Resistance of Plasmodium falciparum malaria to amodiaquine, chloroquine and quinine in the Madang Province of Papua New Guinea, 1990-1993
Détails
ID Serval
serval:BIB_24A0C9EB4E2C
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Resistance of Plasmodium falciparum malaria to amodiaquine, chloroquine and quinine in the Madang Province of Papua New Guinea, 1990-1993
Périodique
Papua New Guinea Medical Journal
ISSN
0031-1480 (Print)
Statut éditorial
Publié
Date de publication
03/1996
Volume
39
Numéro
1
Pages
16-22
Notes
Journal Article --- Old month value: Mar
Résumé
The in vivo response of Plasmodium falciparum parasites to amodiaquine or chloroquine was assessed in children with symptomatic malaria attending different health facilities in the Madang area. Among the 27 subjects who were completely followed up, 4 (15%) were infected with parasites fully susceptible and 23 (85%) with parasites exhibiting some degree of resistance. Out of the latter group, 52% were of RI level, 26% RII and 22% RIII. 14 subjects out of 42 (33%) failed to clear their parasitaemia by day 7 and 92 out of 134 (69%) had persistent or recrudescent parasitaemia at day 21. The level of in vivo resistance was similar for amodiaquine and chloroquine. 86% of the isolates tested in vitro showed resistance to amodiaquine, 86% to chloroquine and 7% to quinine. In ten years the prevalence of resistant isolates in vivo has increased from 47% to 85%. Of more concern is the shift from RI level of resistance to RII and RIII: the proportion of resistant strains that were RI dropped from 90% to 52% over the ten-year period. To determine if the standard antimalarial regimens are still appropriate, there is a need not only to assess the level of parasite resistance but also the prevalence of treatment failure in different parts of Papua New Guinea.
Mots-clé
Acute Disease
Amodiaquine/*therapeutic use
Animals
Antimalarials/*therapeutic use
Case-Control Studies
Child
Child, Preschool
Chloroquine/*therapeutic use
Drug Resistance
Female
Follow-Up Studies
Humans
Infant
Malaria, Cerebral/drug therapy
Malaria, Falciparum/*drug therapy
Male
Papua New Guinea
Parasitemia/drug therapy
Plasmodium falciparum/*drug effects
Prevalence
Quinine/*therapeutic use
Recurrence
Treatment Failure
amodiaquine and chloroquine was assessed in children 1-9 years of age with
symptomatic malaria recruited from health centers in Papua New Guinea's
Madang area. Among the 27 children who were completely followed up, 4
(15%) were infected with fully susceptible parasites, in the remaining 23
cases (85%), there was some degree of resistance. 52% of parasites in the
latter group were RI level, 26% RII, and 22% RIII. There was no
correlation between level of resistance and age. 14 out of 42 children
(33%) failed to clear their parasitemia by day 7 and 92 out of 134 (69%)
had persistent or recrudescent parasitemia at day 21. Both amodiaquine
and chloroquine had similar levels of in vivo resistance. 86% of isolates
tested in vitro showed resistance to amodiaquine, 86% to chloroquine, and
7% to quinine. In 10 years, the prevalence of resistant isolates in vivo
has increased from 47% to 85%. Of particular concern is the finding that
the proportion of resistant strains that were RI dropped from 90% to 52%
over this decade. The increase of resistance is attributed to
indiscriminate use of 4-aminoquinolines in all cases of fever. Needed, to
assess whether standard antimalarial regimens are still appropriate, is a
review of treatment failure in different parts of Papua New Guinea.
Pubmed
Création de la notice
28/01/2008 12:49
Dernière modification de la notice
20/08/2019 14:02