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ARE PLASMODIUM FALCIPARUM PARASITES PRESENT IN PERIPHERAL BLOOD GENETICALLY THE SAME AS THOSE SEQUESTERED IN THE TISSUES?

Since quinine does not inhibit the growth of Plasmodium falciparum ring stages or mature schizonts, parasites may continue to emerge from sequestration sites after starting treatment. We used polymerase chain reaction amplification of P. falciparum merozoite surface protein 1 (MSP-1) and MSP-2 alleles to distinguish genotypes infecting 58 children with severe malaria. To examine changes in parasite populations in peripheral blood over time, we compared changes in number and spectrum of genotypes in samples on admission to a hospital to those obtained up to 24 hours later. Thirty-four children lost genotypes, 21 retained genotypes, and 3 gained an extra P. falciparum genotype at one locus but not the other. The lack of novel genotypes emerging suggests that among children with severe malaria the dominant clones sequestered in deep organs are usually the same as those in peripheral circulation.

Received May 30, 2005. Accepted for publication December 1, 2005.

Acknowledgments: We thank Professor Terrie Taylor and nursing staff (Research Ward, Department of Paediatrics, College of Medicine, University of Malawi) for collecting samples for the study, and the children and their parents and guardians for their participation.

Financial support: This study was supported by the Wellcome Trust (Senior Fellowship 063215 to Stephen J. Rogerson and project grant to 071376 to Malcolm E. Molyneux).

^* Address correspondence to Stephen J. Rogerson, Department of Medicine, University of Melbourne, Post Office, Royal Melbourne Hospital, Victoria 3050, Australia. E-mail: sroger{at}unimelb.edu.au

Authors’ addresses: Edson G Dembo, Happy T Phiri, Jacqui Montgomery, and Malcolm E Molyneux, Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Box 30096, Blantyre 3 Malawi, Telephone: 265-167-6444, Fax: 265-167-5774. Stephen J Rogerson, Department of Medicine, Post Office Royal Melbourne Hospital, Parkville, Victoria 3050, Australia, Telephone: 61-3-8344-3259, Fax: 61-3-9347-1863, E-mail: sroger{at}unimelb.edu.au.

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