In vivo study of the response of Plasmodium falciparum to standard mefloquine/sulfadoxine/pyrimethamine (MSP) treatment among gem miners returning from Cambodia.
An in vivo study of the response of P. falciparum to the combination drug, MSP, was conducted among gem miners who contracted malaria from Cambodia in 1991-1992. High level resistance (RII, RIII responses) was observed in 22.5% of the 40 cases attending Mae Sot malaria clinic, west Thailand border, and in 28.1% of the 96 cases attending Bo Rai malaria clinic, east Thailand border. The observations on in vitro studies conducted prior to the MSP treatment and after recrudescence, together with the findings on adequate mefloquine blood levels strongly indicated the serious deterioration of mefloquine efficacy. The first line treatment for the malaria control program needs to be revised and the use of qinghaosu derivatives considered. Intensive measures to combat spreading of the highly resistant strains to other parts of the country should be taken into account.
Thimasarn
K
K
Department of Communicable Diseases Control, Ministry of Public Health, Bangkok, Thailand.
Sirichaisinthop
J
J
Vijaykadga
S
S
Tansophalaks
S
S
Yamokgul
P
P
Laomiphol
A
A
Palananth
C
C
Thamewat
U
U
Tháithong
S
S
Rooney
W
W
D000328:Adult; D000818:Animals; D000962:Antimalarials / Q000494:pharmacology / Q000627:therapeutic use*; D002160:Cambodia; D016009:Chi-Square Distribution; D004338:Drug Combinations; D004351:Drug Resistance; D005260:Female; D006801:Humans; D016778:Malaria, Falciparum / Q000097:blood / Q000188:drug therapy*; D008297:Male; D015767:Mefloquine / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use; D008906:Mining; D010963:Plasmodium falciparum / Q000187:drug effects; D011739:Pyrimethamine / Q000494:pharmacology / Q000627:therapeutic use*; D013413:Sulfadoxine / Q000494:pharmacology / Q000627:therapeutic use*; D013785:Thailand; D014171:Transients and Migrants; D000096926:Benzenesulfonamides
D000962:Antimalarials; D004338:Drug Combinations; D015767:Mefloquine; D011739:Pyrimethamine; D013413:Sulfadoxine; C046846:mefloquine-sulfadoxine-pyrimethamine; D000096926:Benzenesulfonamides