Artesunate Misuse and P. falciparum Malaria | CDC EID

EID Journal Home > Volume 16, Number 10–October 2010
Volume 16, Number 10–October 2010
Dispatch
Artesunate Misuse and Plasmodium falciparum Malaria in Traveler Returning from Africa

Dea Shahinas, Rachel Lau, Krishna Khairnar, David Hancock, and Dylan R. Pillai Comments to Author
Author affiliations: University of Toronto, Toronto, Ontario, Canada (D. Shahinas, K. Khairnar, D.R. Pillai); Ontario Agency for Health Protection and Promotion, Toronto (R. Lau, D.R. Pillai); and Ajax-Pickering Hospital, Ajax, Ontario, Canada (D. Hancock)

Suggested citation for this article

Abstract
Plasmodium falciparum malaria developed in an African-born traveler who returned to Canada after visiting Nigeria. While there, she took artesunate prophylactically. Isolates had an elevated 50% inhibitory concentration to artemisinin, artesunate, and artemether, compared with that of other African isolates. Inappropriate use of artemisinin derivatives can reduce P. falciparum susceptibility.

Artemisinin derivatives were recently approved by the Food and Drug Administration for the treatment of Plasmodium falciparum malaria in North America and are available through the US Centers for Disease Control and Prevention and through Health Canada (1–3). Artemisinin-based combination therapy (ACT) remains the most effective therapy for P. falciparum malaria throughout the world, with the possible exception of the Thailand–Cambodia border (4). Because of the large numbers in the Toronto area of returning travelers and recent immigrants who have returned to countries of origin and visited friends and relatives, the Public Health Laboratory (Toronto) identifies »200 positive malaria smears annually; most P. falciparum isolates have come from sub-Saharan Africa. Evidence has indicated that such travelers tend not to seek medical advice before travel and are therefore at high risk of acquiring malaria (5).

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Artesunate Misuse and P. falciparum Malaria | CDC EID

Suggested Citation for this Article

Shahinas D, Lau R, Khairnar K, Hancock D, Pillai DR. Artesunate misuse and Plasmodium falciparum malaria in traveler returning from Africa. Emerg Infect Dis [serial on the Internet]. 2010 Oct [date cited]. http://www.cdc.gov/EID/content/16/10/1608.htm

DOI: 10.3201/eid1610.100427

Comments to the Authors

Please use the form below to submit correspondence to the authors or contact them at the following address:

Address for correspondence: Dylan R. Pillai, 81A Resources Rd, Rm 243, Toronto, ON M9P 3T1, Canada; email: dylan.pillai@oahpp.ca