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A HISTIDINE-RICH PROTEIN 2–BASED MALARIA DRUG SENSITIVITY ASSAY FOR FIELD USE

With the spread of antimalarial drug resistance, simple and reliable tools for the assessment of antimalarial drug resistance, particularly in endemic regions and under field conditions, have become more important than ever before. We therefore developed a histidine-rich protein 2 (HRP2)–based drug sensitivity assay for testing of fresh isolates of Plasmodium falciparum in the field. In contrast to the HRP2 laboratory assay, the field assay uses a procedure that further simplifies the handling and culturing of malaria parasites by omitting centrifugation, washing, the use of serum, and dilution with uninfected red blood cells. A total of 40 fresh Plasmodium falciparum isolates were successfully tested for their susceptibility to dihydroartemisinin, mefloquine, quinine, and chloroquine (50% inhibitory concentration [IC₅₀] = 3.43, 61.89, 326.75, and 185.31 nM, respectively). Results very closely matched those obtained with a modified World Health Organization schizont maturation assay (R² = 0.96, P < 0.001; mean log difference at IC₅₀ = 0.054).

Received January 20, 2004. Accepted for publication June 21, 2004.

Acknowledgments: We thank the staff of the Malaria Clinic in Mae Sot for their active support in collecting the samples and Ruth Ellis for her review of the manuscript.

Financial support: This work was supported by the Austrian Science Fund Project No. 15754-B02 and the U.S. Department of Defense Global Emerging Infections System (GEIS) program.

Disclaimer: The opinions reflected herein reflect those of the authors and do not necessarily reflect the official views of the U.S. Army or the U.S. Department of Defense.

Authors’ addresses: Harald Noedl, Bernhard Attlmayr, Walther H. Wernsdorfer, and Herwig Kollaritsch, Department of Specific Prophylaxis and Tropical Medicine, Institute of Pathophysiology, University of Vienna, Kinderspitalgasse 15, A-1095, Vienna, Austria. Robert S. Miller, Armed Forces Research Institute of Medical Sciences, 316/6 Rajvithi Road, Bangkok 10400, Thailand.

Reprint requests: Harald Noedl, Department of Specific Prophylaxis and Tropical Medicine, Institute of Pathophysiology, Vienna Medical School, Kinderspitalgasse 15, A-1095, Vienna, Austria, Telephone: 43-1-4277-64882, Fax: 43-1-403-834390, E-mail: harald.noedl{at}univie.ac.at.

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