Residual antimalarial concentrations before treatment in patients with malaria from Cambodia: indication of drug pressure.

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Serval ID
serval:BIB_C78C1D7C098E
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Residual antimalarial concentrations before treatment in patients with malaria from Cambodia: indication of drug pressure.
Journal
Journal of Infectious Diseases
Author(s)
Hodel Eva Maria, Genton Blaise, Zanolari Boris, Mercier Thomas, Duong Socheat, Beck Hans-Peter, Olliaro Piero, Decosterd Laurent A., Ariey Frederic
ISSN
1537-6613[electronic], 0022-1899[linking]
Publication state
Published
Issued date
2010
Volume
202
Number
7
Pages
1088-1094
Language
english
Abstract
BACKGROUND: The Thai-Cambodian border has been known as the origin of antimalarial drug resistance for the past 30 years. There is a highly diverse market for antimalarials in this area, and improved knowledge of drug pressure would be useful to target interventions aimed at reducing inappropriate drug use.
METHODS: Baseline samples from 125 patients with falciparum malaria recruited for 2 in vivo studies (in Preah Vihear and Pursat provinces) were analyzed for the presence of 14 antimalarials in a single run, by means of a liquid chromatography-tandem mass spectrometry assay.
RESULTS: Half of the patients had residual drug concentrations above the lower limit of calibration for at least 1 antimalarial at admission. Among the drugs detected were the currently used first-line drugs mefloquine (25% and 35% of patients) and piperaquine (15% of patients); the first-line drug against vivax malaria, chloroquine (25% and 41% of patients); and the former first-line drug, quinine (5% and 34% patients).
CONCLUSIONS: The findings demonstrate that there is high drug pressure and that many people still seek treatment in the private and informal sector, where appropriate treatment is not guaranteed. Promotion of comprehensive behavioral change, communication, community-based mobilization, and advocacy are vital to contain the emergence and spread of parasite resistance against new antimalarials.
Keywords
Adolescent, Adult, Antimalarials/blood, Cambodia, Child, Child, Preschool, Chloroquine/blood, Chromatography, Liquid, Drug Resistance, Female, Humans, Malaria, Falciparum/diagnosis, Male, Mefloquine/blood, Middle Aged, Quinine/blood, Quinolines/blood, Selection, Genetic, Serum/chemistry, Tandem Mass Spectrometry, Young Adult
Pubmed
Web of science
Open Access
Yes
Create date
20/10/2010 16:47
Last modification date
25/09/2019 7:10
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