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Qualitative and Semiquantitative Polymerase Chain Reaction to Predict Plasmodium falciparum Treatment Failure

Kevin C. Kain, Dennis E. Kyle, Chansuda Wongsrichanalai, Arthur E. Brown, H. Kyle Webster, S. Vanijanonta and Sornchai Looareesuwan
The Journal of Infectious Diseases
Vol. 170, No. 6 (Dec., 1994), pp. 1626-1630
Published by: Oxford University Press
Stable URL: http://www.jstor.org/stable/30133686
Page Count: 5
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Qualitative and Semiquantitative Polymerase Chain Reaction to Predict Plasmodium falciparum Treatment Failure
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Abstract

Multidrug-resistant falciparum malaria is increasing in most malaria-endemic areas. Rapid methods for predicting treatment failure would aid management and control of drug-resistant infections. In this study, Plasmodium falciparum DNA clearance was examined by qualitative and semiquantitative polymerase chain reaction (PCR). Thai patients with acute falciparum malaria were prospectively followed by light microscopy and by PCR of P. falciparum DNA eluted from filter paper blood samples. A 206-bp P. falciparum sequence was amplified and detected radiometrically and by high-performance liquid chromatography. Clearance of P. falciparum DNA was significantly delayed in treatment failures compared with that in successfully treated patients (P = .02). Semiquantitative PCR levels did not drop to <50% of pretreatment levels until day 3 or later in treatment failures compared with day 1 or earlier for successfully treated parasitemia-matched controls (P = .005). These results suggest that qualitative and semi-quantitative PCR may be useful as a method for monitoring response to therapy.

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