In vivo sensitivity of Plasmodium falciparum to chloroquine in rural areas of Côte d'Ivoire.
In vivo testing of Plasmodium falciparum sensitivity to chloroquine was carried out in four rural sites of differing socio-geographical environment in Côte d'Ivoire. Of a total of 1282 patients of all ages with fever or previous history of fever, 649 were slide positive, with 435 patients with a pure P. falciparum infection; 191 fulfilled all the criteria for inclusion in this study, and 113 completed it. Treatment failure rates ranged from 9.7% (Djébonoua) to 38.1% (Tiéviéssou), and were most often associated with higher degrees of resistance (RII = 54.2%; RIII = 37.5%). Blood chloroquine levels measured by ELISA test suggest that many people take chloroquine routinely; furthermore 37.5% of resistance cases occurred in subjects who had high blood chloroquine concentrations on day 0. Twenty-three out of 24 cases of resistance were found in children under 7 years of age. Nearly all children with persisting parasitaemia were afebrile on day 7, even those (7/8) with RIII resistance. Children aged < 7 years represent the the best sentinel group for monitoring P. falciparum sensitivity to chloroquine in Côte d'Ivoire.
Henry
M C
MC
Department of Epidemiology and Public Health, Wageningen Agricultural University (WAU), The Netherlands.
Docters van Leeuwen
W
W
Watson
P
P
Jansen
A
A
Jacobs
K
K
Zwart
F
F
Agricola
K
K
Nahounou
N
N
Dossou
J
J
Eggelte
T E
TE
D000293:Adolescent; D000818:Animals; D002648:Child; D002675:Child, Preschool; D002738:Chloroquine / Q000627:therapeutic use*; D007560:Cote d'Ivoire / Q000453:epidemiology; D004351:Drug Resistance; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D016778:Malaria, Falciparum / Q000097:blood / Q000188:drug therapy* / Q000469:parasitology; D010963:Plasmodium falciparum / Q000187:drug effects*; D012424:Rural Population
D002738:Chloroquine