Hongwei Zhang
Henan Center for Disease Prevention and Control, China
Title: First case of Artemisinin resistance in a Chinese worker with falciparum malaria imported from Nigeria
Biography
Biography: Hongwei Zhang
Abstract
Artemisinin resistance has been confirmed at Cambodia and Thailand. This paper reports the first case of Artemisinin resistance in a 35-year-old Chinese male construction worker with imported falciparum malaria. The patient suffered two days of febrile illness after returning from Nigeria on Oct 1, 2014. The main symptoms were febrile with the highest axillary temperature of 40℃, headache, and chill. A peripheral blood smear showed parasitemia (2000 asexual parasites/μl) with Plasmodium falciparum. The patient had three times medical history of malaria and was administrated quinine, and stopped treatment after he was afebrile in Nigeria during 2009-2014. The patient was administrated oral total 320mg/2.56g Dihydroartemisinin- Piperaquine (40mg/0.32g per tablet) for 2 days and intravenous total 3060mg artesunate for 19 days, which was 60mg artesunate every 6 hours for 3 days(first dosage double), then every 8 hours for 8 days and then each day for 8 days. Axillary temperature of the patient was 37.5-37.8℃ on Day 1-Day 4 and the patient was afebrile on Day 5. Blood microscopy revealed falciparum parasitemia (10000-20000 asexual parasites/μl) during Day 1 to Day 12. Then falciparum parasitemia decreased and was negative on Day 19. The patient was cured and leaved hospital on Day 24. According to WHO classification of antimalarial drug efficacy(Parasitemia on Day 3 with axillary temperature ≥37.5℃) , the patient must be considered an early treatment failure. With increasing number of workers and travelers into malaria endemic areas more attention should be paid in detect the emergence of artemisinin resistance.