Therapeutic efficacy of chloroquine in Plasmodium vivax from areas with different epidemiological patterns in India and their Pvdhfr gene mutation pattern.
Among the four human malaria parasites, drug resistance occurs mainly in Plasmodium falciparum. However, there are some reports of chloroquine (CQ) resistance in P. vivax from different geographical regions. In India, approximately 50% of a total of 2 million cases of malaria reported annually are due to P. vivax. CQ is the drug of choice for treatment. Since few cases of treatment failure have been reported from India, this study was undertaken to generate data systematically on the efficacy of CQ in 287 patients from different epidemiological regions. Cure rates for 28 days were 100% and there was a rapid parasite clearance rate in all age groups from all study sites. Although P. vivax has been reported to be inherently resistant to sulfonamide and pyrimethamine, Indian isolates exhibited only double mutations in dhfr in vitro.
Valecha
Neena
N
Malaria Research Centre (ICMR), 22-Sham Nath Marg, Delhi 110 054, India. walicha@vsnl.com
Joshi
Hema
H
Eapen
Alex
A
Ravinderan
John
J
Kumar
Ashwani
A
Prajapati
Surendra Kumar
SK
Ringwald
Pascal
P
D000293:Adolescent; D000328:Adult; D000818:Animals; D000962:Antimalarials / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D002738:Chloroquine / Q000627:therapeutic use*; D004338:Drug Combinations; D005260:Female; D017125:Genes, Protozoan / Q000235:genetics; D005838:Genotype; D006801:Humans; D007194:India / Q000453:epidemiology; D016780:Malaria, Vivax / Q000188:drug therapy* / Q000453:epidemiology / Q000235:genetics; D008297:Male; D009154:Mutation; D010966:Plasmodium vivax / Q000235:genetics; D011446:Prospective Studies; D011739:Pyrimethamine / Q000627:therapeutic use; D013413:Sulfadoxine / Q000627:therapeutic use; D013762:Tetrahydrofolate Dehydrogenase / Q000235:genetics*; D016896:Treatment Outcome
D000962:Antimalarials; D004338:Drug Combinations; C001205:fanasil, pyrimethamine drug combination; D013413:Sulfadoxine; D002738:Chloroquine; D013762:Tetrahydrofolate Dehydrogenase; D011739:Pyrimethamine