[Cross resistance to mefloquine and halofantrine in a case of P. falciparum malaria contracted in Sierra Leone].
Malaria caused by P. falciparum occurred during prophylaxis with mefloquine upon return from Sierra Leone (zone II). A typical and not recognized, with negative results of initial hematological examinations. Diagnosed on D.26 with parasitemia of 0.2%. Successful treatment of clinical symptoms with halofantrine but increased anemia and positive parasitemia at D.7. Successful treatment with chloroquine. Chemosensitivity tests confirmed sensitivity to chloroquine, threshold sensitivity to quinine (IC50 = 297), resistance to mefloquine (IC50 = 76) despite high levels in bloods, and to halofantrine (IC50 = 7-laboratory normal value = 1). This cross-resistance of P. falciparum originating from Sierra Leone to mefloquine-halofantrine seems to be the first observation of this danger in Africa. Prescription of chloroquine is still imperative in zone 11 countries.
CHU Pitié-Salpêtrière, Service des Maladies parasitaires et tropicales, Paris.
R
R
Félix
F
F
Gay
A
A
Lyogoubi
M D
MD
Bustos
B
B
Diquet
M
M
Danis
M
M
Gentilini
D000328:Adult; D000818:Animals; D000962:Antimalarials / Q000627:therapeutic use*; D002738:Chloroquine / Q000627:therapeutic use; D003429:Cross Reactions; D004351:Drug Resistance; D006801:Humans; D008288:Malaria / Q000188:drug therapy / Q000469:parasitology*; D008297:Male; D015767:Mefloquine / Q000494:pharmacology / Q000627:therapeutic use*; D010616:Phenanthrenes / Q000494:pharmacology / Q000627:therapeutic use; D010963:Plasmodium falciparum / Q000187:drug effects*
D000962:Antimalarials; D010616:Phenanthrenes; D002738:Chloroquine; C023768:halofantrine; D015767:Mefloquine
Résistance croisée à la méfloquine et à l'halofantrine lors d'un paludisme à P. falciparum contracté en Sierra Leone.