Chloroquine-resistant Plasmodium malariae in south Sumatra, Indonesia.
Oral chloroquine is the treatment of choice for uncomplicated Plasmodium malariae infections worldwide. We did a prospective 28-day in-vivo assessment of the efficacy of chloroquine for treatment of P malariae on Legundi Island in Lampung Bay, Sumatra, Indonesia. Of 28 patients, one had recurrent parasitaemia on day 28, and two had persistent parasitaemia to day 8. Whole-blood chloroquine and desethylchloroquine concentrations were at ordinarily effective levels (> or = 100 microg/L) on day 8 in both cases of persistent parasitaemia. These findings suggest that clinical resistance to chloroquine by P malariae occurs in the Indonesian archipelago of southeast Asia.
Maguire
Jason D
JD
United States Naval Medical Research Unit #2, Jakarta, Indonesia. maguirejd@namru2.med.navy.mil
Sumawinata
Iwa W
IW
Masbar
Sofyan
S
Laksana
Budhi
B
Prodjodipuro
Purnomo
P
Susanti
Ika
I
Sismadi
Priyanto
P
Mahmud
Nurlis
N
Bangs
Michael J
MJ
Baird
J Kevin
JK
D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D000962:Antimalarials / Q000097:blood / Q000627:therapeutic use*; D002648:Child; D002738:Chloroquine / Q000097:blood / Q000627:therapeutic use*; D004351:Drug Resistance; D005260:Female; D006801:Humans; D007214:Indonesia / Q000453:epidemiology; D016778:Malaria, Falciparum / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology; D016780:Malaria, Vivax / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010963:Plasmodium falciparum / Q000302:isolation & purification*; D010966:Plasmodium vivax / Q000302:isolation & purification*; D016133:Polymerase Chain Reaction; D015995:Prevalence; D011446:Prospective Studies
D000962:Antimalarials; D002738:Chloroquine