Volume 71, Issue 6
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645


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 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 isolates were successfully tested for their susceptibility to dihydroartemisinin, mefloquine, quinine, and chloroquine (50% inhibitory concentration [IC] = 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 (R = 0.96, < 0.001; mean log difference at IC = 0.054).


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  1. Bloland P, 2001. Drug Resistance in Malaria. Geneva: World Health Organization. WHO/CDS/DRS.4.
  2. Guerin PJ, Olliaro P, Nosten F, Druilhe P, Laxminarayan R, Binka F, Kilama WL, Ford N, White NJ, 2002. Malaria: current status of control, diagnosis, treatment, and a proposed agenda for research and development. Lancet Infect Dis 2 : 564–573. [Google Scholar]
  3. Noedl H, Wongsrichanalai C, Wernsdorfer WH, 2003. Malaria drug-sensitivity testing: new assays, new perspectives. Trends Parasitol 19 : 175–181. [Google Scholar]
  4. Riekmann KH, Sax LH, Camp GH, Mrema JE, 1978. Drug sensitivity of Plasmodium falciparum. An in vitro micro technique. Lancet 1 : 22–23. [Google Scholar]
  5. Desjardins RE, Canfield CJ, Haynes JD, Chulay JD, 1979. Quantitative assessment of anti-malarial activity in vitro by a semiautomated microdilution technique. Antimicrob Agents Chemother 16 : 710–718. [Google Scholar]
  6. Noedl H, Wernsdorfer WH, Miller RS, Wongsrichanalai C, 2002. Histidine-rich protein II: a novel approach to malaria drug sensitivity testing. Antimicrob Agents Chemother 46 : 1658–1664. [Google Scholar]
  7. WHO, 1990. In Vitro Micro-Test (Mark II) for the Assessment of the Response of Plasmodium falciparum to Chloroquine, Mefloquine, Quinine, Sulfadoxine/Pyrimethamine and Amodiaquine. Geneva: World Health Organization. WHO document MAP/87.2, Revision 1.
  8. Wernsdorfer WH, 1980. Field evaluation of drug resistance in malaria. In vitro micro-test. Acta Trop 37 : 222–227. [Google Scholar]
  9. Bland JM, Altman DG, 1986. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1 : 307–310. [Google Scholar]
  10. Ang HH, Chan KL, Mak JW, 1997. Susceptibility of Malaysian Plasmodium falciparum isolates to antimalarial drugs after cryopreservation and 12 months of continuous in vitro culture. Chemotherapy 43 : 311–315. [Google Scholar]
  11. Basco LK, Marquet F, Makler MM, Le Bras J, 1995. Plasmodium falciparum and Plasmodium vivax: lactate dehydrogenase activity and its application for in vitro drug susceptibility assay. Exp Parasitol 80 : 260–271. [Google Scholar]
  12. Ringwald P, Meche FS, Bickii J, Basco LK, 1999. In vitro culture and drug sensitivity assay of Plasmodium falciparum with non-serum substitute and acute-phase sera. J Clin Microbiol 37 : 700–705. [Google Scholar]
  13. Duraisingh MT, Jones P, Sambou I, von Seidlein L, Pinder M, Warhurst DC, 1999. Inoculum effect leads to overestimation of in vitro resistance for artemisinin derivatives and standard antimalarials: a Gambian field study. Parasitology 119 : 435–440. [Google Scholar]
  14. Noedl H, Wongsrichanalai C, Miller RS, Myint KS, Looareesuwan S, Sukthana Y, Wongchotigul V, Kollaritsch H, Wiedermann G, Wernsdorfer WH, 2002. Plasmodium falciparum: effect of anti-malarial drugs on the production and secretion characteristics of histidine-rich protein II. Exp Parasitol 102 : 157–163. [Google Scholar]

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  • Received : 20 Jan 2004
  • Accepted : 21 Jun 2004

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