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We report the first in vitro and genetic confirmation of Malarone (GlaxoSmithKline; atovaquone and proguanil hydrochloride) resistance in Plasmodium falciparum acquired in Africa. On presenting with malaria two weeks after returning from a 4-week visit to Lagos, Nigeria without prophylaxis, a male patient was given a standard 3-day treatment course of Malarone. Twenty-eight days later the parasitaemia recrudesced. Parasites were cultured from the blood and the isolate (NGATV01) was shown to be resistant to atovaquone and the antifolate pyrimethamine. The cytochrome b gene of isolate NGATV01 showed a single mutation, Tyr268Asn which has not been seen previously.


Journal article


Malar J

Publication Date





Amino Acid Substitution, Animals, Antimalarials, Atovaquone, Codon, Cytochromes b, Drug Combinations, Drug Resistance, Humans, London, Malaria, Falciparum, Male, Middle Aged, Mutation, Missense, Naphthoquinones, Nigeria, Parasitemia, Plasmodium falciparum, Proguanil, Protozoan Proteins, Travel