Drug-resistant Plasmodium falciparum infection in immigrants and non-immune travellers.
OBJECTIVE
To detect the incidence of drug-resistant Plasmodium falciparum malaria infection in immigrants and travellers in non-endemic Kuwait.


METHODS
Over a period of 3 years, July 1995 to September 1998, 1352 malaria patients were enrolled in the study. Of these, 1293 were immigrants from countries where malaria is endemic and 59 were non-immune travellers with a recent history of travel to these countries. The in vitro drug sensitivity was determined in 892 patients.


RESULTS
In all, 892 of 1352 (66.0%) P. falciparum isolates were successfully cultured in vitro for drug sensitivity and 419 (47.0%) isolates showed in vitro resistance to chloroquine or mefloquine. Fifty-six (13.4%) isolates were resistant to both drugs. Chloroquine resistance was observed in > 70% of the isolates from Africa and India followed by Pakistan (39.9%) and Bangladesh (35.9%). The resistance to mefloquine ranged from 26.2% in isolates from Sri Lanka to 47.5% in isolates from African countries.


CONCLUSIONS
The study highlights the important trend in drug resistance in P. falciparum malaria in immigrants from south-east Asian and African countries.
Lqbal
J
J
Department of Microbiology, Faculty of Medicine, Kuwait University, Kuwait. iqbal@hsc.kuniv.edu.kw
Sher
A
A
Hira
P R
PR
Al-Aniezi
A
A
D000328:Adult; D000349:Africa; D000818:Animals; D000962:Antimalarials / Q000494:pharmacology* / Q000627:therapeutic use; D001210:Asia, Southeastern; D002738:Chloroquine / Q000494:pharmacology / Q000627:therapeutic use; D004351:Drug Resistance; D004641:Emigration and Immigration; D005260:Female; D006801:Humans; D020128:Inhibitory Concentration 50; D007730:Kuwait / Q000453:epidemiology; D016778:Malaria, Falciparum / Q000188:drug therapy / Q000453:epidemiology* / Q000469:parasitology* / Q000517:prevention & control; D008297:Male; D015767:Mefloquine / Q000494:pharmacology / Q000627:therapeutic use; D010963:Plasmodium falciparum / Q000187:drug effects*; D014195:Travel
D000962:Antimalarials; D002738:Chloroquine; D015767:Mefloquine