Document Detail


Sensitivity of Plasmodium falciparum in vivo to chloroquine and pyrimethamine-sulfadoxine in Rwandan patients in a refugee camp in Zaire.
MedLine Citation:
PMID:  8594686     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Resistance of Plasmodium falciparum to available antimalarial drugs is now thought to be spreading progressively throughout sub-Sahara Africa. In this study we measured the susceptibility of P. falciparum to chloroquine and pyrimethamine-sulfadoxine in vivo in Rwandan patients living in Kibumba refugee camp in Goma, Zaire. Of the 39 cases treated with chloroquine, only 8 (20.5%) showed sensitive or RI (delayed) response and 31 (79.5%) demonstrated resistance at RI (30.8%), RII (33.3%( and RIII (15.4%) levels. Of the 38 individuals receiving pyrimethamine-sulfadoxine, 13 (34.2%) showed sensitive or RI (delayed) responses, and 25 (65.%) showed resistance at RI (26.3%), RII (36.8%) and RIII (2.6%) levels. Both chloroquine and pyrimethamine-sulfadoxine reduced parasite counts by at least 75% in the majority of the patients within 2 d of treatment. A greater proportion of children with malnutrition showed a higher mean geometric parasite density and slower parasite clearance in vivo than those without malnutrition. Moreover, the frequency and degree of resistance were more pronounced in children with malnutrition. Moreover, the frequency and degree of resistance were more pronounced in children with malnutrition. The results suggest the existence of resistance to chloroquine and pyrimethamine-sulfadoxine. However, the drugs are still effective in significantly reducing parasitaemia and they can still be used as drugs of first and second choice in the region, even in the face of some degree of resistance.
Authors:
D Wolday; T Kibreab; D Bukenya; R Hodes
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Transactions of the Royal Society of Tropical Medicine and Hygiene     Volume:  89     ISSN:  0035-9203     ISO Abbreviation:  Trans. R. Soc. Trop. Med. Hyg.     Publication Date:    1995 Nov-Dec
Date Detail:
Created Date:  1996-04-08     Completed Date:  1996-04-08     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7506129     Medline TA:  Trans R Soc Trop Med Hyg     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  654-6     Citation Subset:  IM    
Affiliation:
American Joint Distribution Committee, Goma, Zaire.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Animals
Antimalarials / therapeutic use*
Child
Child, Preschool
Chloroquine / therapeutic use
Democratic Republic of the Congo / epidemiology
Drug Combinations
Drug Resistance
Female
Humans
Infant
Malaria, Falciparum / drug therapy*,  epidemiology,  ethnology
Male
Middle Aged
Nutritional Status
Plasmodium falciparum / drug effects*
Pyrimethamine / therapeutic use
Refugees*
Rwanda / ethnology
Sulfadoxine / therapeutic use
Chemical
Reg. No./Substance:
0/Antimalarials; 0/Drug Combinations; 2447-57-6/Sulfadoxine; 54-05-7/Chloroquine; 58-14-0/Pyrimethamine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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