromthedemocraticrepublicofthecongotoindia
AT supriyasharma casereportoflatetreatmentfailureinplasmodiumfalciparummalariainatravelerfromthedemocraticrepublicofthecongotoindia
AT naseemahmed casereportoflatetreatmentfailureinplasmodiumfalciparummalariainatravelerfromthedemocraticrepublicofthecongotoindia
AT nafisfaizi casereportoflatetreatmentfailureinplasmodiumfalciparummalariainatravelerfromthedemocraticrepublicofthecongotoindia
AT praveenkbharti casereportoflatetreatmentfailureinplasmodiumfalciparummalariainatravelerfromthedemocraticrepublicofthecongotoindia
AT amitsharma casereportoflatetreatmentfailureinplasmodiumfalciparummalariainatravelerfromthedemocraticrepublicofthecongotoindia
AT binasrivastava casereportoflatetreatmentfailureinplasmodiumfalciparummalariainatravelerfromthedemocraticrepublicofthecongotoindia