Chloroquine- and sulfadoxine-pyrimethamine-resistant Falciparum malaria in vivo - a pilot study in rural Zambia.
BACKGROUND
Chloroquine (CQ) and Sulfadoxine-Pyrimethamine (SP) are the predominantly used antimalarials in Zambia and other parts of East Africa, but increasing resistance of P. falciparum is a major concern.


METHODS
Seventy consecutive patients with uncomplicated falciparum malaria were enrolled. In 43 patients, no prior CQ use could be demonstrated by history and urianalysis (qualitative test, Dill & Glazko) and these patients were given CQ; the other 27 had taken CQ before and received SP.


RESULTS
Combined R-II and R-III CQ-resistance was 58% (60% in under-fives), which is the range previously reported from Zambia. By contrast, SP-resistance (R-II and R-III) was much higher (26%) than previously reported (3% - 17%). The history of prior CQ intake correlated well with the results of the Dill-Glazko test; there was no evidence for prior SP intake to explain these results.


CONCLUSIONS
If our findings of SP resistance are confirmed, other drugs such as quinine, atovaquone/proguanil and artemisinin are required to treat malaria in Zambia.
Bijl
H M
HM
Kaoma District Hospital, Kaoma, Zambia.
Kager
J
J
Koetsier
D W
DW
van der Werf
T S
TS
D000818:Animals; D000962:Antimalarials / Q000494:pharmacology* / Q000627:therapeutic use; D002675:Child, Preschool; D002738:Chloroquine / Q000494:pharmacology* / Q000627:therapeutic use; D004338:Drug Combinations; D004351:Drug Resistance; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D016778:Malaria, Falciparum / Q000188:drug therapy*; D008297:Male; D010865:Pilot Projects; D010963:Plasmodium falciparum / Q000187:drug effects* / Q000254:growth & development; D011739:Pyrimethamine / Q000494:pharmacology* / Q000627:therapeutic use; D012423:Rural Health; D013413:Sulfadoxine / Q000494:pharmacology* / Q000627:therapeutic use; D015024:Zambia
D000962:Antimalarials; D004338:Drug Combinations; C001205:fanasil, pyrimethamine drug combination; D013413:Sulfadoxine; D002738:Chloroquine; D011739:Pyrimethamine