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Case Reports
. 2016 Nov 3;15(1):525.
doi: 10.1186/s12936-016-1572-3.

Failure of dihydroartemisinin-piperaquine treatment of uncomplicated Plasmodium falciparum malaria in a traveller coming from Ethiopia

Federico Gobbi  1 , Dora Buonfrate  2 , Michela Menegon  3 , Gianluigi Lunardi  2 , Andrea Angheben  2 , Carlo Severini  3 , Stefania Gori  2 , Zeno Bisoffi  2
Affiliations
Case Reports

Failure of dihydroartemisinin-piperaquine treatment of uncomplicated Plasmodium falciparum malaria in a traveller coming from Ethiopia

Federico Gobbi et al. Malar J. .

Abstract

Background: Artemisinin combination therapy (ACT) is used worldwide as the first-line treatment against uncomplicated Plasmodium falciparum malaria. Despite the success of ACT in reducing the global burden of malaria, the emerging of resistance to artemisinin threatens its use.

Case report: This report describes the first case of failure of dihydroartemisinin-piperaquine (DHA-PPQ) for the treatment of P. falciparum malaria diagnosed in Europe. It occurred in an Italian tourist returned from Ethiopia. She completely recovered after the DHA-PPQ treatment but 32 days after the end of therapy she had a recrudescence. The retrospective analysis indicated a correct DHA-PPQ absorption and genotyping demonstrated that the same P. falciparum strain was responsible for the both episodes.

Conclusion: In consideration of the growing number of cases of resistance to ACT, it is important to consider a possible recrudescence, that can manifest also several weeks after treatment.

Keywords: Dihydroartemisinin-piperaquine (DHA-PPQ); Failure; Plasmodium falciparum; Recrudescence.

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Figures

Fig. 1
Fig. 1
Genotyping of Plasmodium falciparum isolates responsible for the patient’s infection. M DNA ladder; A sample November 27, 2014; B sample January 7, 2015; C positive control; D negative control
See this image and copyright information in PMC

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