Plasmodium vivax resistance to chloroquine in Dawei, southern Myanmar.

Hdl Handle:
http://hdl.handle.net/10144/26152
Title:
Plasmodium vivax resistance to chloroquine in Dawei, southern Myanmar.
Authors:
Guthmann, J P; Pittet, A; Lesage, A; Imwong, M; Lindegardh, N; Min Lwin, M; Zaw, T; Annerberg, A; de Radiguès, X; Nosten, F
Journal:
Tropical Medicine & International Health
Abstract:
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.
Affiliation:
Epicentre, Paris, France.
Publisher:
Wiley-Blackwell
Issue Date:
Jan-2008
URI:
http://hdl.handle.net/10144/26152
DOI:
10.1111/j.1365-3156.2007.01978.x
PubMed ID:
18291007
Language:
en
ISSN:
1365-3156
Appears in Collections:
Malaria

Full metadata record

DC FieldValue Language
dc.contributor.authorGuthmann, J P-
dc.contributor.authorPittet, A-
dc.contributor.authorLesage, A-
dc.contributor.authorImwong, M-
dc.contributor.authorLindegardh, N-
dc.contributor.authorMin Lwin, M-
dc.contributor.authorZaw, T-
dc.contributor.authorAnnerberg, A-
dc.contributor.authorde Radiguès, X-
dc.contributor.authorNosten, F-
dc.date.accessioned2008-05-15T09:21:59Z-
dc.date.available2008-05-15T09:21:59Z-
dc.date.issued2008-01-
dc.identifier.citationPlasmodium vivax resistance to chloroquine in Dawei, southern Myanmar. 2008, 13 (1):91-8 Trop. Med. Int. Healthen
dc.identifier.issn1365-3156-
dc.identifier.pmid18291007-
dc.identifier.doi10.1111/j.1365-3156.2007.01978.x-
dc.identifier.urihttp://hdl.handle.net/10144/26152-
dc.description.abstractOBJECTIVE: 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.en
dc.language.isoenen
dc.publisherWiley-Blackwellen
dc.rightsArchived on this site with the kind permission of Wiley-Blackwell, [url]http://www.blackwell-synergy.com/loi/tmi[/url]en
dc.subject.meshAdolescenten
dc.subject.meshAnimalsen
dc.subject.meshAntimalarialsen
dc.subject.meshChilden
dc.subject.meshChild, Preschoolen
dc.subject.meshChloroquineen
dc.subject.meshDrug Resistanceen
dc.subject.meshFemaleen
dc.subject.meshGenotypeen
dc.subject.meshHumansen
dc.subject.meshMalaria, Vivaxen
dc.subject.meshMaleen
dc.subject.meshMyanmaren
dc.subject.meshParasitemiaen
dc.subject.meshPlasmodium vivaxen
dc.subject.meshRecurrenceen
dc.subject.meshTreatment Failureen
dc.titlePlasmodium vivax resistance to chloroquine in Dawei, southern Myanmar.en
dc.contributor.departmentEpicentre, Paris, France.en
dc.identifier.journalTropical Medicine & International Healthen

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