Plasmodium vivax resistance to chloroquine in Dawei, southern Myanmar
OBJECTIVE: To assess the efficacy of chloroquine in the treatment of Plasmodium vivax malaria in in Dawei District, southern Myanmar.
METHODS: Enrolled patients at Sonsinphya clinic >6 months of age were assessed clinically and parasitologically every week for 28 days. To differentiate new infections from recrudescence, we genotyped pre- and post-treatment parasitaemia. Blood chloroquine was measured to confirm resistant strains.
RESULTS: Between December 2002 and April 2003, 2661 patients were screened, of whom 252 were included and 235 analysed. Thirty-four per cent (95% CI: 28.1-40.6) of patients had recurrent parasitaemia and were considered treatment failures. 59.4% of these recurrences were with a different parasite strain. Two (0.8%) patients with recurrences on day 14 had chloroquine concentrations above the threshold of 100 ng/ml and were considered infected with chloroquine resistant parasites. 21% of failures occurred during the first 3 weeks of follow-up: early recurrence and median levels of blood chloroquine comparable to those of controls suggested P. vivax resistance.
CONCLUSIONS: Plasmodium vivax resistance to chloroquine seems to be emerging in Dawei, near the Thai-Burmese border. While chloroquine remains the first-line drug for P. vivax infections in this area of Myanmar, regular monitoring is needed to detect further development of parasite resistance.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2008 |
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| Erschienen: |
2008 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:13 |
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| Enthalten in: |
Tropical medicine & international health : TM & IH - 13(2008), 1 vom: 15. Jan., Seite 91-8 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Guthmann, Jean-Paul [VerfasserIn] |
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| Links: |
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| Themen: |
886U3H6UFF |
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| Anmerkungen: |
Date Completed 11.03.2008 Date Revised 21.11.2013 published: Print Citation Status MEDLINE |
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| doi: |
10.1111/j.1365-3156.2007.01978.x |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM177773162 |
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| 024 | 7 | |a 10.1111/j.1365-3156.2007.01978.x |2 doi | |
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| 100 | 1 | |a Guthmann, Jean-Paul |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Plasmodium vivax resistance to chloroquine in Dawei, southern Myanmar |
| 264 | 1 | |c 2008 | |
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| 500 | |a Date Completed 11.03.2008 | ||
| 500 | |a Date Revised 21.11.2013 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a OBJECTIVE: To assess the efficacy of chloroquine in the treatment of Plasmodium vivax malaria in in Dawei District, southern Myanmar | ||
| 520 | |a METHODS: Enrolled patients at Sonsinphya clinic >6 months of age were assessed clinically and parasitologically every week for 28 days. To differentiate new infections from recrudescence, we genotyped pre- and post-treatment parasitaemia. Blood chloroquine was measured to confirm resistant strains | ||
| 520 | |a RESULTS: Between December 2002 and April 2003, 2661 patients were screened, of whom 252 were included and 235 analysed. Thirty-four per cent (95% CI: 28.1-40.6) of patients had recurrent parasitaemia and were considered treatment failures. 59.4% of these recurrences were with a different parasite strain. Two (0.8%) patients with recurrences on day 14 had chloroquine concentrations above the threshold of 100 ng/ml and were considered infected with chloroquine resistant parasites. 21% of failures occurred during the first 3 weeks of follow-up: early recurrence and median levels of blood chloroquine comparable to those of controls suggested P. vivax resistance | ||
| 520 | |a CONCLUSIONS: Plasmodium vivax resistance to chloroquine seems to be emerging in Dawei, near the Thai-Burmese border. While chloroquine remains the first-line drug for P. vivax infections in this area of Myanmar, regular monitoring is needed to detect further development of parasite resistance | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 7 | |a Antimalarials |2 NLM | |
| 650 | 7 | |a Chloroquine |2 NLM | |
| 650 | 7 | |a 886U3H6UFF |2 NLM | |
| 700 | 1 | |a Pittet, Anne |e verfasserin |4 aut | |
| 700 | 1 | |a Lesage, Alexandre |e verfasserin |4 aut | |
| 700 | 1 | |a Imwong, Mallika |e verfasserin |4 aut | |
| 700 | 1 | |a Lindegardh, Niklas |e verfasserin |4 aut | |
| 700 | 1 | |a Min Lwin, Myo |e verfasserin |4 aut | |
| 700 | 1 | |a Zaw, Than |e verfasserin |4 aut | |
| 700 | 1 | |a Annerberg, Anna |e verfasserin |4 aut | |
| 700 | 1 | |a de Radiguès, Xavier |e verfasserin |4 aut | |
| 700 | 1 | |a Nosten, François |e verfasserin |4 aut | |
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