Sy Hendrik, Yadav Sharan, Yangga Peter, Shaffer Alexander, John Amie, Rogers Wesley, Westblade Lars, Marrero Rolón Rebecca, Madison-Antenucci Susan, Thwe Phyu M, Orner Erika, Murphy Kerry, Maldarelli Grace A, Kirkman Laura, Daily Johanna P
Division of Infectious Diseases, Montefiore Medical Center/Albert Einstein College of Medicine, New York, New York.
Division of Infectious Diseases, Weill Cornell Medicine, New York, New York.
Am J Trop Med Hyg. 2025 Jan 7;112(4):771-774. doi: 10.4269/ajtmh.24-0397. Print 2025 Apr 2.
We report two cases of recurrent malaria in U.S. travelers returning from Africa (Ghana and Central African Republic) despite a full course of artemether-lumefantrine (AL). Both patients presented to New York City hospitals, received AL treatment, and clinically improved. Within 2 weeks, they presented with recurrent Plasmodium falciparum malaria. Parasite isolates were sequenced, and P. falciparum kelch 13 propeller domain mutations that are validated or candidate markers of artemisinin partial resistance were not identified. Parasites had mutations within the P. falciparum multidrug resistance protein 1 gene. It is crucial to remain vigilant for recurrent malaria in travelers, even from African regions where partial resistance to artemisinin-based combination therapy has only rarely been reported.
我们报告了两例从非洲（加纳和中非共和国）返回美国的旅行者复发性疟疾病例，尽管他们接受了完整疗程的蒿甲醚-本芴醇（AL）治疗。两名患者均前往纽约市的医院就诊，接受了AL治疗，临床症状有所改善。但在两周内，他们又出现了恶性疟原虫复发性疟疾。对寄生虫分离株进行了测序，未发现已得到验证的或作为青蒿素部分耐药性候选标志物的恶性疟原虫kelch 13螺旋桨结构域突变。寄生虫在恶性疟原虫多药耐药蛋白1基因内存在突变。对于旅行者中的复发性疟疾保持警惕至关重要，即使是来自仅很少报告对青蒿素联合疗法有部分耐药性的非洲地区的旅行者。
