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Parasite lactate dehydrogenase assay for the determination of antimalarial drug susceptibility of Kenyan field isolates
Abstract
Background: Researchers have reported that parasite lactate dehydrogenase p(LDH) could be used to determine chemo-sensitivity of plasmodia to compounds with known or presumed antimalarial activities.
Objective: To determine the drug sensitivity profiles of field adopted malaria isolates from Kisumu using p(LDH) instead of hapoxanthine assay.
Design: Prospective field and laboratory study.
Setting: Walter Reed, KEMRI malaria laboratory (Nairobi) and Kisumu District Hospital.
Subjects: Twelve field laboratory adopted isolates from Kisumu, five laboratory adopted isolates from other regions in Africa and three reference strains from Walter Reed army Institute of Research, Washington, DC.
Results: The p(LDH) enzyme assay was successfully used to measure the IC50 of six antimalarial drugs, chloroquine, quinine, mefloquine, dehydroartemisinin, atovaquone and halofantrine but was not successful with the four other antimalarial drugs, doxycycline, azithromycin, pyrimethamine and sulphadoxine. The Kisumu isolates tested were resistant to chloroquine and mefloquine but sensitive to quinine and the new antimalarial drugs, atovaquone, halofantrine and dehydroartemisinin.
Conclusion: The non-radioactive p(LDH) can be used for the determination of drug sensitivity to Kenyan field isolates. It is more suited for use in a resource limited environment and may lead to more judicious prescription of new and more expensive antimalarial drugs and mitigate against the rapid spread of multi-drug resistant parasites in the East African region.
East African Medical Journal Vol.82(3) 2005: 119-123
Objective: To determine the drug sensitivity profiles of field adopted malaria isolates from Kisumu using p(LDH) instead of hapoxanthine assay.
Design: Prospective field and laboratory study.
Setting: Walter Reed, KEMRI malaria laboratory (Nairobi) and Kisumu District Hospital.
Subjects: Twelve field laboratory adopted isolates from Kisumu, five laboratory adopted isolates from other regions in Africa and three reference strains from Walter Reed army Institute of Research, Washington, DC.
Results: The p(LDH) enzyme assay was successfully used to measure the IC50 of six antimalarial drugs, chloroquine, quinine, mefloquine, dehydroartemisinin, atovaquone and halofantrine but was not successful with the four other antimalarial drugs, doxycycline, azithromycin, pyrimethamine and sulphadoxine. The Kisumu isolates tested were resistant to chloroquine and mefloquine but sensitive to quinine and the new antimalarial drugs, atovaquone, halofantrine and dehydroartemisinin.
Conclusion: The non-radioactive p(LDH) can be used for the determination of drug sensitivity to Kenyan field isolates. It is more suited for use in a resource limited environment and may lead to more judicious prescription of new and more expensive antimalarial drugs and mitigate against the rapid spread of multi-drug resistant parasites in the East African region.
East African Medical Journal Vol.82(3) 2005: 119-123
