• Mariusz Wojnarski, Oussama Mouri, Charlotte Chambrion, Camille Roussel, Nathalie Chartrel, Bryan Smith, Philip Smith, Marc Thellier, Pierre Buffet, and Papa Alioune Ndour.
• Walter Reed Army Institute of Research, Silver Spring, Maryland.
• J. Infect. Dis. 2019 Jul 2; 220 (3): 535-539.

AbstractPitting, the removal of dead parasites from their host erythrocyte, has been studied in patients with severe malaria treated parenterally with quinine or artesunate, and was recently shown to contribute to delayed hemolysis, a frequent adverse event of artesunate. We quantified pitting in 81 travelers treated with oral antimalarial therapy. Pitting rate was high (55.8%) with artemisinin-based combinations, but <10% with the nonartemisinin drugs quinine, mefloquine, and atovaquone-proguanil. This may, in part, explain the slower parasite clearance in patients treated with antimalarial drugs lacking an artemisinin component, as well as the absence of posttreatment hemolysis with these drugs.© The Author(s) 2019. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

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