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Multi-drug resistant Plasmodium falciparum malaria in Assam, India: timing of recurrence and anti-malarial drug concentrations in whole blood.

Abstract
The susceptibility of 23 cases of Plasmodium falciparum malaria from the Sonapur primary health center in the Kamrup district of Assam, India to different antimalarials was investigated using the 28-day World Health Organization in vivo test. Whole blood concentrations of chloroquine, sulfadoxine, and quinine were determined at different intervals and at the time of parasites recrudescence after completion of treatment with the respective drugs to confirm the status of drug sensitivity. A case of multi-drug resistant P. falciparum malaria was found where recrudescence occurred, despite standard oral treatment with chloroquine, sulfadoxine/pyrimethamine, and quinine sequentially. Whole blood concentrations of chloroquine, sulfadoxine, and quinine at the time of recrudescence were 0.35 microg/ml (day 7), 18 microg/ml (day 14), and 0.009 microg/ml (day 14), respectively. Therefore, monitoring of drug-resistant P. falciparum malaria and its proper treatment should be intensified to check the spread of multi-drug resistant strains in other parts of the country.
AuthorsVirendra K Dua, Vas Dev, S Phookan, N C Gupta, V P Sharma, S K Subbarao
JournalThe American journal of tropical medicine and hygiene (Am J Trop Med Hyg) Vol. 69 Issue 5 Pg. 555-7 (Nov 2003) ISSN: 0002-9637 [Print] United States
PMID14695096 (Publication Type: Journal Article)
Chemical References
  • Antimalarials
  • Sulfadoxine
  • Chloroquine
  • Quinine
Topics
  • Adolescent
  • Adult
  • Animals
  • Antimalarials (administration & dosage, blood)
  • Child
  • Chloroquine (administration & dosage, blood)
  • Drug Resistance, Multiple
  • Female
  • Humans
  • India (epidemiology)
  • Malaria, Falciparum (blood, drug therapy, epidemiology, pathology)
  • Male
  • Plasmodium falciparum (drug effects, pathogenicity)
  • Quinine (administration & dosage, blood)
  • Recurrence
  • Sulfadoxine (administration & dosage, blood)
  • Time Factors

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