[In Vivo Drug Sensitivity of Plasmodium Falciparum in the Tabou Region of Ivory Coast]
Abstract
Malaria caused by Plasmodium falciparum is one of the major health problems in West-Africa, mainly affecting young children. This situation is further complicated by the emergence and rapid progression of resistance to chloroquine, the recommended first line treatment. In order to document the level of resistance of P. falciparum to chloroquine, pyrimethamine/sulfadoxine (Fansidar) and quinine, we performed a survey in Tabou district, Côre d'Ivoire, from June to August 1995. This area has been hosting some 100,000 Liberian refugees since September 1994. Children aged 1 to 15 years old attending the dispensary with a complain of fever or suspected malaria, were included into the study, diagnosed and followed for 7 days according to the WHO Standard Field (in vivo) Tests. Overall proportion of P. falciparum resistant to chloroquine reached 45.1% and was made of 34.3% type II and 10.8% type III resistance. Being less than 5 years of age and having received a lower dose of drug were 2 factors associated with the risk of resistance to chloroquine. Levels of R II resistance to pyrimethamine/sulfadoxine and quinine (3-day treatment) were respectively 5.4% and 4.2%. No R III resistance was found in neither pyrimethaminelsulfadoxine or quinine treatment groups. These results challenge the current chloroquine-based first line malaria treatment in Côre d'Ivoire. Alternative based on pyrimethamine/sulfadoxine could be considered, especially in high risk populations during transient situation (refugees). However, elaborating new treatment policy must take into consideration cost, side-effects, compliance and acceptability. Further studies are needed to evaluate the cost-benefit of alternative strategies.PubMed ID
9264740Language
frISSN
0037-9085Collections
Related articles
- [Limits of the efficacy of chloroquine and sulfadoxine-pyrimethamine in Northern Abidjan (Cote d'Ivoire): Combined in vivo and in vitro studies].
- Authors: Djaman J, Abouanou S, Basco L, Koné M
- Issue date: 2004 Oct-Dec
- [Monitoring the chemoresistance of Plasmodium falciparum malaria in Yopougon (Abidjan): in vivo study of chloroquine sensitivity and evaluation of pyrimethamine resistance following the analysis of point mutation in the dihydrofolate reductase gene].
- Authors: Djaman AJ, Basco LK, Mazabraud A
- Issue date: 2002 Oct-Dec
- [Chemosensitivity of Plasmodium falciparum in Sainte Marie island, east coast of Madagascar: in vivo and in vitro studies].
- Authors: Raharimalala AL, Randrianarivelojosia M, Randriamanantena A, Ranarivelo LA, Jaureguiberry S, Rason MA, Rakotomalala E, Ariey F
- Issue date: 2000
- [Therapeutic efficacy of chloroquine in the uncomplicated malaria due to Plasmodium falciparum in hospital patients in central Ivory Coast (1997-2000)].
- Authors: Adou-Bryn KD, Krelo K, Akoussi CF, Boni NM, Yapo GC, Penali LK, Ouhon J, Assoumou A, Ehouman A
- Issue date: 2002 Nov
- Parasitological and clinical efficacy of standard treatment regimens against Plasmodium falciparum, P. vivax and P. malariae in Papua New Guinea.
- Authors: Genton B, Baea K, Lorry K, Ginny M, Wines B, Alpers MP
- Issue date: 2005 Sep-Dec