In vivo drug resistance of falciparum malaria in mining areas of Venezuela.
The Lot Quality Assurance Double-Sampling Plan (LQADSP) technique was used in three areas, Maripa, Kilómetro 88 and Ikabaru, to assess the efficacy of antimalarials used routinely by the Venezuelan Malaria Programme. The use of chloroquine (25 mg/kg), chloroquine (40 mg/kg) and the combination of sulfadoxine (500 mg) and pyrimethamine (25 mg) registered treatment failures above the threshold level of 25% in Maripa and Kilómertro 88. In Ikabaru the use of chloroquine (40 mg/kg) did not surpass that quality level and could possibly be less than 10%. Quinine (30 mg/kg) was totally effective in curing patients in all three areas. The use of this technique seems adequate for rapid field evaluations and in this case for providing appropriate information to assist this health programme. However, whilst being an ideal technique for surveying areas in which considerable variation may exist among lots and particularly for Plasmodium falciparum infections in these areas, repeated surveys should be carried out in the same areas over time to monitor changes in the susceptibility of this parasite to first-, second- and third-line drugs. In that way, national drug policies can be modified adequately.
Aché
A
A
División de Epidemiología, Malariología y Saneamiento Ambiental del Estado Bolívar, Región III, Venezuela.
Escorihuela
M
M
Vivas
E
E
Páez
E
E
Miranda
L
L
Matos
A
A
Pérez
W
W
Díaz
O
O
Izarra
E
E
D000328:Adult; D000818:Animals; D000962:Antimalarials / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D002738:Chloroquine / Q000008:administration & dosage / Q000627:therapeutic use; D004338:Drug Combinations; D004351:Drug Resistance; D005260:Female; D006293:Health Promotion; D006801:Humans; D016778:Malaria, Falciparum / Q000097:blood / Q000453:epidemiology* / Q000517:prevention & control*; D008297:Male; D008906:Mining; D010963:Plasmodium falciparum / Q000187:drug effects / Q000302:isolation & purification; D011739:Pyrimethamine / Q000008:administration & dosage / Q000627:therapeutic use; D011803:Quinine / Q000008:administration & dosage / Q000627:therapeutic use; D013413:Sulfadoxine / Q000008:administration & dosage / Q000627:therapeutic use; D017211:Treatment Failure; D016896:Treatment Outcome; D014687:Venezuela / Q000453:epidemiology
D000962:Antimalarials; D004338:Drug Combinations; C001205:fanasil, pyrimethamine drug combination; D013413:Sulfadoxine; D002738:Chloroquine; D011803:Quinine; D011739:Pyrimethamine