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dc.contributor.authorWanida Ittaraten_US
dc.contributor.authorAmy L. Pickarden_US
dc.contributor.authorPanthip Rattanasinganchanen_US
dc.contributor.authorPolrat Wilairatanaen_US
dc.contributor.authorSornchai Looareesuwanen_US
dc.contributor.authorKathryn Emeryen_US
dc.contributor.authorJonathan Lowen_US
dc.contributor.authorRachanee Udomsangpetchen_US
dc.contributor.authorSteven R. Meshnicken_US
dc.contributor.otherMahidol Universityen_US
dc.contributor.otherThe University of North Carolina at Chapel Hillen_US
dc.contributor.otherUniversity of Michigan School of Public Healthen_US
dc.contributor.otherBox 0944en_US
dc.identifier.citationAmerican Journal of Tropical Medicine and Hygiene. Vol.68, No.2 (2003), 147-152en_US
dc.description.abstractArtemisinin derivatives are first-line antimalarial drugs in Thailand. No firm evidence of clinically relevant artemisinin resistance exists. When used as monotherapy, artesunate has been associated with a high treatment failure (recrudescence) rate, which could be due to low-level artemisinin resistance. To understand the causes of recrudescence, we retrospectively studied a cohort of 104 malaria patients treated with artesunate monotherapy, 32 of whom recrudesced. There was no difference in in vitro artesunate sensitivities between 6 nonrecrudescent isolates and 16 paired admission and recrudescent isolates. Paired admission and recrudescent isolates from 10 patients were genotyped; only 3 had pfmdr1 mutations. Patients with admission parasitemias >10,000 per μl had a 9-fold higher likelihood of recrudescence (adjusted odds ratio) compared with patients with lower parasitemias. This study suggests (1) recrudescence after treatment with artesunate is not the result of inherent parasite resistance, and (2) admission parasitemia may be useful in choosing therapeutic options.en_US
dc.rightsMahidol Universityen_US
dc.subjectImmunology and Microbiologyen_US
dc.titleRecrudescence in artesunate-treated patients with falciparum malaria is dependent on parasite burden not on parasite factorsen_US
Appears in Collections:Scopus 2001-2005

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