Plasmodium falciparum: increased proportion of severe resistance (RII and RIII) to chloroquine and high rate of resistance to sulfadoxine-pyrimethamine in Peninsular Malaysia after two decades.
Uncomplicated falciparum malaria patients were randomly assigned to receive either 25 mg/kg chloroquine (CHL) over 3 d or a statim dose of 25 mg/kg sulfadoxine (SDX) plus 1.25 mg/kg pyrimethamine (PYR). Patients were followed up for 28 d and the parasite response graded according to World Health Organization criteria. Overall resistance to CHL was 63.3% and 47.4% to SDX/PYR. RI, RII and RIII rates were 9.1%, 42.4% and 12.1% for CHL and 10.5%, 21.1% and 15.8% for SDX/PYR, respectively. Degree and rates of resistance to CHL were significantly correlated with pre-treatment parasite density, but not those to SDX/PYR. Plasma CHL and SDX/PYR levels were within the reported ranges and were not significantly different in patients with sensitive and resistant responses.
Lokman Hakim
S
S
Institute for Medical Research, Jalan Pahang, Kuala Lumpur, Malaysia.
Sharifah Roohi
S W
SW
Zurkurnai
Y
Y
Noor Rain
A
A
Mansor
S M
SM
Palmer
K
K
Navaratnam
V
V
Mak
J W
JW
D000293:Adolescent; D000328:Adult; D000962:Antimalarials / Q000097:blood / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D002738:Chloroquine / Q000097:blood / Q000627:therapeutic use*; D004338:Drug Combinations; D018432:Drug Resistance, Multiple; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016778:Malaria, Falciparum / Q000097:blood / Q000188:drug therapy*; D008296:Malaysia; D008297:Male; D008875:Middle Aged; D018512:Parasitemia / Q000188:drug therapy; D011446:Prospective Studies; D011739:Pyrimethamine / Q000097:blood / Q000627:therapeutic use*; D013413:Sulfadoxine / Q000097:blood / Q000627:therapeutic use*
D000962:Antimalarials; D004338:Drug Combinations; C001205:fanasil, pyrimethamine drug combination; D013413:Sulfadoxine; D002738:Chloroquine; D011739:Pyrimethamine