title: Antimalarial drug resistance in Bangladesh, 1996-2012.
abstract: Malaria remains an important health problem in Bangladesh, with approximately 14 million people at risk. Antimalarial drug resistance is a major obstacle to the control of malaria in endemic countries. In 2012, Bangladesh reported an estimated 29 522 malaria episodes, of which 94% were reported as being caused by Plasmodium falciparum. In this study, we reviewed and summarized antimalarial drug resistance data from Bangladesh published until June 2013. We searched published sources for data referring to any type of P. falciparum drug resistance (in vivo, in vitro, or molecular) and found 169 articles published in peer-reviewed journals. Of these, 143 articles were excluded because they did not meet our inclusion criteria. After detailed review of the remaining 26 articles, 14 were selected for evaluation. Published studies indicate that P. falciparum shows varying levels of resistance to chloroquine, mefloquine and sulfadoxine-pyrimethamine. Combination therapy of chloroquine and primaquine has proven ineffective and combinations of sulfadoxine-pyrimethamine with either quinine or chloroquine have also shown poor efficacy. Recent studies indicate that artemisinin derivatives, such as artesunate, remain highly efficacious in treating P. falciparum malaria. Available data suggest that artemisinins, quinine, doxycyline, mefloquine-artesunate and azithromycin-artesunate combination therapy remain efficacious in the treatment of P. falciparum malaria in Bangladesh.
authors.affiliation: W. Harry Feinstone Department of Molecular Microbiology & Immunology.
authors.forename: Ubydul
authors.initials: U
authors.lastname: Haque
authors.forename: Gregory E
authors.initials: GE
authors.lastname: Glass
authors.forename: Waziul
authors.initials: W
authors.lastname: Haque
authors.forename: Nazrul
authors.initials: N
authors.lastname: Islam
authors.forename: Shyamal
authors.initials: S
authors.lastname: Roy
authors.forename: Jahirul
authors.initials: J
authors.lastname: Karim
authors.forename: Harald
authors.initials: H
authors.lastname: Noedl
mesh_terms: D000962:Antimalarials / Q000009:adverse effects* / Q000627:therapeutic use; D001459:Bangladesh / Q000453:epidemiology; D004351:Drug Resistance; D006801:Humans; D016778:Malaria, Falciparum / Q000188:drug therapy* / Q000469:parasitology; D010963:Plasmodium falciparum / Q000187:drug effects*; D016896:Treatment Outcome
chemical_list: D000962:Antimalarials
keywords: Bangladesh; Drug; Malaria; Resistance