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

HARALD NOEDL Department of Immunology and Medicine, United States Army Medical Component, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand; Department of Specific Prophylaxis and Tropical Medicine, Institute of Pathophysiology, University of Vienna, Vienna, Austria

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BERNHARD ATTLMAYR Department of Immunology and Medicine, United States Army Medical Component, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand; Department of Specific Prophylaxis and Tropical Medicine, Institute of Pathophysiology, University of Vienna, Vienna, Austria

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WALTHER H. WERNSDORFER Department of Immunology and Medicine, United States Army Medical Component, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand; Department of Specific Prophylaxis and Tropical Medicine, Institute of Pathophysiology, University of Vienna, Vienna, Austria

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HERWIG KOLLARITSCH Department of Immunology and Medicine, United States Army Medical Component, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand; Department of Specific Prophylaxis and Tropical Medicine, Institute of Pathophysiology, University of Vienna, Vienna, Austria

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ROBERT S. MILLER Department of Immunology and Medicine, United States Army Medical Component, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand; Department of Specific Prophylaxis and Tropical Medicine, Institute of Pathophysiology, University of Vienna, Vienna, Austria

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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).

Author Notes

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@univie.ac.at.
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