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PLASMODIUM FALCIPARUM GENOTYPING BY MICROSATELLITES AS A METHOD TO DISTINGUISH BETWEEN RECRUDESCENT AND NEW INFECTIONS

In vivo tests for susceptibility to antimalarial drugs require molecular methods to distinguish recrudescence from new infection. The most commonly used DNA markers (merozoite surface proteins [MSPs]) are under immune selective pressure, which might lead to misclassification. We evaluated immunologically neutral microsatellite markers in blood samples collected during a drug efficacy trial in Rwanda. Fifty percent of the infections classified as recrudescent by MSP were classified as new by microsatellite markers. Reciprocally, 23.3% of infections classified as recrudescent by microsatellite markers were identified as new by MSP. In drug efficacy studies, microsatellite markers should complement MSP genotyping to distinguish a recrudescence from a new infection.

Received November 22, 2004. Accepted for publication February 5, 2005.

Acknowledgments: We thank Dr. Claude Rwagacondo and Dr. Corinne Karema for collecting and supplying samples for our analysis, and Dr. G. Van Gemert (Koninklijke Universiteit van Nijmegen, Nijmegen, The Netherlands) for providing long-term cultivated P. falciparum DNA. We also thank the families in Rwanda for allowing samples to be obtained from their children.

Financial support: This study was supported by the Flemish Interuniversity Council, the East Africa Network for Monitoring Antimalarial Treatment, and the Belgian Development Co-operation.

^* Address correspondence to Umberto D’Alessandro, Prince Leopold Institute of Tropical Medicine, Nationalstraat 155, B-2000 Antwerp, Belgium. E-mail: udalessandro{at}itg.be

Authors’ address: Atunga Nyachieo, Chantal van Overmeir, Thierry Laurent, Jean-Claude Dujardin, and Umberto D’Alessandro, Department of Parasitology, Prince Leopold Institute of Tropical Medicine, Nationalestraat 155, B-2000 Antwerp, Belgium, Telephone: 32-3-247-6355, Fax: 32-3-247-6359, E-mail: udalessandro{at}itg.be.

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